Department of Psychiatry and APC Microbiome Institute, University College Cork, Ireland.
Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria.
Can J Psychiatry. 2019 Nov;64(11):747-760. doi: 10.1177/0706743719874168. Epub 2019 Sep 17.
The gut microbiome as a potential therapeutic target for mental illness is a hot topic in psychiatry. Trillions of bacteria reside in the human gut and have been shown to play a crucial role in gut-brain communication through an influence on neural, immune, and endocrine pathways. Patients with various psychiatric disorders including depression, bipolar disorder, schizophrenia, and autism spectrum disorder have been shown to have significant differences in the composition of their gut microbiome. Enhancing beneficial bacteria in the gut, for example, through the use of probiotics, prebiotics, or dietary change, has the potential to improve mood and reduce anxiety in both healthy people and patient groups. Much attention is being given to this subject in the general media, and patients are becoming increasingly interested in the potential to treat mental illness with microbiome-based therapies. It is imperative that those working with people with mental illness are aware of the rationale and current evidence base for such treatment strategies. In this review, we provide an overview of the gut microbiome, what it is, and what it does in relation to gut-brain communication and psychological function. We describe the fundamental principles and basic techniques used in microbiome-gut-brain axis research in an accessible way for a clinician audience. We summarize the current evidence in relation to microbiome-based strategies for various psychiatric disorders and provide some practical advice that can be given to patients seeking to try a probiotic for mental health benefit.
肠道微生物组作为精神疾病的潜在治疗靶点是精神病学领域的一个热门话题。人体内有数万亿细菌,它们通过对神经、免疫和内分泌途径的影响,在肠道-大脑通讯中发挥着至关重要的作用。患有各种精神疾病的患者,包括抑郁症、双相情感障碍、精神分裂症和自闭症谱系障碍,其肠道微生物组的组成有明显差异。例如,通过使用益生菌、益生元或饮食改变来增强肠道中的有益细菌,有可能改善健康人群和患者群体的情绪和减轻焦虑。这一主题在大众媒体中受到了广泛关注,患者对使用基于微生物组的疗法治疗精神疾病的兴趣日益浓厚。对于从事精神疾病患者治疗的人员来说,了解这种治疗策略的基本原理和当前证据基础至关重要。在这篇综述中,我们概述了肠道微生物组是什么,它在肠道-大脑通讯和心理功能方面的作用。我们以一种易于临床医生理解的方式,描述了微生物组-肠道-大脑轴研究中使用的基本原则和基本技术。我们总结了与各种精神障碍的基于微生物组的策略相关的当前证据,并为寻求通过益生菌改善心理健康的患者提供了一些实用建议。