Department of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Maurice Müller Laboratories, Department for Biomedical Research, Inselspital, University of Bern, Bern, Switzerland.
Clin Gastroenterol Hepatol. 2020 Aug;18(9):2019-2029.e11. doi: 10.1016/j.cgh.2019.09.022. Epub 2019 Sep 20.
BACKGROUND & AIMS: Depression and anxiety are frequent comorbidities with inflammatory bowel diseases (IBD). Alterations to the intestinal microbiome promote not only intestinal inflammation but also psychologic function. We studied the interactions between the composition of the intestinal microbiota and psychological outcomes in patients with IBD in Switzerland.
We performed a prospective study of psychological comorbidities and quality of life (QoL) in 171 participants in the Swiss IBD Cohort Study with IBD in remission. Participants complete the Hospital Anxiety and Depression Scale, Perceived Stress Questionnaire, the 36-Item Short Form Survey, and the IBD QoL Questionnaire. Microbes were collected from intestinal biopsies and analyzed by 16S rRNA high-throughput sequencing.
Microbiomes of patients with higher perceived stress had significantly lower alpha diversity. Anxiety and depressive symptoms were significantly associated with beta diversity. We found a negative correlation between psychological distress and abundance of Clostridia, Bacilli, Bacteroidia, and Beta- and Gamma-proteobacteria. Psychological distress was also associated with decreases in operational taxonomic units from the lineages of Lachnospiraceae, Fusobacteriaceae, Ruminococcaceae, Veillonellaceae, Alcaligenaceae, Desulfovibrionaceae, and Bacteroidaceae families. The relative abundance of Bifidobacterium in patients with Crohn's disease and Desulfovibrio in patients with ulcerative colitis correlated with depression, whereas abundance of Sutterella, RF 32, and Lactococcus correlated with quality of life in patients with Crohn's disease.
We identified correlations between the composition of the intestinal microbiota in patients with IBD and remission, psychological well-being, and QoL. Further studies should investigate how intestinal inflammation, the microbiome, and microbial metabolites affect psychological well-being and whether these components are mono- or bi-directionally linked.
抑郁和焦虑是炎症性肠病（IBD）常见的共病。肠道微生物组的改变不仅促进肠道炎症，还影响心理功能。我们研究了瑞士 IBD 队列研究中 IBD 缓解期患者肠道微生物组组成与心理结局之间的相互作用。
我们对瑞士 IBD 队列研究中 171 例 IBD 缓解期患者进行了心理共病和生活质量（QoL）的前瞻性研究。参与者完成医院焦虑抑郁量表、感知压力问卷、36 项简短健康调查问卷和 IBD 生活质量问卷。从肠道活检中采集微生物，并通过 16S rRNA 高通量测序进行分析。
感知压力较高患者的微生物组 alpha 多样性显著降低。焦虑和抑郁症状与 beta 多样性显著相关。我们发现心理困扰与厚壁菌门、芽孢杆菌门、拟杆菌门、β和γ变形菌门的丰度呈负相关。心理困扰还与lachnospiraceae、fusobacteriaceae、ruminococcaceae、veillonellaceae、alcaligenaceae、desulfovibrionaceae 和 bacteroidaceae 家族的分类单元数量减少有关。克罗恩病患者双歧杆菌相对丰度和溃疡性结肠炎患者脱硫弧菌丰度与抑郁相关，而克罗恩病患者 Sutterella、RF32 和 Lactococcus 丰度与 QoL 相关。
我们鉴定了 IBD 患者肠道微生物组组成与缓解、心理健康和 QoL 之间的相关性。进一步的研究应探讨肠道炎症、微生物组和微生物代谢产物如何影响心理健康，以及这些成分是单向还是双向关联的。
