Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, Federal University of São Paulo, São Paulo, SP, Brazil.
Brain Behav Immun. 2018 Oct;73:115-124. doi: 10.1016/j.bbi.2018.07.006. Epub 2018 Jul 18.
During the past decade, there has been renewed interest in the relationship between brain-based disorders, the gut microbiota, and the possible beneficial effects of probiotics. Emerging evidence suggests that modifying the composition of the gut microbiota via probiotic supplementation may be a viable adjuvant treatment option for individuals with major depressive disorder (MDD). Convergent evidence indicates that persistent low-grade inflammatory activation is associated with the diagnosis of MDD as well as the severity of depressive symptoms and probability of treatment response. The objectives of this review are to (1) evaluate the evidence supporting an anti-inflammatory effect of probiotics and (2) describe immune system modulation as a potential mechanism for the therapeutic effects of probiotics in populations with MDD. A narrative review of studies investigating the effects of probiotics on systemic inflammation was conducted. Studies were identified using PubMed/Medline, Google Scholar, and clinicaltrials.gov (from inception to November 2017) using the following search terms (and/or variants): probiotic, inflammation, gut microbiota, and depression. The available evidence suggests that probiotics should be considered a promising adjuvant treatment to reduce the inflammatory activation commonly found in MDD. Several controversial points remain to be addressed including the role of leaky gut, the role of stress exposure, and the role of blood-brain-barrier permeability. Taken together, the results of this review suggest that probiotics may be a potentially beneficial, but insufficiently studied, antidepressant treatment intervention.
在过去的十年中，人们对基于大脑的疾病、肠道微生物群以及益生菌可能产生的有益影响之间的关系重新产生了兴趣。新出现的证据表明，通过益生菌补充来改变肠道微生物群的组成可能是一种可行的辅助治疗选择，适用于患有重度抑郁症（MDD）的个体。一致的证据表明，持续的低度炎症激活与 MDD 的诊断以及抑郁症状的严重程度和治疗反应的可能性有关。本综述的目的是：(1) 评估支持益生菌具有抗炎作用的证据；(2) 描述免疫系统调节作为益生菌对 MDD 人群治疗效果的潜在机制。对研究益生菌对全身炎症影响的研究进行了叙述性综述。使用 PubMed/Medline、Google Scholar 和 clinicaltrials.gov（从开始到 2017 年 11 月），使用以下搜索词（和/或变体）来确定研究：益生菌、炎症、肠道微生物群和抑郁。现有的证据表明，益生菌应被视为一种有前途的辅助治疗方法，以减轻 MDD 中常见的炎症激活。仍有几个有争议的问题需要解决，包括漏肠的作用、压力暴露的作用和血脑屏障通透性的作用。综上所述，本综述的结果表明，益生菌可能是一种潜在有益但研究不足的抗抑郁治疗干预措施。
