Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
Department of Stem Cell Biology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
Int J Mol Sci. 2022 Sep 21;23(19):11111. doi: 10.3390/ijms231911111.
Inflammatory bowel disease (IBD) comprises Crohn's disease (CD) and ulcerative colitis (UC) and is associated with neuropsychiatric symptoms like anxiety and depression. Both conditions strongly worsen IBD disease burden. In the present review, we summarize the current understanding of the pathogenesis of depression and anxiety in IBD. We present a stepwise cascade along a gut-immune-brain axis initiated by evasion of chronic intestinal inflammation to pass the epithelial and vascular barrier in the gut and cause systemic inflammation. We then summarize different anatomical transmission routes of gut-derived peripheral inflammation into the central nervous system (CNS) and highlight the current knowledge on neuroinflammatory changes in the CNS of preclinical IBD mouse models with a focus on microglia, the brain-resident macrophages. Subsequently, we discuss how neuroinflammation in IBD can alter neuronal circuitry to trigger symptoms like depression and anxiety. Finally, the role of intestinal microbiota in the gut-immune-brain axis in IBD will be reviewed. A more comprehensive understanding of the interaction between the gastrointestinal tract, the immune system and the CNS accounting for the similarities and differences between UC and CD will pave the path for improved prediction and treatment of neuropsychiatric comorbidities in IBD and other inflammatory diseases.
炎症性肠病(IBD)包括克罗恩病(CD)和溃疡性结肠炎(UC),并伴有焦虑和抑郁等神经精神症状。这两种疾病都会使 IBD 的疾病负担大大加重。在本综述中,我们总结了目前对 IBD 中抑郁和焦虑发病机制的理解。我们提出了一个沿着肠道-免疫-脑轴的逐步级联反应,由慢性肠道炎症的逃避引发,穿过肠道的上皮和血管屏障,导致全身炎症。然后,我们总结了肠道来源的外周炎症向中枢神经系统(CNS)的不同解剖传播途径,并强调了目前关于临床前 IBD 小鼠模型中 CNS 神经炎症变化的知识,重点是小胶质细胞,即大脑驻留巨噬细胞。随后,我们讨论了 IBD 中的神经炎症如何改变神经元回路,从而引发抑郁和焦虑等症状。最后,将回顾肠道微生物群在 IBD 中肠道-免疫-脑轴中的作用。更全面地了解胃肠道、免疫系统和中枢神经系统之间的相互作用,解释 UC 和 CD 之间的异同,将为改善 IBD 和其他炎症性疾病的神经精神合并症的预测和治疗铺平道路。
Public Health Rev. 2021-5-5
Gastroenterology. 2018-1-31
Eur Arch Psychiatry Clin Neurosci. 2025-6-20
J Inflamm Res. 2025-2-10
NPJ Sci Food. 2025-1-30
J Neuroinflammation. 2022-2-7