본문 바로가기
KERD
논문KCI 등재

Neuroinflammation, Gut-Brain Axis and Depression

2

조회

0

다운로드

2

인용

0

참고문헌

키워드

주제분류정신과학

초록

Psychiatric diseases are the manifestations that result from the individual’s genetic structure, physiology, immunology and ways of coping with environmental stressors. The current psychiatric diagnostic systems do not include any systematic characterization in regard to neurobiological processes that reveal the clinical picture in individuals who got psychiatric diagnosis. It is obvious that further research in different areas is needed to understand the psychopathology. The problems in the functions of immune system and the correlation of neuroinflammatory processes with psychiatric disorders have been one of the main research topics of psychiatry in recent years and have contributed to our understanding of psychopathology. Recent advances in the fields of immunology and genetics as well as rapidly increasing knowledge on the effects of immunological processes on brain functions have drawn attention to the correlations between psychiatric disorders and immune system dysfunctions. There are still unfilled gaps in the biology, pathophysiology, and treatment of major depressive disorder, which is quite prevalent among the psychiatric disorders, can lead to significant disability, and frequently has a recurrent course. It appears that low-grade chronic neuroinflammation plays a key role in forming a basis for the interaction between psychological stress, impaired gut microbiota and major depressive disorder. In this review, the role of neuroinflammation in the etiopathogenesis of depression and the mechanism of action of the gut-brain axis that leads to this are discussed in the light of current studies.

Abstract

Psychiatric diseases are the manifestations that result from the individual’s genetic structure, physiology, immunology and ways of coping with environmental stressors. The current psychiatric diagnostic systems do not include any systematic characterization in regard to neurobiological processes that reveal the clinical picture in individuals who got psychiatric diagnosis. It is obvious that further research in different areas is needed to understand the psychopathology. The problems in the functions of immune system and the correlation of neuroinflammatory processes with psychiatric disorders have been one of the main research topics of psychiatry in recent years and have contributed to our understanding of psychopathology. Recent advances in the fields of immunology and genetics as well as rapidly increasing knowledge on the effects of immunological processes on brain functions have drawn attention to the correlations between psychiatric disorders and immune system dysfunctions. There are still unfilled gaps in the biology, pathophysiology, and treatment of major depressive disorder, which is quite prevalent among the psychiatric disorders, can lead to significant disability, and frequently has a recurrent course. It appears that low-grade chronic neuroinflammation plays a key role in forming a basis for the interaction between psychological stress, impaired gut microbiota and major depressive disorder. In this review, the role of neuroinflammation in the etiopathogenesis of depression and the mechanism of action of the gut-brain axis that leads to this are discussed in the light of current studies.

참고문헌 (82)

