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益生菌与肠道菌群-脑轴:关注抑郁症患者。对当前研究的综述。

Probiotics and the microbiota-gut-brain axis: focus on patients with depression. A review of current research.

机构信息

Doctoral School of Biological and Biomedical Sciences, University of Oradea, Oradea, Romania.

Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania.

出版信息

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2023 Sep;167(3):219-224. doi: 10.5507/bp.2023.024. Epub 2023 Jun 14.

Abstract

This review covers recent data on the relationship between major depressive disorder (MDD) and faecal microbiome and examines the co-relations between the use of probiotics and changes in psychiatric state. We conducted a thorough search of academic databases for articles published between 2018 and 2022, using specific keywords and previously established inclusion/exclusion criteria regarding faecal microbiota, depressive disorder, and probiotics. Of 192 eligible articles (reviews, original papers, and clinical trials), we selected 10 that fully met our criteria and performed a careful review to determine any correlation between microbiome, probiotic treatment, and depression. All patients were adults (mean age, 36.8), with at least one MDD episode and onset of depression during adolescence (duration of 31.39 years of depressive episodes). We found mixed but mostly positive results regarding the influence of probiotic/prebiotic/postbiotic effects on depression. We could not identify the precise mechanism of action that led to their improvement. Antidepressants did not alter the microbiota, according to studies that evaluated this aspect. Probiotic/prebiotic/postbiotic treatments were proven to be safe, with few and mild side effects. Probiotics seemingly could be beneficial in patients with depression, as evidenced by well-established depression scales. Based on this finding and the high tolerability and safety of probiotics, no caveats against their routine use can be made. Some unmet needs in this field include determination of the dominant type of microbiota in specific patients with depression; study of microbiome-directed/driven treatment regarding dose and duration adjustments; and multiple versus single strain treatments.

摘要

本综述涵盖了近期关于重度抑郁症(MDD)与粪便微生物群之间关系的研究数据,并探讨了益生菌的使用与精神状态变化之间的相关性。我们使用特定的关键词和先前建立的粪便微生物群、抑郁障碍和益生菌的纳入/排除标准,对 2018 年至 2022 年期间发表的学术数据库中的文章进行了全面搜索。在 192 篇符合条件的文章(综述、原始论文和临床试验)中,我们选择了 10 篇完全符合我们标准的文章,并进行了仔细审查,以确定微生物群、益生菌治疗和抑郁之间是否存在任何相关性。所有患者均为成年人(平均年龄 36.8 岁),至少有一次 MDD 发作,且在青春期开始出现抑郁(抑郁发作持续时间为 31.39 年)。我们发现,关于益生菌/益生元/后生元对抑郁的影响,结果存在差异,但大多为阳性。我们无法确定导致其改善的确切作用机制。根据评估这一方面的研究,抗抑郁药并未改变微生物群。益生菌/益生元/后生元治疗被证明是安全的,仅有少数和轻度的副作用。益生菌似乎对抑郁症患者有益,这一点得到了经过验证的抑郁症量表的支持。基于这一发现以及益生菌的高耐受性和安全性,我们可以常规使用益生菌,而无需顾虑。该领域仍存在一些未满足的需求,包括确定特定抑郁症患者中优势菌群的类型;研究针对微生物群的靶向/驱动治疗,包括剂量和持续时间的调整;以及多菌株与单菌株治疗的比较。

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