APC Microbiome Ireland, University College Cork, Cork, Ireland.
Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.
Neurogastroenterol Motil. 2021 Mar;33(3):e14095. doi: 10.1111/nmo.14095. Epub 2021 Feb 13.
The gastrointestinal microbiota has emerged as a key regulator of gut-brain axis signalling with important implications for neurogastroenterology. There is continuous bidirectional communication between the gut and the brain facilitated by neuronal, endocrine, metabolic, and immune pathways. The microbiota influences these signalling pathways via several mechanisms. Studies have shown compositional and functional alterations in the gut microbiota in stress-related psychiatric disorders. Gut microbiota reconfigurations are also a feature of irritable bowel syndrome (IBS), a gut-brain axis disorder sharing high levels of psychiatric comorbidity including both anxiety and depression. It remains unclear how the gut microbiota alterations in IBS align with both core symptoms and these psychiatric comorbidities.
In this review, we highlight common and disparate features of these microbial signatures as well as the associated gut-brain axis signalling pathways. Studies suggest that patients with either IBS, depression or anxiety, alone or comorbid, present with alterations in gut microbiota composition and harbor immune, endocrine, and serotonergic system alterations relevant to the common pathophysiology of these comorbid conditions.
Research has illustrated the utility of fecal microbiota transplantation in animal models, expanding the evidence base for a potential causal role of disorder-specific gut microbiota compositions in symptom set expression. Moreover, an exciting study by Constante and colleagues in this issue highlights the possibility of counteracting this microbiota-associated aberrant behavioral phenotype with a probiotic yeast, Saccharomyces boulardii CNCM I-745.
Such data highlights the potential for therapeutic targeting of the gut microbiota as a valuable strategy for the management of comorbid psychiatric symptoms in IBS.
胃肠道微生物群已成为调节肠-脑轴信号的关键因素，对神经胃肠病学具有重要意义。肠道和大脑之间通过神经元、内分泌、代谢和免疫途径进行持续的双向通讯。微生物群通过几种机制影响这些信号通路。研究表明，在与压力相关的精神疾病中，肠道微生物群的组成和功能发生了改变。肠易激综合征（IBS）也是一种肠-脑轴障碍，其特点是存在高水平的精神共病，包括焦虑和抑郁。目前尚不清楚 IBS 中肠道微生物群的改变与核心症状和这些精神共病如何相关。
在这篇综述中，我们强调了这些微生物特征的共同和不同特征，以及相关的肠-脑轴信号通路。研究表明，单独患有 IBS、抑郁症或焦虑症的患者，或同时患有这些疾病的患者，其肠道微生物组成发生改变，并存在与这些共病共同病理生理学相关的免疫、内分泌和 5-羟色胺能系统改变。
研究已经说明了粪便微生物移植在动物模型中的应用，为特定于疾病的肠道微生物组成在症状表现中的潜在因果作用提供了更多证据。此外，Constante 及其同事在本期杂志上的一项令人兴奋的研究表明，用一种益生菌酵母 Saccharomyces boulardii CNCM I-745 对抗这种与微生物群相关的异常行为表型是可能的。
这些数据强调了针对肠道微生物群进行治疗的潜力，作为管理 IBS 中伴发精神症状的有价值策略。