  1. Gerhard DM, "Emerging treatment mechanisms for depression : focus on glutamate and synaptic plasticity", Drug Discov Today, 21, pp.454~464 (2016)
  2. Ledford H, "Medical research : if depression were cancer", Nature, 515, pp.182~184 (2014)
  3. Smith K, "Mental health : a world of depression", Nature, 515, pp.181~ (2014)
  4. Belmaker RH, "Major depression disorder", N Engl J Med, 358, pp.55~68 (2008)
  5. Corfield EC, "A continuum of genetic liability for minor and major depression", Transl Psychiatry, 7, pp.e1131~ (2017)
  6. Bukh JD, "Interaction between genetic polymorphisms and stressful life events in first episode depression", J Affect Disord, 119, pp.107~115 (2009)
  7. Alper Evrensel, "The Gut-Brain Axis: The Missing Link in Depression", Clinical Psychopharmacology and Neuroscience, 13(3), pp.239~244 (2015), 대한정신약물학회
  8. Evrensel A, "Frontiers in Psychiatry. Advances in Experimental Medicine and Biology, vol 1192", pp.565~581 (2019), Springer
  9. Stahl SM, "Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications" (2013), Cambridge University Press
  10. Pytka K, "The role of glutamatergic, gaba-ergic, and cholinergic receptors in depression and antidepressant-like effect", Pharmacol Rep, 68, pp.443~450 (2016)
  11. Liu B, "From serotonin to neuroplasticity : evolvement of theories for major depressive disorder", Front Cell Neurosci, 11, pp.305~ (2017)
  12. Barden N, "Implication of the hypothalamic-pituitary-adrenal axis in the physiopathology of depression", J Psychiatry Neurosci, 29, pp.185~193 (2004)
  13. Juruena MF, "The hypothalamic pituitary adrenal axis, glucocorticoid receptor function and relevance to depression", Braz J Psychiatry, 26, pp.189~201 (2004)
  14. Evrensel A, "Therapeutic potential of the microbiome in the treatment of neuropsychiatric disorders", Med Sci(Basel), 7, pp.21~ (2019)
  15. Seferovic MD, "Visualization of microbes by 16s in situ hybridization in term and preterm placentae without ıntraamniotic ınfection", Am J Obstet Gynecol, 221, pp.146.e1~146.e23 (2019)
  16. Honda K, "The microbiota in adaptive immune homeostasis and disease", Nature, 535, pp.75~84 (2016)
  17. Sudo N, "Microbiome, HPA axis and production of endocrine hormones in the gut", Adv Exp Med Biol, 817, pp.177~194 (2014)
  18. Bien-Ly N, "The blood-brain barrier’s gut check", Sci Transl Med, 6, pp.263fs46~ (2014)
  19. Ogbonnaya ES, "Adult hippocampal neurogenesis ıs regulated by the microbiome", Biol Psychiatry, 78, pp.e7~e9 (2015)
  20. Hoban AE, "Regulation of prefrontal cortex myelination by the microbiota", Transl Psychiatry, 6, pp.e774~ (2016)
  21. Jiang H, "Altered fecal microbiota composition in patients with major depressive disorder", Brain Behav Immun, 48, pp.186~194 (2015)
  22. Liu Y, "Similar fecal microbiota signatures in patients with diarrhea-predominant irritable bowel syndrome and patients with depression", Clin Gastroenterol Hepatol, 14, pp.1602~1611 (2016)
  23. Aizawa E, "Possible association of bifidobacterium and lactobacillus in the gut microbiota of patients with major depressive disorder", J Affect Disord, 202, pp.254~257 (2016)
  24. Park AJ, "Altered colonic function and microbiota profile in a mouse model of chronic depression", Neurogastroenterol Motil, 25, pp.733~e575 (2013)
  25. Yu M, "Variations in gut microbiota and fecal metabolic phenotype associated with depression by 16S rRNA gene sequencing and LC", MS-based metabolomics, 2017, pp.138, 231~239
  26. Lin P, "Prevotella and Klebsiella proportions in fecal microbial communities are potential characteristic parameters for patients with major depressive disorder", J Affect Disord, 207, pp.300~304 (2017)
  27. Zheng P, "Gut microbiome remodeling induces depressive-like behaviors through a pathway mediated by the host’s metabolism", Mol Psychiatry, 21, pp.786~796 (2016)
  28. Kelly JR, "Transferring the blues : Depression-associated gut microbiota ınduces neurobehavioural changes in the rat", J Psychiatr Res, 82, pp.109~118 (2016)
  29. GBD 2016 DALYs and HALE Collaborators, "Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016", Lancet, 390, pp.1260~1344 (2017)
