Abstrakt

Depresja jest coraz powszechniej występującą chorobą, znacznie obniżającą jakość życia. Liczba chorych stale rośnie, szczególnie wśród młodych osób. Istnieje wiele prawdopodobnych przyczyn powstawania depresji związanych z funkcjonowaniem organizmu, jak i z czynnikami środowiskowymi. Przypuszcza się, że w powstawaniu objawów depresyjnych istotną rolę może odgrywać mikrobiota jelitowa. Jej różnorodność jest ważna dla prawidłowego rozwoju i funkcjonowania układu nerwowego, w czym istotną rolę odgrywa oś mózgowo-jelitowa, czyli droga komunikacji drobnoustrojów jelitowych z ośrodkowym układem nerwowym. Zmiany liczebności i różnorodności mikrobioty jelitowej wywierają wpływ na wiele szlaków potencjalnie powiązanych z nastrojem, m.in. oś podwzgórze-przysadka-nadnercza, metabolizm tryptofanu, a także na syntezę neuroprzekaźników, krótkołańcuchowych kwasów tłuszczowych (SCFA, short chain fatty acids) i BDNF (neurotroficzny czynnik pochodzenia mózgowego, brain-derived neurotrophic factor). Zmiany te mogą również wpływać na reakcję układu immunologicznego i przebieg procesów zapalnych. Dlatego wydaje się, że modulacja mikrobioty jelitowej poprzez składniki diety oraz suplementację probiotyczną może być niezmiernie ważna w zwalczaniu depresji, także jako jedna z metod leczenia tej opornej na farmakoterapię. W artykule omówiono wpływ mikrobioty jelitowej i jej zmian na samopoczucie pacjentów chorych na depresję.

Przypisy

• 1. Ait-Belgnaoui A., Colom A., Braniste V., Ramalho L., Marrot A.,Cartier C., Houdeau E., Theodorou V., Tompkins T.: Probiotic guteffect prevents the chronic psychological stress-induced brainactivity abnormality in mice. Neurogastroenterol. Motil., 2014;26: 510–520
  Google Scholar
• 2. Akkasheh G., Kashani-Poor Z., Tajabadi-Ebrahimi M., Jafari P.,Akbari H., Taghizadeh M., Memarzadeh M.R., Asemi Z., EsmaillzadehA.: Clinical and metabolic response to probiotic administrationin patients with major depressive disorder: A randomized,double-blind, placebo-controlled trial. Nutrition, 2016; 32: 315–320
  Google Scholar
• 3. Bangsgaard Bendtsen K.M., Krych L., Sørensen D.B., Pang W.,Nielsen D.S., Josefsen K., Hansen L.H., Sørensen S.J., Hansen A.K.:Gut microbiota composition is correlated to grid floor inducedstress and behavior in the BALB/c mouse. PLoS One, 2012; 7: e46231
  Google Scholar
• 4. Barrett E., Ross R.P., O’Toole P.W., Fitzgerald G.F., Stanton C.:γ-Aminobutyric acid production by culturable bacteria from thehuman intestine. J. Appl. Microbiol., 2012; 113: 411–417
  Google Scholar
• 5. Belmaker R.H., Agam G.: Major depressive disorder. N. Engl.J. Med., 2008; 358: 55–68
  Google Scholar
• 6. Bercik P., Denou E., Collins J., Jackson W., Lu J., Jury J., Deng Y.,Blennerhassett P., Macri J., McCoy K.D., Verdu E.F., Collins S.M.:The intestinal microbiota affect central levels of brain-derivedneurotropic factor and behavior in mice. Gastroenterology, 2011;141: 599–609
  Google Scholar
• 7. Berk M., Williams L.J., Jacka F.N., O’Neil A., Pasco J.A., Moylan S.,Allen N.B., Stuart A.L., Hayley A.C., Byrne M.L., Maes M.: So depressionis an inflammatory disease, but where does the inflammationcome from? BMC Med., 2013; 11: 200
  Google Scholar
• 8. Bravo J.A., Forsythe P., Chew M.V., Escaravage E., Savignac H.M.,Dinan T.G., Bienenstock J., Cryan J.F.: Ingestion of Lactobacillusstrain regulates emotional behavior and central GABA receptorexpression in a mouse via the vagus nerve. Proc. Natl. Acad. Sci.USA, 2011; 108: 16050–16055
  Google Scholar
