Pan Jiayue, Lin Shuairong, Qian Qiuling, Fu Shanni, Liu Xiaoliu
Brain Science and Advanced Technology Institute, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei, China.
School of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei, China.
Front Pharmacol. 2025 Jun 25;16:1621678. doi: 10.3389/fphar.2025.1621678. eCollection 2025.
Post-traumatic stress disorder (PTSD) is a severe mental disorder that occurs after experiencing or witnessing a traumatic event. Not only does this disorder severely impair the quality of life and emotional wellbeing of patients, but in recent years the global rate of PTSD diagnoses has increased to 1.5-2 times, and the prevalence of PTSD associated with COVID-19 events in particular has surged to 10%-25%, underscoring the urgency of developing effective treatments. The lifetime prevalence of PTSD in the general population is estimated to be approximately 3.9%, while in high-risk populations, such as war veterans, it can be as high as 30%. As a key pathway connecting the central nervous system to peripheral organs, the gut-brain axis has received increasing attention for its role in PTSD. Although the gut-brain axis has been shown to be associated with several psychiatric disorders, especially depression, its specific role in PTSD remains undercharacterized. Existing studies suggest that specific strains of (e.g., ) may alleviate inflammatory responses and improve PTSD-like behaviors by down-regulating the expression of pro-inflammatory factors (IL-6 and TNF-α). In this study, we used a narrative review approach to sort out the research progress of gut microbiota alteration in PTSD, and compared the characteristics of changes in specific microbial taxa (e.g., , , ), the index of microbiota diversity (α/β diversity), and the levels of inflammatory markers (e.g., IL-6, TNF-α) between the animal model and the human patients, respectively, in order to We further explored the potential pathogenic mechanisms mediated by microorganisms, such as influencing the vagal pathway, hypothalamic-pituitary-adrenal (HPA) axis function, immune system and other processes involved in the pathology of PTSD, and summarized the intervention strategies targeting gut microecology, such as probiotic supplementation, dietary interventions and fecal bacteria transplantation.
创伤后应激障碍（PTSD）是一种严重的精神障碍，发生于经历或目睹创伤性事件之后。这种障碍不仅严重损害患者的生活质量和情绪健康，近年来全球PTSD的诊断率已增至1.5 - 2倍，尤其是与新冠疫情相关事件的PTSD患病率已飙升至10% - 25%，凸显了开发有效治疗方法的紧迫性。一般人群中PTSD的终生患病率估计约为3.9%，而在高危人群（如退伍军人）中，这一比例可能高达30%。作为连接中枢神经系统与外周器官的关键通路，肠 - 脑轴因其在PTSD中的作用而受到越来越多的关注。尽管肠 - 脑轴已被证明与多种精神障碍有关，尤其是抑郁症，但其在PTSD中的具体作用仍未得到充分表征。现有研究表明，特定菌株（如 ）可能通过下调促炎因子（IL - 6和TNF - α）的表达来减轻炎症反应并改善PTSD样行为。在本研究中，我们采用叙述性综述方法梳理了PTSD中肠道微生物群改变的研究进展，并分别比较了动物模型和人类患者之间特定微生物分类群（如 、 、 ）变化的特征、微生物群多样性指数（α/β多样性）以及炎症标志物（如IL - 6、TNF - α）的水平，以便进一步探索微生物介导的潜在致病机制，如影响迷走神经通路、下丘脑 - 垂体 - 肾上腺（HPA）轴功能、免疫系统以及PTSD病理过程中涉及的其他过程，并总结了针对肠道微生态的干预策略，如补充益生菌、饮食干预和粪便细菌移植。