  30. Lurie I, "Antibiotic exposure and the risk for depression, anxiety, or psychosis : a nested case-control study", J Clin Psychiatry, 76, pp.1522~1528 (2015)
  31. Frohlich EE; Farzi A, "Cognitive impairment by antibiotic-ınduced gut dysbiosis : analysis of gut microbiota-brain communication", Brain Behav Immun, 56, pp.140~155 (2016)
  32. Bercik P, "The effects of inflammation, infection and antibiotics on the microbiota-gut-brain axis", Adv Exp Med Biol, 817, pp.279~289 (2014)
  33. Kohler O, "Infections and exposure to anti-ınfective agents and the risk of severe mental disorders : A nationwide study", Acta Psychiatr Scand, 135, pp.97~105 (2017)
  34. Slykerman RF, "Antibiotics in the first year of life and subsequent neurocognitive outcomes", Acta Paediatr, 106, pp.87~94 (2017)
  35. Slykerman RF, "Exposure to antibiotics in the first 24 months of life and neurocognitive outcomes at 11 years of age", Psychopharmacology(Berl), 236, pp.1573~1582 (2019)
  36. Bereswill S, "A possible link between food and mood : dietary ımpact on gut microbiota and behavior in BALB", c mice, 2014, pp.9, e103398~
  37. Oriach CS, "Food for thought : the role of nutrition in the microbiota-gut–brain axis", Clin Nutr Exp, 6, pp.25~38 (2016)
  38. Owen L, "The role of diet and nutrition on mental health and wellbeing", Proc Nutr Soc, 76, pp.425~426 (2017)
  39. Slyepchenko A, "Gut microbiota, bacterial translocation, and ınteractions with diet : pathophysiological links between major depressive disorder and non-communicable medical comorbidities", Psychother Psychosom, 86, pp.31~46 (2017)
  40. Noble EE, "Gut to brain dysbiosis : mechanisms linking western diet consumption, the microbiome, and cognitive ımpairment", Front Behav Neurosci, 1, pp.9~ (2017)
  41. Jeon SW, "The role of neuroinflammation and neurovascular dysfunction in major depressive disorder", J Inflamm Res, 11, pp.179~192 (2018)
  42. Carvalho LA, "Lack of clinical therapeutic benefit of antidepressants is associated overall activation of the inflammatory system", J Affect Disord, 148, pp.136~140 (2013)
  43. Kiecolt-Glaser JK, "Inflammation : depression fans the flames and feasts on the heat", Am J Psychiatry, 172, pp.1075~1091 (2015)
  44. Miller AH, "The role of inflammation in depression : from evolutionary imperative to modern treatment target", Nat Rev Immunol, 16, pp.22~34 (2016)
  45. Woelfer M, "The role of depressive subtypes within the neuroinflammation hypothesis of major depressive disorder", Neuroscience, 403, pp.93~110 (2019)
  46. Song C, "Cytokines mediated inflammation and decreased neurogenesis in animal models of depression", Prog Neuropsychopharmacol Biol Psychiatry, 35, pp.760~768 (2011)
  47. Dantzer R, "From inflammation to sickness and depression : when the immune system subjugates the brain", Nat Rev Neurosci, 9, pp.46~56 (2008)
  48. Berk M, "So depression is an inflammatory disease, but where does the inflammation come from?", BMC Med, 11, pp.200~ (2013)
  49. Moylan S, "Oxidative and nitrosative stress in depression: why so much stress?", Neurosci Biobehav Rev, 45, pp.46~62 (2014)
  50. Shelton RC, "Eating ourselves to death(and despair) : the contribution of adiposity and in ammation to depression", Prog Neurobiol, 91, pp.275~299 (2010)
  51. Raison CL, "Inflammatory depression : a trifecta of trouble", J Clin Psychiatry, 75, pp.663~664 (2014)
  52. Kopschina Feltes P, "Anti-inflammatory treatment for major depressive disorder : implications for patients with an elevated immune profile and non-responders to standard antidepressant therapy", J Psychopharmacol, 31, pp.1149~1165 (2017)
  53. Dowlati Y, "A meta-analysis of cytokines in major depression", Biol Psychiatry, 67, pp.446~457 (2010)
  54. Smith RS, "The macrophage theory of depression", Med Hypotheses, 35, pp.298~306 (1991)
  55. Liu Y, "Interleukin(IL)-6, tumour necrosis factor alpha(TNF-α)and soluble interleukin-2 receptors(sIL-2R)are elevated in patients with major depressive dis-order : a meta-analysis and meta-regression", J Affect Disord, 139, pp.230~239 (2012)
  56. Sukoff Rizzo SJ, "Evidence for sustained elevation of IL-6 in the CNS as a key contributor of depressive-like phenotypes", Transl Psychiatry, 2, pp.e199~ (2012)
