粪菌移植通过微生物-肠-脑轴改善抑郁症的研究进展

Fecal microbiota transplantation to improve depression by modulating microbiota-gut-brain axis:a review

人类粪菌移植(fecal microbiota transplantation,FMT)早在19世纪50年代的西方医学中便有临床应用。FMT已被证明可以很好地缓解艰难梭菌感染(aostridium difficile infection,CDI)的胃肠道疾病,在调节微生物-肠-脑轴(microbiota-gut-brain axis,MGBA)从而改善抑郁症方面也有一定的应用和疗效。为了探讨粪菌移植通过调节微生物-肠-脑轴改善抑郁症的可能性,为抑郁症的改善提供新的思路和方法,本文参考了近5年的相关文献,梳理了抑郁症发生的微生物-肠-脑轴相关机制,主要有自主神经系统异常、下丘脑-垂体-肾上腺(hopothalamic-pituitary-adrenal,HPA)轴异常、肠神经系统异常、循环系统异常和"肠漏"假说等,就微生物-肠-脑轴与抑郁症的关系、FMT改善抑郁症的动物实验、临床试验、现状分析和未来展望等方面作一综述。目前粪菌移植在改善抑郁症上展现了很大的潜能,但仍需要更多的实验研究。

Since the 1850 s,human fecal microbiota transplantation(FMT)has been used in clinical practice in western medicine.It has been evidenced that FMT can alleviate gastrointestinal disorders such as Clostridium difficile infection(CDI).Moreover,some studies have concluded that FMT is effective in relieving depression by modulating the microbiota-gut-brain axis(MGBA),which,however,needs to be further verified.Therefore,this paper described the relationship between MGBA and depression and summarized MGBA-related mechanisms of depression:abnormalities in the autonomic nervous system,hypothalamic-pituitary-adrenal(HPA)axis,enteric nervous system,and circulatory system,and the“leaky gut”hypothesis.Based on the above mechanisms,this review listed the animal experiments and clinical trials on the treatment of depression with FMT in recent years and dissected the current and future status of FMT,in an attempt to explore whether FMT is practical and reliable in the treatment of depression and provide ideas and methods for the treatment of depression.Despite the huge potential of FMT in the treatment of depression,more compelling research and experimental evidence are needed.