Houston Methodist Hospital, Houston, TX, USA; Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA.
Alkek Center for Metagenomics and Microbiome Research, Baylor College of Medicine, Houston, TX, USA.
J Affect Disord. 2020 Mar 1;264:98-106. doi: 10.1016/j.jad.2019.12.020. Epub 2019 Dec 14.
Emerging evidence implicates the gut microbiota in central nervous system functioning via its effects on inflammation, the hypothalamic-pituitary axis, and/or neurotransmission. Our understanding of the cellular underpinnings of the brain-gut relationship is based almost exclusively on animal models with some small-scale human studies. This study examined the relationship between the gut microbiota and psychiatric symptom severity and treatment response among inpatients with serious mental illness.
We collected data from adult inpatients (N = 111). Measures of diagnoses, suicide severity, trauma, depression, and anxiety were collected shortly after admission, while self-collected fecal swabs were collected early in the course of hospitalization and processed using 16S rRNA gene sequencing and whole genome shotgun sequencing methods.
Results indicate that depression and anxiety severity shortly after admission were negatively associated with bacterial richness and alpha diversity. Additional analyses revealed a number of bacterial taxa associated with depression and anxiety severity. Gut microbiota richness and alpha diversity early in the course of hospitalization was a significant predictor of depression remission at discharge.
This study is among the first to demonstrate a gut microbiota relationship with symptom severity among psychiatric inpatients as well as a relationship to remission of depression post-treatment. These findings are consistent with animal models and limited human studies as well as with the broader literature implicating inflammation in the pathophysiology of depression. These findings offer the foundation for further studies of novel therapeutic approaches to the treatment, prevention of, or recurrence of serious mental illness.
越来越多的证据表明，肠道微生物群通过其对炎症、下丘脑-垂体轴和/或神经递质的影响，在中枢神经系统功能中发挥作用。我们对大脑-肠道关系的细胞基础的理解几乎完全基于动物模型，只有一些小规模的人类研究。本研究检查了肠道微生物群与严重精神疾病住院患者的精神症状严重程度和治疗反应之间的关系。
我们收集了成年住院患者（N=111）的数据。在入院后不久收集了诊断、自杀严重程度、创伤、抑郁和焦虑的测量值，而自我采集的粪便拭子则在住院早期采集，并使用 16S rRNA 基因测序和全基因组鸟枪法测序方法进行处理。
结果表明，入院后不久的抑郁和焦虑严重程度与细菌丰富度和 alpha 多样性呈负相关。进一步的分析表明，一些细菌类群与抑郁和焦虑严重程度有关。住院早期的肠道微生物群丰富度和 alpha 多样性是出院时抑郁缓解的显著预测因子。
这项研究是首次证明肠道微生物群与住院精神病患者的症状严重程度以及治疗后抑郁缓解之间存在关系的研究之一。这些发现与动物模型和有限的人类研究以及更广泛的文献一致，这些文献表明炎症在抑郁症的病理生理学中起作用。这些发现为进一步研究治疗、预防或复发严重精神疾病的新治疗方法提供了基础。
