Gruenbaum Benjamin F, Merchant Kiran S, Zlotnik Alexander, Boyko Matthew
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL 32224, USA.
Department of Anesthesiology and Critical Care, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel.
Nutrients. 2024 Dec 22;16(24):4405. doi: 10.3390/nu16244405.
The gut-brain axis plays an integral role in maintaining overall health, with growing evidence suggesting its impact on the development of various neuropsychiatric disorders, including depression. This review explores the complex relationship between gut microbiota and glutamate (Glu) regulation, highlighting its effect on brain health, particularly in the context of depression following certain neurological insults. We discuss how microbial populations can either facilitate or limit Glu uptake, influencing its bioavailability and predisposing to neuroinflammation and neurotoxicity. Additionally, we examine the role of gut metabolites and their influence on the blood-brain barrier and neurotransmitter systems involved in mood regulation. The therapeutic potential of microbiome-targeted interventions, such as fecal microbiota transplantation, is also highlighted. While much research has explored the role of Glu in major depressive disorders and other neurological diseases, the contribution of gut microbiota in post-neurological depression remains underexplored. Future research should focus on explaining the mechanisms linking the gut microbiota to neuropsychiatric outcomes, particularly in conditions such as post-stroke depression, post-traumatic brain-injury depression, and epilepsy-associated depression. Systematic reviews and human clinical studies are needed to establish causal relationships and assess the efficacy of microbiome-targeted therapies in improving the neuropsychiatric sequalae after neurological insults.
肠-脑轴在维持整体健康方面发挥着不可或缺的作用，越来越多的证据表明其对包括抑郁症在内的各种神经精神疾病的发展有影响。本综述探讨了肠道微生物群与谷氨酸（Glu）调节之间的复杂关系，强调了其对大脑健康的影响，特别是在某些神经损伤后的抑郁症背景下。我们讨论了微生物群体如何促进或限制Glu的摄取，影响其生物利用度，并易引发神经炎症和神经毒性。此外，我们研究了肠道代谢产物的作用及其对血脑屏障和参与情绪调节的神经递质系统的影响。还强调了以微生物群为靶点的干预措施（如粪便微生物群移植）的治疗潜力。虽然许多研究探讨了Glu在重度抑郁症和其他神经疾病中的作用，但肠道微生物群在神经损伤后抑郁症中的作用仍未得到充分研究。未来的研究应侧重于解释肠道微生物群与神经精神结果之间的联系机制，特别是在中风后抑郁症、创伤性脑损伤后抑郁症和癫痫相关性抑郁症等情况下。需要进行系统评价和人体临床研究，以建立因果关系，并评估以微生物群为靶点的疗法在改善神经损伤后神经精神后遗症方面的疗效。