• 9. Brunoni A.R., Baeken C., Machado-Vieira R., Gattaz W.F., VanderhasseltM.A.: BDNF blood levels after electroconvulsive therapyin patients with mood disorders: A systematic review and meta–analysis. World J. Biol. Psychiatry, 2014; 15: 411–418
  Google Scholar
• 10. Burokas A., Arboleya S., Moloney R.D., Peterson V.L., MurphyK., Clarke G., Stanton C., Dinan T.G., Cryan J.F.: Targeting the microbiotagut-brain axis: Prebiotics have anxio-lytic and antidepressant-like effects and reverse the impact of chronic stress in mice.Biol. Psychiatry, 2017; 82: 472–487
  Google Scholar
• 11. Butler M.I., Sandhu K., Cryan J.F., Dinan T.G.: From isoniazid topsychobiotics: The gut microbiome as a new antidepressant target.Br. J. Hosp. Med., 2019; 80: 139–145
  Google Scholar
• 12. Dantzer R., O’Connor J.C., Freund G.G., Johnson R.W., KelleyK.W.: From inflammation to sickness and depression: When theimmune system subjugates the brain. Nat. Rev. Neurosci., 2008;9: 46–56
  Google Scholar
• 13. Desbonnet L., Garrett L., Clarke G., Bienenstock J., Dinan T.G.:The probiotic Bifidobacteria infantis: An assessment of potentialantidepressant properties in the rat. J. Psychiatr. Res., 2008; 43:164–174
  Google Scholar
• 14. Desbonnet L., Garrett L., Clarke G., Kiely B., Cryan J.F., DinanT.G.: Effects of the probiotic Bifidobacterium infantis in the maternalseparation model of depression. Neurosci-ence, 2010; 170:1179–1188
  Google Scholar
• 15. Dinan T.G., Cryan J.F.: The microbiome-gut-brain axis in healthand disease. Gastroen-terol. Clin. North. Am., 2017; 46: 77–89
  Google Scholar
• 16. Dinan T.G., Stanton C., Cryan J.F.: Psychobiotics: A novel classof psychotropic. Biol. Psychiatry, 2013; 74: 720–726
  Google Scholar
• 17. Duclot F., Kabbaj M.: Epigenetic mechanisms underlying therole of brain-derived neurotrophic factor in depression and responseto antidepressants. J. Exp. Biol., 2015; 218: 21–31
  Google Scholar
• 18. El Aidy S., Dinan T.G., Cryan J.F.: Immune modulation of thebraingut-microbe axis. Front. Microbiol., 2014; 5: 146
  Google Scholar
• 19. Evrensel A., Ceylan M.E.: The gut-brain axis: The missing linkin depression. Clin. Psychopharmacol. Neurosci., 2015; 13: 239–244
  Google Scholar
• 20. Guida F., Turco F., Iannotta M., De Gregorio D., Palumbo I.,Sarnelli G., Furiano A., Napolitano F., Boccella S., Luongo L., MazzitelliM., Usiello A., De Filippis F., Iannotti F.A., Piscitelli F. i wsp.:Antibiotic-induced microbiota perturbation causes gut endocannabinoidomechanges, hippocampal neuroglial reorganization anddepression in mice. Brain. Behav. Immun., 2018; 67: 230–245
  Google Scholar
• 21. Han A., Sung Y.B., Chung S.Y., Kwon M.S.: Possible additionalantidepressant-like mechanism of sodium butyrate: Targeting thehippocampus. Neuropharmacology, 2014; 81: 292–302
  Google Scholar
• 22. Hasler G.: Pathophysiology of depression: Do we have anysolid evidence of interest to clinicians? World Psychiatry, 2010;9: 155–161
  Google Scholar
• 23. Iannone L.F., Preda A., Blottière H.M., Clarke G., Albani D.,Belcastro V., Carotenuto M., Cattaneo A., Citraro R., Ferraris C.,Ronchi F., Luongo G., Santocchi E., Guiducci L., Baldelli P. i wsp.:Microbiota-gut brain axis involvement in neuropsychiatric disorders.Expert. Rev. Neurother., 2019; 19: 1037–1050
  Google Scholar
• 24. Inserra A., Rogers G.B., Licinio J., Wong M.L.: The microbiota–inflammasome hypothesis of major depression. Bioessays, 2018;40: e1800027
  Google Scholar
