Intersections between the gut-brain-microbiota axis and the pathophysiological mechanisms of depressive disorders: a narrative review.
Article Sidebar
Main Article Content
Abstract
Depression impacts millions of people globally, with severe individual and societal repercussions. Despite decades of efforts, its etiology remains uncertain. A growing body of literature has been dedicated to exploring the interactions of the gut-brain-microbiota axis and its association with the onset and progression of neurological and neuropsychiatric conditions, including depression. In this article, we review the literature on the intersections between the mentioned axis and the pathophysiological mechanisms of depressive disorders. To do so, a search for full articles published from 2018 onwards, indexed in the PubMed/MEDLINE database, was conducted. We address the components of the gut-brain-microbiota axis, the function of the intestinal barrier, the role of the autonomic nervous system, and the hypothalamus-pituitary-adrenal axis in the interactions between the brain and gut, in addition to the apparent link between stress, dysbiosis, and depression mediated by pro-inflammatory cytokines. Although it is not possible, given the current body of evidence, to establish a causal relationship between gut dysbiosis and depression, understanding the intersections between these two conditions paves the way for research aimed at determining biomarkers and contributes to expanding the scope of therapeutic interventions.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
• The author (s) warrant that the contribution is original and unpublished and that it is not in the process of being evaluated in other journal (s);
• The journal is not responsible for the opinions, ideas and concepts issued in the texts, as they are the sole responsibility of the author (s);
• Publishers have the right to make textual adjustments and to adapt the article to the rules of publication.
Authors retain the copyright and grant the journal the right of first publication, with the work simultaneously licensed under the Creative Commons Attribution License, which allows the sharing of work with acknowledgment of authorship and initial publication in this journal.
Authors are authorized to take additional contracts separately, for non-exclusive distribution of the version of the work published in this journal (eg publish in institutional repository or as book chapter), with acknowledgment of authorship and initial publication in this journal.
Authors are allowed and encouraged to publish and distribute their work online (eg in institutional repositories or on their personal page) at any point before or during the editorial process, as this can generate productive changes as well as increase the impact and citation of the published work (See The Effect of Free Access) at http://opcit.eprints.org/oacitation-biblio.html
References
ABP - ASSOCIAÇÃO BRASILEIRA DE PSIQUIATRIA. A Próxima Geração de Antidepressivos, para Além da Hipótese Monoaminérgica da Depressão. Disponível em: https://www.abp.org.br/post/pec-geracao-antidepressivos-acioly. Acesso em: 19 de jun de 2023.
AHMAD, R.; SORELL, M.; BATRA, S.; DHAWAN, P.; SINGH, A. B. Gut permeability and mucosal inflammation: bad, good or context dependent. Mucosal Immunology, v. 10, p. 307-317, 2017.
ALLAIRE, J. M.; CROWLEY, S. M.; LAW, H. T.; CHANG, S.; KO, H.; VALLANCE, B. A.. The Intestinal Epithelium: Central Coordinator of Mucosal Immunity. Trends in immunology, v. 39, n. 9, p. 677-696, 2018.
ALMEIDA, I. B.; GOMES, I. A.; SHANMUGAM, S.; DE MOURA, T. R.; MAGALHÃES, L. S.; DE AQUINO, L. A. G.; DE SOUZA ARAÚJO, A. A.; OLIVEIRA, P. D.; SANTOS, M. R. V. Inflammatory modulation of fluoxetine use in patients with depression: A systematic review and meta-analysis. Cytokine, v. 131, p. 155100, 2020.
ANITHA, M.; VIJAY-KUMAR, M.; SITARAMAN, S. V.; GEWIRTZ, A. T.; SRINIVASAN, S. Gut microbial products regulate murine gastrointestinal motility via Toll-like receptor 4 signaling. Gastroenterology, v. 143, n. 4, p. 1006-1016, 2012.
APA - AMERICAN PSYCHIATRIC ASSOCIATION. Manual Diagnóstico e Estatístico de Transtornos Mentais: DSM-5. 5. ed. Porto Alegre: Artmed, 2014. p. 155-157.
BUDNI, J.; MORETTI, M.; FREITAS, A. E.; NEIS, V. B.; RIBEIRO, C. M.; BALEN, G. O.; RIEGER, D. K.; LEAL, R. B.; RODRIGUES, A. L. S. Behavioral and neurochemical effects of folic acid in a mouse model of depression induced by TNF-α. Behavioural Brain Research, v. 414, p. 113512, 2021.
BEUREL, E.; TOUPS, M.; NEMEROFF, C. B. The Bidirectional Relationship of Depression and Inflammation: Double Trouble. Neuron, v. 107, n. 2, p. 234-256, 2020.
BOHÓRQUEZ, D. V.; LIDDLE, R. A. The gut connectome: making sense of what you eat. The Journal of clinical investigation, v. 125, n. 3, p. 888-890, 2015.
