Cheng Qisheng, Ran Yuxin, Mo Xiaolong, Xiao Rui, He Dian, Guo Siyi, Wang Haiyang, Liu Lanxiang, Xie Peng
Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Faculty of Basic Medicine, Department of Pathology, Chongqing Medical University, Chongqing, China.
Gen Hosp Psychiatry. 2025 Jul-Aug;95:122-132. doi: 10.1016/j.genhosppsych.2025.05.004. Epub 2025 May 4.
Some preclinical and clinical studies have demonstrated the positive effect of Lactobacillus reuteri (L. reuteri) supplementation on depressive symptoms. We conducted an updated systematic review on this topic.
PubMed, EMBASE, Cochrane, Web of Science, and international trial registries were searched. We included randomized controlled trials (RCTs) and animal experiments on the use of mixed probiotics containing L. reuteri in the treatment of depression. Analyses were done using Review Manager version 5.4 and Stata 18.0.
In total, 12 RCTs including 1258 patients were included. The efficacy of the mixed probiotics containing L. reuteri in the treatment of depression was superior to the control group (SMD: -0.44, 95 %CI: -0.72 to -0.16). In terms of acceptability, there was no significant difference between the probiotic and control groups (OR: 1.04, 95 %CI: 0.75 to 1.45). In 9 animal experiments, mixed probiotics containing L. reuteri improved the symptoms of anxiety and depression. Subgroup analyses showed patients using multi-strain interventions (SMD: -0.56, 95 %CI: -0.97 to -0.15), having depressive symptoms (SMD: -0.39, 95 %CI: -0.74 to -0.03), and other clinical populations (SMD: -0.59, 95 %CI: -1.06 to -0.13), age < 60 years (SMD: -0.52, 95 %CI: -0.88 to -0.15), female patients (SMD: -0.45, 95 %CI: -0.78 to -0.13) may benefit more.
Mixed probiotics containing L. reuteri ameliorated depressive symptoms in patients and depression-like behaviors in animals. Combined microbiota seems to be more effective than single strain intervention in the treatment of depression. Patients with depressive symptoms, other clinical populations, age < 60 years, female patients may benefit more from probiotics. L. reuteri alone did not improve depressive symptoms.
一些临床前和临床研究已证明补充罗伊氏乳杆菌（L. reuteri）对抑郁症状有积极作用。我们针对该主题进行了一项更新的系统评价。
检索了PubMed、EMBASE、Cochrane、Web of Science和国际试验注册库。我们纳入了使用含罗伊氏乳杆菌的混合益生菌治疗抑郁症的随机对照试验（RCT）和动物实验。使用Review Manager 5.4版和Stata 18.0进行分析。
总共纳入了包括1258名患者的12项RCT。含罗伊氏乳杆菌的混合益生菌治疗抑郁症的疗效优于对照组（标准化均数差：-0.44，95%置信区间：-0.72至-0.16）。在可接受性方面，益生菌组和对照组之间无显著差异（比值比：1.04，95%置信区间：0.75至1.45）。在9项动物实验中，含罗伊氏乳杆菌的混合益生菌改善了焦虑和抑郁症状。亚组分析显示，使用多菌株干预的患者（标准化均数差：-0.56，95%置信区间：-0.97至-0.15）、有抑郁症状的患者（标准化均数差：-0.39，95%置信区间：-0.74至-0.03）、其他临床人群（标准化均数差：-0.59，95%置信区间：-1.06至-0.13）、年龄<60岁的患者（标准化均数差：-0.52，95%置信区间：-0.88至-0.15）、女性患者（标准化均数差：-0.45，95%置信区间：-0.78至-0.13）可能获益更多。
含罗伊氏乳杆菌的混合益生菌改善了患者的抑郁症状和动物的抑郁样行为。联合微生物群在治疗抑郁症方面似乎比单一菌株干预更有效。有抑郁症状的患者、其他临床人群、年龄<60岁的患者、女性患者可能从益生菌中获益更多。单独使用罗伊氏乳杆菌并未改善抑郁症状。
