Interseções entre o eixo microbiota-intestino-cérebro e os mecanismos fisiopatológicos dos transtornos depressivos: uma revisão narrativa
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A depressão impacta milhões de pessoas globalmente, com severas repercussões individuais e sociais. Apesar de décadas de esforços, sua etiologia permanece incerta. Um crescente corpo de publicações tem se dedicado a explorar as interações do eixo microbiota-intestino-cérebro e sua associação com o surgimento e progressão de condições neurológicas e neuropsiquiátricas, incluindo a depressão. Neste artigo, revisamos a literatura sobre as interseções entre o referido eixo e os mecanismos fisiopatológicos dos transtornos depressivos. Para tanto, realizou-se uma busca por artigos completos, publicados a partir de 2018, indexados na base de dados PubMed/MEDLINE. Abordamos os componentes do eixo microbiota-intestino-cérebro, a função da barreira intestinal, o papel do sistema nervoso autônomo e do eixo hipotálamo-hipófise-adrenal nas interações entre cérebro e intestino, além da aparente ligação entre estresse, disbiose e depressão mediada por citocinas pró-inflamatórias. Embora não seja possível, diante do atual corpo de evidências, estabelecer uma relação causal entre disbiose intestinal e depressão, a compreensão das interseções entre essas duas condições abre caminho para pesquisas voltadas à determinação de biomarcadores e contribui para ampliar o escopo de intervenções terapêuticas.
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