穿越镜子：现代抗逆转录病毒治疗时代的心理神经免疫学和微生物群-肠道-大脑轴。

Through the Looking-Glass: Psychoneuroimmunology and the Microbiome-Gut-Brain Axis in the Modern Antiretroviral Therapy Era.

机构信息

From the Department of Public Health Sciences (Carrico, Cherenack, Ghanooni, Chavez), University of Miami Miller School of Medicine, Miami, Florida; Departments of Neurology (Rubin) and Psychiatry and Behavioral Sciences (Rubin), Johns Hopkins University School of Medicine; Department of Epidemiology (Rubin), Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Psychology (McIntosh), University of Miami College of Arts and Sciences, Coral Gables, Florida; Department of Surgery (Klatt), University of Minnesota School of Medicine, Minneapolis, Minnesota; and Department of Psychological Sciences (Paul), University of Missouri St. Louis, St. Louis, Missouri.

出版信息

Psychosom Med. 2022 Oct 1;84(8):984-994. doi: 10.1097/PSY.0000000000001133. Epub 2022 Aug 28.

DOI:10.1097/PSY.0000000000001133

PMID:36044613

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9553251/

Abstract

OBJECTIVE

Depression, substance use disorders, and other neuropsychiatric comorbidities are common in people with HIV (PWH), but the underlying mechanisms are not sufficiently understood. HIV-induced damage to the gastrointestinal tract potentiates residual immune dysregulation in PWH receiving effective antiretroviral therapy. However, few studies among PWH have examined the relevance of microbiome-gut-brain axis: bidirectional crosstalk between the gastrointestinal tract, immune system, and central nervous system.

METHODS

A narrative review was conducted to integrate findings from 159 articles relevant to psychoneuroimmunology (PNI) and microbiome-gut-brain axis research in PWH.

RESULTS

Early PNI studies demonstrated that neuroendocrine signaling via the hypothalamic-pituitary-adrenal axis and autonomic nervous system could partially account for the associations of psychological factors with clinical HIV progression. This review highlights the need for PNI studies examining the mechanistic relevance of the gut microbiota for residual immune dysregulation, tryptophan catabolism, and oxytocin release as key biological determinants of neuropsychiatric comorbidities in PWH (i.e., body-to-mind pathways). It also underscores the continued relevance of neuroendocrine signaling via the hypothalamic-pituitary-adrenal axis, autonomic nervous system, and oxytocin release in modifying microbiome-gut-brain axis functioning (i.e., mind-to-body pathways).

CONCLUSIONS

Advancing our understanding of PNI and microbiome-gut-brain axis pathways relevant to depression, substance use disorders, and other neuropsychiatric comorbidities in PWH can guide the development of novel biobehavioral interventions to optimize health outcomes. Recommendations are provided for biobehavioral and neurobehavioral research investigating bidirectional PNI and microbiome-gut-brain axis pathways among PWH in the modern antiretroviral therapy era.

摘要

目的

抑郁症、物质使用障碍和其他神经精神合并症在 HIV 感染者（PWH）中很常见，但潜在机制尚未充分了解。HIV 对胃肠道的损害加剧了接受有效抗逆转录病毒治疗的 PWH 中残留的免疫失调。然而，在 PWH 中，很少有研究探讨微生物组-肠道-大脑轴的相关性：胃肠道、免疫系统和中枢神经系统之间的双向串扰。

方法

进行了叙述性综述，以整合与 PWH 中的心理神经免疫学（PNI）和微生物组-肠道-大脑轴研究相关的 159 篇文章的研究结果。

结果

早期的 PNI 研究表明，通过下丘脑-垂体-肾上腺轴和自主神经系统的神经内分泌信号可以部分解释心理因素与 HIV 临床进展之间的关联。本综述强调了 PNI 研究的必要性，这些研究需要检验肠道微生物群对残留免疫失调、色氨酸分解代谢和催产素释放的机制相关性，这些是 PWH 中神经精神合并症的关键生物学决定因素（即身体到思维途径）。它还强调了通过下丘脑-垂体-肾上腺轴、自主神经系统和催产素释放来调节微生物组-肠道-大脑轴功能的神经内分泌信号的持续相关性（即思维到身体途径）。