Department of Psychiatry, Columbia University, New York, NY, USA.
Department of Molecular Imaging & Neuropathology, New York State Psychiatric Institute, New York, NY, USA.
Bipolar Disord. 2021 Sep;23(6):544-564. doi: 10.1111/bdi.13049. Epub 2021 Mar 1.
The microbiome is a rapidly advancing biomedical frontier with relevance for psychiatric illness. The gut microbiota interact with the central nervous system bidirectionally through the gut-brain axis and generate substances that may influence host metabolism, including short-chain fatty acids such as butyrate. Understanding gut microbiota in bipolar disorder (BD) may suggest new disease markers and treatment approaches.
A PubMed search was performed on January 7, 2020 using terms "bipolar AND (microbiome OR microbiota)", for articles in English in which the study population included a distinct BD group and the gut microbiota/microbiome was assessed.
Thirteen articles met the inclusion criteria. In four of five studies that reported on group comparisons with respect to diversity, lower α-diversity was observed in BD relative to healthy controls (HC). The most convergent taxonomic finding was that in four studies, one particular clade distinguished gut microbiota between BD and HC: family Ruminococcaceae, genus Faecalibacterium, and species Faecalibacterium prausnitzii. Members of this clade, known for butyrate production, were reduced in BD relative to HC in three studies but elevated in a fourth. Additionally, genera Bacteroides or Bacteroides-Prevotella group species were elevated in BD in two studies but lower in a third.
Despite few studies and modest sample sizes, salient findings suggest that low α-diversity and dysbiosis with respect to abundance of Faecalibacterium and Bacteroides may characterize BD in both a trait and state-dependent fashion. Decreased richness and butyrate production also foster inflammation, which may be a hitherto unrecognized part of the pathophysiology underlying BD.
微生物组是一个快速发展的生物医学前沿领域，与精神疾病有关。肠道微生物群通过肠-脑轴与中枢神经系统双向相互作用，并产生可能影响宿主代谢的物质，包括丁酸等短链脂肪酸。了解双相情感障碍（BD）中的肠道微生物群可能提示新的疾病标志物和治疗方法。
于 2020 年 1 月 7 日在 PubMed 上使用术语“bipolar AND (microbiome OR microbiota)”对英文文献进行了检索，纳入了包含明确的 BD 组且评估了肠道微生物群/微生物组的文章。
符合纳入标准的文章有 13 篇。在五项关于组间比较多样性的研究中，有四项研究观察到 BD 患者的 α-多样性低于健康对照组（HC）。最趋同的分类学发现是，在四项研究中，一个特定的菌群区分了 BD 和 HC 之间的肠道微生物群：Ruminococcaceae 科、Faecalibacterium 属和 Faecalibacterium prausnitzii 种。该菌群以产生丁酸而闻名，在三项研究中，BD 患者的丁酸产量低于 HC，而在第四项研究中则升高。此外，两项研究表明，Bacteroides 属或 Bacteroides-Prevotella 组的物种在 BD 中升高，但在第三项研究中则降低。
尽管研究较少且样本量较小，但有重要发现表明，Faecalibacterium 和 Bacteroides 丰度的低 α-多样性和失调可能以特质和状态依赖的方式来描述 BD。丰富度降低和丁酸产量减少也会促进炎症，这可能是 BD 潜在病理生理学中一个尚未被认识到的部分。
