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脑-肠-微生物群轴在治疗神经和精神疾病中的作用。

The brain-gut-microbiota axis in the treatment of neurologic and psychiatric disorders.

机构信息

Universidade Federal de São Paulo, Departamento de Fisiologia, São Paulo SP, Brazil.

Universidade Federal de São Paulo, Departamento de Psicobiologia, São Paulo SP, Brazil.

出版信息

Arq Neuropsiquiatr. 2023 Jul;81(7):670-684. doi: 10.1055/s-0043-1767818. Epub 2023 Jul 4.

Abstract

The human gut microbiota is a complex ecosystem made of trillions of microorganisms. The composition can be affected by diet, metabolism, age, geography, stress, seasons, temperature, sleep, and medications. The increasing evidence about the existence of a close and bi-directional correlation between the gut microbiota and the brain indicates that intestinal imbalance may play a vital role in the development, function, and disorders of the central nervous system. The mechanisms of interaction between the gut-microbiota on neuronal activity are widely discussed. Several potential pathways are involved with the brain-gut-microbiota axis, including the vagus nerve, endocrine, immune, and biochemical pathways. Gut dysbiosis has been linked to neurological disorders in different ways that involve activation of the hypothalamic-pituitary-adrenal axis, imbalance in neurotransmitter release, systemic inflammation, and increase in the permeability of the intestinal and the blood-brain barrier. Mental and neurological diseases have become more prevalent during the coronavirus disease 2019pandemic and are an essential issue in public health globally. Understanding the importance of diagnosing, preventing, and treating dysbiosis is critical because gut microbial imbalance is a significant risk factor for these disorders. This review summarizes evidence demonstrating the influence of gut dysbiosis on mental and neurological disorders.

摘要

人类肠道微生物群是一个由数万亿微生物组成的复杂生态系统。其组成可受饮食、代谢、年龄、地理位置、压力、季节、温度、睡眠和药物等因素影响。越来越多的证据表明,肠道微生物群与大脑之间存在密切的双向关联,这表明肠道失衡可能在中枢神经系统的发育、功能和紊乱中发挥重要作用。肠道微生物群对神经元活动的相互作用机制正在广泛讨论中。几个潜在的途径涉及脑-肠-微生物群轴,包括迷走神经、内分泌、免疫和生化途径。肠道菌群失调与不同方式的神经精神疾病有关,包括下丘脑-垂体-肾上腺轴的激活、神经递质释放失衡、全身炎症和肠道及血脑屏障通透性增加。在 2019 冠状病毒病大流行期间,精神和神经疾病变得更为普遍,是全球公共卫生的一个重要问题。了解诊断、预防和治疗菌群失调的重要性至关重要,因为肠道微生物失衡是这些疾病的一个重要危险因素。本综述总结了肠道菌群失调对精神和神经疾病影响的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c538/10371417/157b1fc401dd/10-1055-s-0043-1767818-i220225-1.jpg

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