Lai Yaoyong, Xiong Peng
Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.
Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.
Gen Hosp Psychiatry. 2025 May-Jun;94:206-218. doi: 10.1016/j.genhosppsych.2025.03.012. Epub 2025 Mar 22.
Emerging evidence supports gut microbiota's association with mental distress, particularly depression and anxiety, the microbiota-gut-brain axis was the believed to be the underlying mechanism. This study investigated the causal relationships between specific gut microbiota and depression and anxiety disorders using large-scale genome-wide association study (GWAS) data.
A two-sample bidirectional Mendelian randomization (MR) analysis was conducted to explore the causal effects of 211 microbial taxa on depression and anxiety across three large GWAS databases: FinnGen, Pan-UKBB, and PGC. Sensitive analyses were followed to validate the robustness of results. Random-effect meta-analysis was further performed to enhance the statistical power.
The MR analysis revealed that the Bifidobacteriales (IVW: OR 0.90, 95 %CI 0.83 to 0.98) and Bifidobacteriaceae (IVW: OR 0.90, 95 %CI 0.83 to 0.98) had a protective effect against depression. Clostridiales (cML-MA: OR 0.88, 95 %CI 0.81 to 0.95) and Parasutterella (cML-MA: OR 0.75, 95 %CI 0.64 to 0.88) showed negative associations with depression. Increased abundance of Oxalobacteraceae (cML-MA: OR 1.78, 95 %CI 1.24 to 2.56), Deltaproteobacteria (cML-MA: OR 2.17, 95 %CI 1.38 to 3.40), and Desulfovibrionales (cML-MA: OR 2.22, 95 %CI 1.41 to 3.49) was associated with a higher risk of depression. For anxiety, protective effects were found for Actinobacteria (phylum: IVW: OR 0.83, 95 %CI 0.76 to 0.87; class: IVW: OR 0.84, 95 %CI 0.75 to 0.93), Bifidobacteriales (IVW: OR 0.80, 95 %CI 0.75 to 0.85), Bifidobacteriaceae (IVW: OR 0.80, 95 %CI 0.75 to 0.85) and Bifidobacterium [g] (IVW: OR 0.79, 95 %CI 0.74 to 0.84). Lactobacillaceae [f] (cML-MA: OR 1.18, 95 %CI 1.08 to 1.28), Clostridia [c] (cML-MA: OR 1.15, 95 %CI 0.1.06 to 1.26) and Clostridiales [o] (IVW: OR 1.15, 95 %CI 1.05 to 1.27) were associated with increased anxiety risk. Meta-analysis results indicated significant associations, particularly the protective effects of Actinobacteria (OR 0.90, 95 % CI, 0.83 to 0.98) and Clostridiaceae1 (OR 0.91, 95 % CI, 0.83 to 0.99) on depression and several taxa on anxiety. No significant instrumental variables for depression or anxiety on gut microbiota were identified.
Our findings highlight specific gut microbiota that are associated with depression and anxiety, underscoring the causal relationships between these intestinal microbes and psychiatric disorders. These results suggest potential strategies for mitigating disease symptoms and improving quality of life through microbiome-targeted therapies. Further studies, including randomized controlled trials and investigations into sex-specific effects, are essential to validate and expand upon these findings.
越来越多的证据支持肠道微生物群与精神困扰,尤其是抑郁症和焦虑症之间的关联,微生物-肠道-脑轴被认为是潜在机制。本研究利用大规模全基因组关联研究(GWAS)数据调查了特定肠道微生物群与抑郁症和焦虑症之间的因果关系。
进行了两样本双向孟德尔随机化(MR)分析,以探究211种微生物分类群对来自三个大型GWAS数据库(芬兰基因数据库、泛英国生物银行和精神病基因组学联盟)的抑郁症和焦虑症的因果效应。随后进行敏感性分析以验证结果的稳健性。进一步进行随机效应荟萃分析以增强统计效力。
MR分析显示,双歧杆菌目(逆方差加权法:优势比0.90,95%置信区间0.83至0.98)和双歧杆菌科(逆方差加权法:优势比0.90,95%置信区间0.83至0.98)对抑郁症具有保护作用。梭菌目(因果中介孟德尔随机化分析:优势比0.88,95%置信区间0.81至0.95)和副萨特氏菌属(因果中介孟德尔随机化分析:优势比0.75,95%置信区间0.64至0.88)与抑郁症呈负相关。草酸杆菌科(因果中介孟德尔随机化分析:优势比1.78,95%置信区间1.24至2.56)、δ-变形菌纲(因果中介孟德尔随机化分析:优势比2.17,95%置信区间1.38至3.40)和脱硫弧菌目(因果中介孟德尔随机化分析:优势比2.22,95%置信区间1.41至3.49)丰度增加与抑郁症风险较高相关。对于焦虑症,放线菌门(逆方差加权法:优势比0.83,95%置信区间0.76至0.87;纲:逆方差加权法:优势比0.84,95%置信区间0.75至0.93)、双歧杆菌目(逆方差加权法:优势比0.80,95%置信区间0.75至0.85)、双歧杆菌科(逆方差加权法:优势比0.80,95%置信区间0.75至0.85)和双歧杆菌属(逆方差加权法:优势比0.79,95%置信区间0.74至0.84)具有保护作用。乳杆菌科(因果中介孟德尔随机化分析:优势比1.18,95%置信区间1.08至1.28)、梭菌纲(因果中介孟德尔随机化分析:优势比1.15,95%置信区间0.1.06至1.26)和梭菌目(逆方差加权法:优势比1.15,95%置信区间1.05至1.27)与焦虑症风险增加相关。荟萃分析结果表明存在显著关联,尤其是放线菌门(优势比0.90,95%置信区间0.83至0.98)和梭菌科1(优势比0.91,95%置信区间0.83至0.99)对抑郁症的保护作用以及几种分类群对焦虑症的作用。未发现对肠道微生物群有抑郁症或焦虑症显著影响的工具变量。
我们的研究结果突出了与抑郁症和焦虑症相关的特定肠道微生物群,强调了这些肠道微生物与精神疾病之间的因果关系。这些结果提示了通过针对微生物群的疗法减轻疾病症状和改善生活质量的潜在策略。进一步的研究,包括随机对照试验和对性别特异性效应的调查,对于验证和扩展这些发现至关重要。