  57. Rawdin B, "Dysregulated relationship of inflammation and oxidative stress in major depression", Brain Behav Immun, 31, pp.143~152 (2013)
  58. Krogh J, "The association between depressive symptoms, cognitive function, and inflammation in major depression", Brain Behav Immun, 35, pp.70~76 (2014)
  59. Lanquillon S, "Cytokine production and treatment response in major depressive disorder", Neuropsychopharmacol, 22, pp.370~379 (2000)
  60. O’Brien SM, "Cytokines : abnormalities in major depression and implications for pharmacological treatment", Hum Psychopharmacol, 19, pp.397~403 (2004)
  61. Agus A, "Gut microbiota regulation of tryptophan metabolism in health and disease", Cell Host Microbe, 23, pp.716~724 (2018)
  62. Maes M, "The gut-brain barrier in major depression : intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria(leaky gut)plays a role in the inflammatory pathophysiology of depression", Neuro Endocrinol Lett, 29, pp.117~124 (2008)
  63. Zhang JC, "Blockade of interleukin-6 receptor in the periphery promotes rapid and sustained antidepressant actions: a possible role of gut-microbiota-brain axis", Transl Psychiatry, 7, pp.e1138~ (2017)
  64. Rieder R, "Microbes and mental health : a review", Brain Behav Immun, 66, pp.9~17 (2017)
  65. Grenham S, "Brain-gut-microbe communication in health and disease", Front Physiol, 2, pp.94~ (2011)
  66. Alper Evrensel, "Fecal Microbiota Transplantation and Its Usage in Neuropsychiatric Disorders", Clinical Psychopharmacology and Neuroscience, 14(3), pp.231~237 (2016), 대한정신약물학회
  67. Sandhu KV, "Feeding the microbiota-gut-brain axis : Diet, microbiome, and neuropsychiatry", Transl Res, 179, pp.223~244 (2017)
  68. Gibson GR, "Expert consensus document : The International Scientific Association For Probiotics And Prebiotics(ISAPP)consensus statement on the definition and scope of prebiotics", Nat Rev Gastroenterol Hepatol, 14, pp.491~502 (2017)
  69. Bollrath J, "Immunology. Feed your Tregs more fiber", Science, 341, pp.463~464 (2013)
  70. Dinan TG, "Psychobiotics : A novel class of psychotropic", Biol Psychiatry, 74, pp.720~726 (2013)
  71. Phillips JGP, "The treatment of melancholia by the lactic acid bacillus", Br J Psychiatry, 56, pp.422~431 (1910)
  72. Pirbaglou M, "Probiotic supplementation can positively affect anxiety and depressive symptoms : a systematic review of randomized controlled trials", Nutr Res, 36, pp.889~898 (2016)
  73. Wallace CJK, "The effects of probiotics on depressive symptoms in humans : A systematic review", Ann Gen Psychiatry, 16, pp.14~ (2017)
  74. Liang S, "Administration of Lactobacillus helveticus NS8 improves behavioral, cognitive, and biochemical aberrations caused by chronic restraint stress", Neuroscience, 310, pp.561~577 (2015)
  75. Akkasheh G, "Clinical and metabolic response to probiotic administration in patients with major depressive disorder : A randomized, double-blind, placebo-controlled trial", Nutrition, 32, pp.315~320 (2016)
  76. Abildgaard A, "Probiotic treatment reduces depressive-like behaviour in rats independently of diet", Psychoneuroendocrinology, 79, pp.40~48 (2017)
  77. Evrensel A, "Treatment Resistance in Psychiatry", pp.369~376 (2019), Springer
  78. Evrensel A, "The effect of fecal microbiota transplantation on psychiatric symptoms among patients with inflammatory bowel disease: an experimental study", Actas Esp Psiquiatr (2019)
  79. Stahl SM, "Beyond the dopamine hypothesis of schizophrenia to three neural networks of psychosis : dopamine, serotonin, and glutamate", CNS Spectrums, 23, pp.187~191 (2018)
  80. Macedo D, "Antidepressants, antimicrobials or both? Gut microbiota dysbiosis in depression and possible ımplications of the antimicrobial effects of antidepressant drugs for antidepressant effectiveness", J Affect Disord, 208, pp.22~32 (2017)
  81. Bambling M, "Combination of probiotics and magnesium orotate attenuate depression in a small SSRI resistant cohort : an intestinal anti-inflammatory response is suggested", Inflammopharmacology, 25, pp.271~274 (2017)
  82. Ng QX, "A meta-analysis of the use of probiotics to alleviate depressive symptoms", J Affect Disord, 228, pp.13~19 (2018)

관련 논문AI추천

이 간행물의 다른 논문 (10건)