The Microbiome-Mental health axis: a new frontier in managing depression and anxiety

Wendy de Klerk

Authors

Wendy de Klerk Ann Latsky College of Nursing, Hurst Hill, Johannesburg, 2092, South Africa.

Keywords:

Gut Microbiome, Gut Brain Connection, Depression, Anxiety, Prebiotics.

Abstract

The gut microbiome, in turn, has significant effects on mental health via the gut-brain axis, affecting depression and anxiety systems through the neural, immune, and metabolic systems. The study is a synthesis of 2020-2025 research about such mechanisms of neuroinflammation, the creation of neurotransmitters, and the metabolism of short-chain fatty acids (SCFA), as well as interventions such as using probiotics, prebiotics, dietary additions, and even a medical process known as fecal microbiota transplantation (FMT). This was done through a systematic literature search that gave 85 peer-reviewed works across PubMed, Scopus, and PsycINFO. Results support the connection between microbial dysbiosis and the severity of mood disorders and demonstrate the possible clinical prospects of this connection, although the remaining problems, such as the variation of the results in diverse patients and scarce clinical trials, remain. Microbial profiles, outcomes of interventions, and research designs are described with the help of tables and figures. Future development focuses on individualized treatments, the increased scale of trials, and integrations to promote mental health.

References

Cryan JF, O'Riordan KJ, Cowan CS, Sandhu KV, Bastiaanssen TF, Boehme M, et al. The microbiota-gut-brain axis. Physiol Rev. 2019;99(4):1877-2013. https://doi.org/10.1152/physrev.00018.2018

Dinan TG, Cryan JF. Gut instincts: microbiota as a key regulator of brain development, ageing and neurodegeneration. J Physiol. 2017;595(2):489-503. https://doi.org/10.1113/jp273106

Simpson CA, Diaz-Arteche C, Eliby D, Schwartz OS, Simmons JG, Cowan CS. The gut microbiota in anxiety and depression—A systematic review. Clin Psychol Rev. 2021;83:101943. https://doi.org/10.1016/j.cpr.2020.101943

Cipriani A, Furukawa TA, Salanti G, Chaimani A, Atkinson LZ, Ogawa Y, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet. 2018;391(10128):1357-1366. https://doi.org/10.1016/S0140-6736(17)32802-7

Liu RT, Walsh RF, Sheehan AE. Prebiotics and probiotics for depression and anxiety: A systematic review and meta-analysis of controlled clinical trials. Neurosci Biobehav Rev. 2019;102:13-23. https://doi.org/10.1016/j.neubiorev.2019.03.023

Bravo JA, Forsythe P, Chew MV, Escaravage E, Savignac HM, Dinan TG, et al. Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Proc Natl Acad Sci U S A. 2011;108(38):16050-16055. https://doi.org/10.1073/pnas.1102999108

Reininghaus EZ, Platzer M, Kohlhammer-Dohr A, Hamm C, Mörkl S, Bengesser SA, et al. PROVIT: Supplementary Probiotic Treatment and Vitamin B7 in Depression—A Randomized Controlled Trial. Nutrients. 2020;12(11):3422. https://doi.org/10.3390/nu12113422

Johnstone N, Milesi C, Burn O, et al. Anxiolytic effects of a galacto-oligosaccharide prebiotic in healthy females (18–25 years) with corresponding changes in gut bacterial composition. Sci Rep. 2021;11:8302. https://doi.org/10.1038/s41598-021-87865-w

Valles-Colomer M, Falony G, Darzi Y, et al. The neuroactive potential of the human gut microbiota in quality of life and depression. Nat Microbiol. 2019;4:623–632. https://doi.org/10.1038/s41564-018-0337-x

Sandhu KV, Sherwin E, Schellekens H, Stanton C, Dinan TG, Cryan JF. Feeding the microbiota-gut-brain axis: diet, microbiome, and neuropsychiatry. Transl Res. 2017;179:223-244. https://doi.org/10.1016/j.trsl.2016.10.002

Schmidt K, Cowen PJ, Harmer CJ, et al. Prebiotic intake reduces the waking cortisol response and alters emotional bias in healthy volunteers. Psychopharmacology. 2015;232:1793–1801. https://doi.org/10.1007/s00213-014-3810-0

Marx W, Lane M, Hockey M, et al. Diet and depression: exploring the biological mechanisms of action. Mol Psychiatry. 2021;26:134–150. https://doi.org/10.1038/s41380-020-00925-x

Sánchez-Villegas A, Martínez-González MA, Estruch R, et al. Mediterranean dietary pattern and depression: the PREDIMED randomized trial. BMC Med. 2013;11:208. https://doi.org/10.1186/1741-7015-11-208

Burokas A, Arboleya S, Moloney RD, Peterson VL, Murphy K, Clarke G, et al. Targeting the microbiota-gut-brain axis: Prebiotics have anxiolytic and antidepressant-like effects and reverse the impact of chronic stress in mice. Biol Psychiatry. 2017;82(7):472-487. https://doi.org/10.1016/j.biopsych.2016.12.031

Nikolova VL, Smith MRB, Hall LJ, Cleare AJ, Stone JM, Young AH. Perturbations in Gut Microbiota Composition in Psychiatric Disorders: A Review and Meta-analysis. JAMA Psychiatry. 2021;78(12):1343-1354. https://doi.org/10.1001/jamapsychiatry.2021.2573

Huang R, Wang K, Hu J. Effect of probiotics on depression: a systematic review and meta-analysis of randomized controlled trials. Nutrients. 2016;8(8):483. https://doi.org/10.3390/nu8080483

Allen A, Hutch W, Borre Y, et al. Bifidobacterium longum 1714 as a translational psychobiotic: modulation of stress, electrophysiology, and neurocognition in healthy volunteers. Transl Psychiatry. 2016;6:e939. https://doi.org/10.1038/tp.2016.191

Jacka FN, O’Neil A, Opie R, et al. A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial). BMC Med. 2017;15:23. https://doi.org/10.1186/s12916-017-0791-y

Kelly JR, Minuto C, Cryan JF, Clarke G, Dinan TG. The role of the gut microbiome in the development of schizophrenia. Schizophr Res. 2021;234:4-23. https://doi.org/10.1016/j.schres.2020.02.010

Zmora N, Zilberman-Schapira G, Suez J, Mor U, Dori-Bachash M, Bashiardes S, et al. Personalized gut mucosal colonization resistance to empiric probiotics is associated with unique host and microbiome features. Cell. 2018;174(6):1388-1405. https://doi.org/10.1016/j.cell.2018.08.041

Strandwitz P. Neurotransmitter modulation by the gut microbiota. Brain Res. 2018;1693:128-133. https://doi.org/10.1016/j.brainres.2018.03.015

DeFilipp Z, Bloom PP, Torres Soto M, Mansour MK, Sater MR, Huntley MH, et al. Drug-resistant E. coli bacteremia transmitted by fecal microbiota transplant. N Engl J Med. 2019;381(21):2043-2050. https://doi.org/10.1056/NEJMoa1910437

Messaoudi M, Lalonde R, Violle N, et al. Assessment of psychotropic-like properties of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects. Br J Nutr. 2011;105(5):755-764. https://doi.org/10.1017/S0007114510004319

Degnan FH. The US Food and Drug Administration and probiotics: regulatory categorization. Clin Infect Dis. 2008;46(Suppl 2):S133-S136. https://doi.org/10.1086/523324

World Health Organization. Depression and other common mental disorders: global health estimates. Geneva: World Health Organization; 2017. https://iris.who.int/handle/10665/254610