Kopera Ann F, Khiew Yii Chun, Amer Alsamman Mohd, Mattar Mark C, Olsen Raena S, Doman David B
Department of Internal Medicine, MedStar Georgetown University Hospital, Washington, DC.
Department of Gastroenterology, MedStar Georgetown University Hospital, Washington, DC.
Gastroenterol Hepatol (N Y). 2024 Jan;20(1):30-40.
Depression is one of the most common mental health disorders affecting adults in the United States. The current treatment is the combination of pharmacotherapy and psychotherapy. Recently, the evidence linking gut microbiome dysregulation to the development of depression has grown. The pathophysiology is currently poorly understood, although leading hypotheses include involvement of the hypothalamic-pituitary-adrenal axis, a bidirectional relationship between the gut microbiome and the central nervous system, and production of signaling molecules by the gut microbiome. Available and emerging treatments of the aberrant microbiome include antidepressants, antibiotics, diet modification, probiotics, and fecal microbiota transplant. This article explores the interconnectivity of gut microbiota and depression and treatments targeted toward the gut, reviews the gastroenterologist's potential role in managing gut dysbiosis in patients with depression, and highlights research topics to be addressed to create evidence-based guidelines.
抑郁症是影响美国成年人的最常见心理健康障碍之一。目前的治疗方法是药物治疗和心理治疗相结合。最近，将肠道微生物群失调与抑郁症发展联系起来的证据越来越多。尽管主要假说是下丘脑-垂体-肾上腺轴的参与、肠道微生物群与中枢神经系统之间的双向关系以及肠道微生物群产生信号分子，但目前对其病理生理学了解甚少。针对异常微生物群的现有和新兴治疗方法包括抗抑郁药、抗生素、饮食调整、益生菌和粪便微生物群移植。本文探讨了肠道微生物群与抑郁症的相互联系以及针对肠道的治疗方法，回顾了胃肠病学家在管理抑郁症患者肠道菌群失调方面的潜在作用，并强调了为制定循证指南而需要解决的研究课题。