• 25. Kelly J.R., Allen A.P., Temko A., Hutch W., Kennedy P.J., Farid N., Murphy E., Boylan G., Bienenstock J., Cryan J.F., Clarke G., DinanT.G.: Lost in translation? The potential psychobiotic Lactobacillusrhamnosus (JB-1) fails to modulate stress or cognitive performancein healthy male subjects. Brain Behav. Immun., 2017; 61: 50–59
  Google Scholar
• 26. Kelly J.R., Borre Y., O’ Brien C., Patterson E., El Aidy S., DeaneJ., Kennedy P.J., Beers S., Scott K., Moloney G., Hoban A.E., ScottL., Fitzgerald P., Ross P., Stanton C., Clarke G., Cryan J.F., DinanT.G.: Transferring the blues: Depression-associated gut microbiotainduces neurobehavioural changes in the rat. J. Psychiatr. Res.,2016; 82: 109–118
  Google Scholar
• 27. Köhler C.A., Freitas T.H., Maes M., de Andrade N.Q., Liu C.S.,Fernandes B.S., Stubbs B., Solmi M., Veronese N., Herrmann N.,Raison C.L., Miller B.J., Lanctôt K.L., Carvalho A.F.: Peripheral cytokineand chemokine alterations in depression: A meta-analysisof 82 studies. Acta. Psychiatr. Scand., 2017; 135: 373–387
  Google Scholar
• 28. Köhler C.A., Freitas T.H., Stubbs B., Maes M., Solmi M., VeroneseN., de Andrade N.Q., Morris G., Fernandes B.S., Brunoni A.R.,Herrmann N., Raison C.L., Miller B.J., Lanctôt K.L., Carvalho A.F.:Peripheral alterations in cytokine and chemokine levels after antidepressantdrug treatment for major depressive disorder: Systematicreview and meta-analysis. Mol. Neurobiol., 2018; 55: 4195–4206
  Google Scholar
• 29. Kopp M.V., Goldstein M., Dietschek A., Sofke J., HeinzmannA., Urbanek R.: Lactoba-cillus GG has in vitro effects on enhancedinterleukin-10 and interferon-γ release of mononuclear cells butno in vivo effects in supplemented mothers and their neonates.Clin. Exp. Allergy, 2008; 38: 602–610
  Google Scholar
• 30. Kunugi H., Hori H., Adachi N., Numakawa T.: Interface betweenhypothalamic-pituitary-adrenal axis and brain-derived neurotrophicfactor in depression. Psychiatry Clin. Neurosci., 2010;64: 447–459
  Google Scholar
• 31. Levkovich T., Poutahidis T., Smillie C., Varian B.J., IbrahimY.M., Lakritz J.R., Alm E.J., Erdman S.E.: Probiotic bacteria inducea ‘glow of health’. PLoS One, 2013; 8: e53867
  Google Scholar
• 32. Liang S., Wang T., Hu X., Luo J., Li W., Wu X., Duan Y., Jin F.: Administrationof Lactobacillus helveticus NS8 improves behavioral,cognitive, and biochemical aberrations caused by chronic restraintstress. Neuroscience, 2015; 310: 561–577
  Google Scholar
• 33. Liang S., Wu X., Hu X., Wang T., Jin F.: Recognizing depressionfrom the microbiota-gut-brain axis. Int. J. Mol. Sci., 2018; 29; 1592
  Google Scholar
• 34. Liu W.H., Chuang H.L., Huang Y.T., Wu C.C., Chou G.T., Wang S.,Tsai Y.C.: Alteration of behavior and monoamine levels attributableto Lactobacillus plantarum PS128 in germ-free mice. Behav. BrainRes., 2016; 298: 202–209
  Google Scholar
• 35. Lombardi V.C., De Meirleir K.L., Subramanian K., Nourani S.M.,Dagda R.K., Delaney S.L., Palotás A.: Nutritional modulation ofthe intestinal microbiota; future opportunities for the preventionand treatment of neuroimmune and neuroinflammatory disease.J. Nutr. Biochem., 2018; 61: 1–16
  Google Scholar
• 36. Lukić I., Getselter D., Koren O., Elliott E.: Role of tryptophanin microbiota-induced depressive-like behavior: Evidence fromtryptophan depletion study. Front. Behav. Neuro-sci., 2019; 13: 123
  Google Scholar
• 37. Lyte M.: Microbial endocrinology and the microbiota-gut-brainaxis. Adv. Exp. Med. Biol., 2014; 817: 3–24
  Google Scholar
• 38. Lyte M.: Microbial endocrinology in the microbiome-gut-brainaxis: how bacterial production and utilization of neurochemicalsinfluence behavior. PLoS Pathog., 2013; 9: e1003726
