Department of Psychiatry, Showa University School of Medicine, Tokyo, Japan.
Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
J Affect Disord. 2020 Apr 1;266:1-13. doi: 10.1016/j.jad.2020.01.102. Epub 2020 Jan 23.
Growing attention has been paid to the field of gut microbiota for mental disorders over the last decade. However, to our knowledge, no studies have conducted systematic reviews on the association between gut microbiota and major depressive disorder (MDD) in both interventional and non-interventional studies.
We conducted a systematic review and meta-analysis of 16 studies (10 observational [701 participants] and six interventional trials [302 participants]) examining gut microbiota in patients with MDD. The primary outcome measures were differences in the profile of microbiota in the observational studies, and symptom changes for depression between pre- and post-intervention with probiotics in the interventional trials.
In the observational studies, significant reductions in several taxa at the family and genus levels were observed in patients with MDD compared to non-depressed controls. In the interventional studies with probiotics, a significant improvement was found in depressive symptomatology compared to controls (SMD = -1.62, 95% CI = -2.73 to -0.51, p< 0.01).
Lack of consideration of the effects of diet and pharmacotherapy was a possible limitation.
Our results indicate that several taxa at the family and genus levels, specifically family Prevotellaceae, genus Corprococcus, and Faecalibacterium, were decreased in MDD compared to non-depressed controls in observational studies, and depressive symptoms were improved compared to controls in interventional studies with probiotics. Due to the limited number of studies, further studies considering diet and pharmacotherapy are needed to explore the relationships between gut microbiota and MDD in humans.
在过去的十年中，人们对肠道微生物群与精神障碍相关的领域越来越关注。然而，据我们所知，在干预性和非干预性研究中，没有研究对肠道微生物群与重度抑郁症（MDD）之间的关系进行系统评价。
我们对 16 项研究（10 项观察性研究[701 名参与者]和 6 项干预性试验[302 名参与者]）进行了系统评价和荟萃分析，以检查 MDD 患者的肠道微生物群。主要结局指标是观察性研究中微生物群特征的差异，以及干预性试验中益生菌干预前后抑郁症状的变化。
在观察性研究中，与非抑郁对照组相比，MDD 患者的几个科和属水平的微生物群明显减少。在益生菌干预性研究中，与对照组相比，抑郁症状明显改善（SMD=-1.62，95%CI=-2.73 至-0.51，p<0.01）。
未考虑饮食和药物治疗的影响可能是一个局限性。
我们的结果表明，在观察性研究中，与非抑郁对照组相比，MDD 患者的几个科和属水平的微生物群，特别是科 Prevotellaceae、属 Corprococcus 和 Faecalibacterium，明显减少，而益生菌干预性研究中，与对照组相比，抑郁症状有所改善。由于研究数量有限，需要进一步考虑饮食和药物治疗的研究来探索人类肠道微生物群与 MDD 之间的关系。
