Simpson Carra A, Mu Andre, Haslam Nick, Schwartz Orli S, Simmons Julian G
Melbourne School of Psychological Sciences, The University of Melbourne, 12th floor Redmond Barry Building, Parkville, VIC, Australia; Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, VIC, Australia.
Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, VIC, Australia; Doherty Applied Microbial Genomics, Department of Microbiology and Immunology at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, VIC, Australia; Microbiological Diagnostic Unit Public Health Laboratory, at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, VIC, Australia.
J Affect Disord. 2020 Apr 1;266:429-446. doi: 10.1016/j.jad.2020.01.124. Epub 2020 Jan 22.
Background Anxiety/depression and irritable bowel syndrome (IBS) are highly prevalent and burdensome conditions, whose co-occurrence is estimated between 44 and 84%. Shared gut microbiota alterations have been identified in these separate disorders relative to controls; however, studies have not adequately considered their comorbidity. This review set out to identify case-control studies comparing the gut microbiota in anxiety/depression, IBS, and both conditions comorbidly relative to each other and to controls, as well as gut microbiota investigations including measures of both IBS and anxiety/depression. Methods Four databases were systematically searched using comprehensive search terms (OVID Medline, Embase, PsycINFO, and PubMed), following PRISMA guidelines. Results Systematic review identified 17 studies (10 human, 7 animal). Most studies investigated the gut microbiota and anxiety/depression symptoms in IBS cohorts. Participants with IBS and high anxiety/depression symptoms had lower alpha diversity compared to controls and IBS-only cohorts. Machine learning and beta diversity distinguished between IBS participants with and without anxiety/depression by their gut microbiota. Comorbid IBS and anxiety/depression also had higher abundance of Proteobacteria, Prevotella/Prevotellaceae, Bacteroides and lower Lachnospiraceae relative to controls. Limitations A large number of gut microbiota estimation methods and statistical techniques were utilized; therefore, meta-analysis was not possible. Conclusions Well-designed case-control and longitudinal studies are required to disentangle whether the gut microbiota is predicted as a continuum of gastrointestinal and anxiety/depression symptom severity, or whether reported dysbiosis is unique to IBS and anxiety/depression comorbidity. These findings may inform the development of targeted treatment through the gut microbiota for individuals with both anxiety/depression and IBS.
焦虑/抑郁与肠易激综合征（IBS）是高度常见且负担沉重的疾病，据估计二者共病率在44%至84%之间。相对于对照组，在这些独立的疾病中已发现肠道微生物群存在共同改变；然而，研究尚未充分考虑它们的共病情况。本综述旨在确定病例对照研究，比较焦虑/抑郁、IBS以及二者共病状态下相对于彼此及对照组的肠道微生物群，以及包括IBS和焦虑/抑郁测量指标的肠道微生物群研究。方法：按照PRISMA指南，使用综合检索词（OVID Medline、Embase、PsycINFO和PubMed）对四个数据库进行系统检索。结果：系统综述确定了17项研究（10项人体研究，7项动物研究）。大多数研究调查了IBS队列中的肠道微生物群和焦虑/抑郁症状。与对照组和仅患有IBS的队列相比，患有IBS且焦虑/抑郁症状严重的参与者的α多样性较低。机器学习和β多样性通过肠道微生物群区分了患有和未患有焦虑/抑郁的IBS参与者。相对于对照组，IBS与焦虑/抑郁共病时，变形菌门、普雷沃氏菌属/普雷沃氏菌科、拟杆菌属的丰度也更高，而毛螺菌科的丰度更低。局限性：使用了大量的肠道微生物群估计方法和统计技术；因此，无法进行荟萃分析。结论：需要设计良好的病例对照研究和纵向研究，以厘清肠道微生物群是被预测为胃肠道和焦虑/抑郁症状严重程度的连续统一体，还是所报道的生态失调是IBS与焦虑/抑郁共病所特有的。这些发现可能为针对同时患有焦虑/抑郁和IBS的个体通过肠道微生物群进行靶向治疗提供依据。