  Google Scholar
• 39. Messaoudi M., Violle N., Bisson J.F., Desor D., Javelot H., RougeotC.: Beneficial psychological effects of a probiotic formulation(Lactobacillus helveticus R0052 and Bifidobacterium longumR0175) in healthy human volunteers. Gut Microbes, 2011;2: 256–261
  Google Scholar
• 40. Misra S., Mohanty D.: Psychobiotics: A new approach for treatingmental illness? Crit. Rev. Food Sci. Nutr., 2019; 59: 1230–1236
  Google Scholar
• 41. Murawiec S., Wierzbiński P.: Depresja 2016. Via Medica,Gdańsk 2016
  Google Scholar
• 42. Naseribafrouei A., Hestad K., Avershina E., Sekelja M.,Linløkken A., Wilson R., Rudi K.: Correlation between the humanfecal microbiota and depression. Neurogastroenterol. Motil.,2014; 26: 1155–1162
  Google Scholar
• 43. Ogawa S., Fujii T., Koga N., Hori H., Teraishi T., Hattori K.,Noda T., Higuchi T., Moto-hashi N., Kunugi H.: Plasma L-tryptophanconcentration in major depressive disorder: New data andmeta-analysis. J. Clin. Psychiatry.; 2014; 75: e906–e915
  Google Scholar
• 44. O’Mahony S.M., Clarke G., Borre Y.E., Dinan T.G., Cryan J.F.:Serotonin, tryptophan metabolism and the brain-gut-microbiomeaxis. Behav. Brain Res., 2015; 277: 32–48
  Google Scholar
• 45. Pariante C.M., Lightman S.L.: The HPA axis in major depression:Classical theories and new developments. Trends Neurosci.,2008; 31: 464–468
  Google Scholar
• 46. Perez-Burgos A., Wang B., Mao Y.K., Mistry B., McVey NeufeldK.A., Bienenstock J., Kunze W.: Psychoactive bacteria Lactobacillusrhamnosus (JB-1) elicits rapid frequency facilitation invagal afferents. Am. J. Physiol. Gastrointest. Liver Physiol., 2013;304: G211–G220
  Google Scholar
• 47. Perry R.J., Peng L., Barry N.A., Cline G.W., Zhang D., CardoneR.L., Petersen K.F., Kibbey R.G., Goodman A.L., Shulman G.I.:Acetate mediates a microbiome-brain-β-cell axis to promotemetabolic syndrome. Nature, 2016; 534: 213–217
  Google Scholar
• 48. Piekarzewska M., Wieczorkowski R., Zajenkowska-KozłowskaA.: Stan zdrowia ludności Polski w 2014 roku. GUS, Warszawa 2016
  Google Scholar
• 49. Pinto-Sanchez M.I., Hall G.B., Ghajar K., Nardelli A., BolinoC., Lau J.T., Martin F.P., Cominetti O., Welsh C., Rieder A., TraynorJ., Gregory C., De Palma G., Pigrau M., Ford A.C. i wsp.: ProbioticBifidobacterium longum NCC3001 reduces depression scores andal-ters brain activity: A pilot study in patients with irritable bowelsyndrome. Gastroenterolo-gy, 2017; 153: 448–459.e8
  Google Scholar
• 50. Polyakova M., Schroeter M.L., Elzinga B.M., Holiga S., SchoenknechtP., de Kloet E.R., Molendijk M.L.: Brain-derived neurotrophicfactor and antidepressive effect of electroconvulsivetherapy: Systematic review and meta-analyses of the preclinicaland clinical literature. PLoS One, 2015; 10: e0141564
  Google Scholar
• 51. Pompili M., Lionetto L., Curto M., Forte A., Erbuto D., MonteboviF., Seretti M.E., Berardelli I., Serafini G.,Innamorati M.,Amore M., Baldessarini R.J., Girardi P., Simmaco M.: Tryptophanand kynurenine metabolites: Are they related to depression?Neuropsycho-biology, 2019; 77: 23–28
  Google Scholar
• 52. Rao A.V., Bested A.C., Beaulne T.M., Katzman M.A., Iorio C.,Berardi J.M., Logan A.C.: A randomized, double-blind, placebo–controlled pilot study of a probiotic in emotional symptoms ofchronic fatigue syndrome. Gut Pathog., 2009; 1: 6
  Google Scholar
