Department of Psychiatry, Queen's University, 752 King St. West, Kingston, ON, K7L 4X3, Canada.
Providence Care Hospital, 752 King St. West, Kingston, ON, K7L 4X3, Canada.
BMC Psychiatry. 2020 Jun 15;20(1):299. doi: 10.1186/s12888-020-02654-5.
BACKGROUND: The Gut-Brain-Axis is a bidirectional signaling pathway between the gastrointestinal (GI) tract and the brain. The hundreds of trillions of microorganisms populating the gastrointestinal tract are thought to modulate this connection, and have far reaching effects on the immune system, central and autonomic nervous systems, and GI functioning. These interactions Diagnostic and statistical manual of mental disorders have also been linked to various psychiatric illnesses such as depression, anxiety, substance abuse, autism spectrum disorder, and eating disorders. It is hypothesized that techniques aimed at strengthening and repopulating the gut microbiome, such as Fecal Microbiota Transplant (FMT), may be useful in the prevention and treatment of psychiatric illnesses. METHODS: A systematic search of five databases was conducted using key terms related to FMT and psychiatric illnesses. All results were then evaluated based on specific eligibility criteria. RESULTS: Twenty-one studies met the eligibility criteria and were analysed for reported changes in mood and behavioural measures indicative of psychiatric wellbeing. The studies included were either entirely clinical (n = 8), preclinical with human donors (n = 9), or entirely preclinical (n = 11). All studies found a decrease in depressive and anxiety-like symptoms and behaviours resulting from the transplantation of healthy microbiota. The inverse was also found, with the transmission of depressive and anxiety-like symptoms and behaviours resulting from the transplantation of microbiota from psychiatrically ill donors to healthy recipients. CONCLUSION: There appears to be strong evidence for the treatment and transmission of psychiatric illnesses through FMT. Further research with larger sample sizes and stronger scientific design is warranted in order to fully determine the efficacy and safety of this potential treatment. Registered on PROSPERO, IRD: CRD42019126795.
背景:肠脑轴是胃肠道(GI)和大脑之间的双向信号通路。数以万亿计的微生物栖息在胃肠道中,被认为可以调节这种联系,并对免疫系统、中枢和自主神经系统以及胃肠道功能产生深远影响。这些相互作用也与各种精神疾病有关,如抑郁症、焦虑症、物质滥用、自闭症谱系障碍和饮食失调。据推测,旨在增强和重新填充肠道微生物组的技术,如粪便微生物群移植(FMT),可能有助于预防和治疗精神疾病。
方法:使用与 FMT 和精神疾病相关的关键词对五个数据库进行了系统搜索。然后根据特定的入选标准对所有结果进行评估。
结果:符合入选标准的 21 项研究分析了报告的情绪和行为变化,这些变化表明精神健康状况有所改善。这些研究要么完全是临床研究(n=8),要么是有人类供体的临床前研究(n=9),要么是完全的临床前研究(n=11)。所有研究都发现,移植健康微生物群会降低抑郁和焦虑样症状和行为。相反,从患有精神疾病的供体向健康受者移植抑郁和焦虑样症状和行为也会导致这种情况。
结论:通过 FMT 治疗和传播精神疾病似乎有强有力的证据。需要进行更大规模的样本量和更强科学设计的进一步研究,以充分确定这种潜在治疗方法的疗效和安全性。在 PROSPERO 上注册,IRD:CRD42019126795。
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