Department of Psychiatry, Patton State Hospital, San Bernardino, USA.
Department of Psychiatry, University of California Riverside, USA.
Adv Clin Exp Med. 2023 Apr;32(4):395-399. doi: 10.17219/acem/159477.
Emil Kraepelin believed that dementia praecox, the disorder we now call schizophrenia, was caused by the brain being poisoned with toxins generated in other parts of the body, especially the mouth, intestine or genitals. In this regard, Kraepelin hinted at the microbiome and conceptualized microbial molecules as drivers of severe psychiatric illness. However, it was not until the coronavirus disease (COVID-19) pandemic that Kraepelin's paradigm gained traction, particularly because this virus was associated with both gut barrier disruption and new-onset psychosis.Likewise, despite numerous studies linking severe psychiatric illness to genomic damage and dysfunctional DNA repair, this pathogenetic mechanism was underappreciated before the COVID-19 pandemic. The use of the psychotomimetic anesthetic, ketamine, for treatment-resistant depression has reawakened the interest in endogenous serotonergic hallucinogens, especially tryptamine and N,N-dimethyltryptamine (DMT), which are beneficial for depression but associated with psychosis.In this editorial, we take a closer look at the role of the microbiome in psychopathology, attempting to answer 2 questions:1. Why may psychosis-predisposing serotonergic hallucinogens alleviate depression?2. Are microbiota-derived psychedelics part of an inbuilt antidepressant system similar to endogenous opioids?
埃米尔·克雷佩林（Emil Kraepelin）认为，精神分裂症，即我们现在所说的痴呆症，是由大脑中毒素引起的，这些毒素产生于身体的其他部位，特别是口腔、肠道或生殖器。在这方面，克雷佩林暗示了微生物组的存在，并将微生物分子概念化为严重精神疾病的驱动因素。然而，直到冠状病毒病（COVID-19）大流行，克雷佩林的范式才引起关注，尤其是因为这种病毒与肠道屏障破坏和新发精神病有关。同样，尽管有许多研究将严重精神疾病与基因组损伤和功能失调的 DNA 修复联系起来，但在 COVID-19 大流行之前，这种发病机制并未得到充分重视。使用致幻麻醉剂氯胺酮治疗难治性抑郁症重新引起了对内源性血清素致幻剂的兴趣，特别是色胺和 N,N-二甲基色胺（DMT），它们对抑郁症有益，但与精神病有关。在这篇社论中，我们更仔细地研究了微生物组在精神病理学中的作用，试图回答两个问题：1. 为什么易患精神病的血清素致幻剂可以缓解抑郁？2. 微生物衍生的迷幻药是否是内源性阿片样物质类似的内置抗抑郁系统的一部分？