• 53. Rios A.C., Maurya P.K., Pedrini M., Zeni-Graiff M., Asevedo E.,Mansur R.B., Wieck A., Grassi-Oliveira R., McIntyre R.S., HayashiM.A.F., Brietzke E.: Microbiota abnormalities and the therapeuticpotential of probiotics in the treatment of mood disorders. Rev.Neurosci., 2017; 28: 739–749
  Google Scholar
• 54. Rudzki L., Frank M., Szulc A., Gałęcka M., Szachta P, BarwinekD.: Od jelit do depresji – rola zaburzeń ciągłości bariery jelitoweji następcza aktywacja układu immunologicznego w zapalnej hipoteziedepresji. Neuropsychiatr. Neuropsychol., 2012; 7: 76–84
  Google Scholar
• 55. Savignac H.M., Corona G., Mills H., Chen L., Spencer J.P.,Tzortzis G., Burnet P.W.: Prebiotic feeding elevates central brainderived neurotrophic factor, N-methyl-D-aspartate receptor subunitsand D-serine. Neurochem. Int., 2013; 63: 756–764
  Google Scholar
• 56. Schmidt K., Cowen P.J., Harmer C.J., Tzortzis G., ErringtonS., Burnet P.W.: Prebiotic intake reduces the waking cortisol responseand alters emotional bias in healthy volunteers. Psychopharmacology,2015; 232: 1793–1801
  Google Scholar
• 57. Sherwin E., Dinan T.G., Cryan J.F.: Recent developments inunderstanding the role of the gut microbiota in brain health anddisease. Ann. N. Y. Acad. Sci., 2018; 1420: 5–25
  Google Scholar
• 58. Steck S.E., Shivappa N., Tabung F.K., Harmon B.E., Wirth M.D.,Hurley T.G., Hebert J.R.: The dietary inflammatory index: A newtool for assessing diet quality based on in-flammatory potential.The Digest, 2014; 49; 1–9
  Google Scholar
• 59. Steenbergen L., Sellaro R., van Hemert S., Bosch J.A., ColzatoL.S.: A randomized con-trolled trial to test the effect of multispeciesprobiotics on cognitive reactivity to sad mood. Brain Behav.Immun., 2015; 48: 258–264
  Google Scholar
• 60. Stilling R.M., Dinan T.G., Cryan J.F.: Microbial genes, brain &behaviour – epigenetic regulation of the gut-brain axis. GenesBrain Behav., 2014; 13: 69–86
  Google Scholar
• 61. Sublette M.E., Galfalvy H.C., Fuchs D., Lapidus M., GrunebaumM.F., Oquendo M.A., Mann J.J., Postolache T.T.: Plasma kynureninelevels are elevated in suicide attempters with major depressivedisorder. Brain Behav. Immun., 2011; 25: 1272–1278
  Google Scholar
• 62. Światowa Organizacja Zdrowia: Międzynarodowa StatystycznaKlasyfikacja Chorób i Problemów Zdrowotnych. ICD-10. CentrumSystemów Informacyjnych Ochrony Zdro-wia, 2008: 220–222
  Google Scholar
• 63. Takada M., Nishida K., Kataoka-Kato A., Gondo Y., IshikawaH., Suda K., Kawai M., Hoshi R., Watanabe O., Igarashi T., KuwanoY., Miyazaki K., Rokutan K.: Probiotic Lac-tobacillus casei strainShirota relieves stress-associated symptoms by modulating thegut-brain interaction in human and animal models. Neurogastroenterol.Motil., 2016; 28: 1027–1036
  Google Scholar
• 64. Tilg H., Moschen A.R.: Food, immunity, and the microbiome.Gastroenterology, 2015; 148: 1107–1119
  Google Scholar
• 65. Vlainić J.V., Šuran J., Vlainić T., Vukorep A.L.: Probiotics as anadjuvant therapy in ma-jor depressive disorder. Curr. Neuropharmacol.,2016; 14: 952–958
  Google Scholar
• 66. Wang J., Zhou Y., Chen K., Jing Y., He J., Sun H., Hu X.: Dietaryinflammatory index and depression: A meta-analysis. Public HealthNutr., 2019; 22: 654–660
  Google Scholar
• 67. Wu G.: Functional amino acids in growth, reproduction, andhealth. Adv. Nutr., 2010; 1: 31–37
  Google Scholar
• 68. Yu M., Jia H., Zhou C., Yang Y., Zhao Y., Yang M., Zou Z.: Variationsin gut microbio-ta and fecal metabolic phenotype associatedwith depression by 16S rRNA gene sequenc-ing and LC/MS-basedmetabolomics. J. Pharm. Biomed. Anal., 2017; 138: 231–239
  Google Scholar

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