Nikolova Viktoriya L, Cleare Anthony J, Young Allan H, Stone James M
Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
National Institute for Health Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London SE5 8AF, UK.
J Clin Med. 2021 Feb 8;10(4):647. doi: 10.3390/jcm10040647.
Recent years have seen a rapid increase in the use of gut microbiota-targeting interventions, such as probiotics, for the treatment of psychiatric disorders. The objective of this update review was to evaluate all randomised controlled clinical trial evidence on the efficacy of probiotics for clinical depression. Cochrane guidelines for updated reviews were followed. By searching PubMed and Web of Science databases, we identified 546 new records since our previous review. A total of seven studies met selection criteria, capturing 404 people with depression. A random effects meta-analysis using treatment type (stand-alone vs. adjunctive) as subgroup was performed. The results demonstrated that probiotics are effective in reducing depressive symptoms when administered in addition to antidepressants (SMD = 0.83, 95%CI 0.49-1.17), however, they do not seem to offer significant benefits when used as stand-alone treatment (SMD = -0.02, 95%CI -0.34-0.30). Potential mechanisms of action may be via increases in brain-derived neurotrophic factor (BDNF) and decreases in C-reactive protein (CRP), although limited evidence is available at present. This review offers stronger evidence to support the clinical use of probiotics in depressed populations and provides an insight into the mode of administration more likely to yield antidepressant effects.
近年来，针对肠道微生物群的干预措施，如益生菌，在治疗精神疾病方面的应用迅速增加。本次更新综述的目的是评估所有关于益生菌治疗临床抑郁症疗效的随机对照临床试验证据。遵循Cochrane更新综述指南。通过检索PubMed和Web of Science数据库，自上次综述以来，我们确定了546条新记录。共有7项研究符合入选标准，涉及404名抑郁症患者。以治疗类型（单独使用与辅助使用）为亚组进行随机效应荟萃分析。结果表明，益生菌与抗抑郁药联合使用时可有效减轻抑郁症状（标准化均数差=0.83，95%置信区间0.49-1.17），然而，单独使用时似乎没有显著益处（标准化均数差=-0.02，95%置信区间-0.34-0.30）。潜在的作用机制可能是通过增加脑源性神经营养因子（BDNF）和降低C反应蛋白（CRP），尽管目前证据有限。本综述为支持在抑郁症患者中临床使用益生菌提供了更有力的证据，并深入探讨了更有可能产生抗抑郁作用的给药方式。