BOKU, S.; NAKAGAWA, S.; TODA, H.; HISHIMOTO, A. Neural basis of major depressive disorder: Beyond monoamine hypothesis. Psychiatry and clinical neurosciences, v. 72, n. 1, p. 3-12, 2018.
BONAZ, B.; BAZIN, T.; PELLISSIER, S.. The Vagus Nerve at the Interface of the Microbiota-Gut-Brain Axis. Frontiers in Neuroscience, v. 12, p. 49, 2018.
BREIT, S.; KUPFERBERG, A.; ROGLER, G.; HASLER, G. Vagus Nerve as Modulator of the Brain-Gut Axis in Psychiatric and Inflammatory Disorders. Frontiers in Psychiatry, v. 9, p. 44, 2018.
BOTTOMLEY, J. M.; LEREUN, C.; DIAMANTOPOULOS, A.; MITCHELL, S. Vagus nerve stimulation (VNS) therapy in patients with treatment resistant depression: A systematic review and meta-analysis. Comprehensive psychiatry, v. 98, p. 152156, 2019.
BUCKLEY, A.; TURNER, J. R. Cell Biology of Tight Junction Barrier Regulation and Mucosal Disease. Cold Spring Harbor perspectives in biology, v. 10, n. 1, p. a029314, 2018.
CAMPOS, A. I.; MULCAHY, A.; THORP, J. G.; WRAY, N. M.; BYRNE, E. M.; LIND, P. A.; MEDLAND, S. E.; MARTIN, N. G.; HICKIE, I. B.; RENTERÍA, M. E. Understanding genetic risk factors for common side effects of antidepressant medications. Communications medicine, v. 1, p. 45, 2021.
CAPURON, L.; MILLER, A. H. Immune system to brain signaling: neuropsychopharmacological implications. Pharmacology & therapeutics, v. 130, n. 2, p. 226-238, 2011.
CHANG, L.; WEI, Y.; HASHIMOTO, K. Brain-gut-microbiota axis in depression: A historical overview and future directions. Brain Research Bulletin, v. 182, p. 44-56, 2022.
CHENG, Y.; DESSE, S.; MARTINEZ, A.; WORTHEN, R. J.; JOPE, R. S.; BEUREL, E. TNFα disrupts blood brain barrier integrity to maintain prolonged depressive-like behavior in mice. Brain, behavior, and immunity, v. 69, p. 556-567, 2018.
COLLINS, J.; BOROJEVIC, R.; VERDU, E. F.; HUIZINGA, J. D.; RATCLIFFE, E. M. Intestinal microbiota influence the early postnatal development of the enteric nervous system. Neurogastroenterology and motility, v. 26, n. 1, p. 98-107, 2014.
COLLINS, S. M.; SURETTE, M.; BERCIK, P. The interplay between the intestinal microbiota and the brain. Nature reviews. Microbiology, v. 10, n. 11, p. 735-742, 2012.
CHRISTOVICH, A.; LUO, X. M. Gut Microbiota, Leaky Gut, and Autoimmune Diseases. Frontiers in immunology, n. 13, p. 946248, 2022.
CRYAN, J. F.; O'RIORDAN, K. J.; COWAN, C. S. M.; SANDHU, K. V.; BASTIAANSSEN, T. F. S.; BOEHME, M.; CODAGNONE, M. G.; CUSSOTTO, S.; FULLING, C.; GOLUBEVA, A. V.; GUZZETTA, K. E.; JAGGAR, M.; LONG-SMITH, C. M.; LYTE, J. M.; MARTIN, J. A.; MOLINERO-PEREZ, A.; MOLONEY, G.; MORELLI, E.; MORILLAS, E.; O’CONNOR, R.; CRUZ-PEREIRA, J. S.; PETERSON, V. L.; REA, K.; RITA, N. L.; SHERWIN, E.; SPICHAK, S.; TEICHMAN, E. M.; WOUW, M. V. D.; VENTURA-SILVA, A. P.; WALLACE-FITZSIMONS, S. E.; HYLAND, N.; CLARKE, G.; DINAN, T. G.. The Microbiota-Gut-Brain Axis. Physiological reviews, v. 99, n. 4, p. 1877-2013, 2019.
DANEMAN, R.; PRAT, A. The blood-brain barrier. Cold Spring Harbor perspectives in biology, v. 7, n. 1, p. a020412, 2015.
DE VADDER, F.; GRASSET, E.; MANNERAS HOLM, L.; KARSENTY, G.; MACPHERSON, A. J.; OLOFSSON, L. E.; BÄCKHED, F. Gut microbiota regulates maturation of the adult enteric nervous system via enteric serotonin networks. PNAS, v. 115, n. 25, p. 6458-6463, 2018.
DEAN, J.; KESHAVAN, M. The neurobiology of depression: An integrated view. Asian Journal of Psychiatry, v. 27, p. 101-111, 2017.
DI TOMMASO, N.; GASBARRINI, A.; PONZIANI, F. R. Intestinal Barrier in Human Health and Disease. International journal of environmental research and public health, v. 18, n. 23, p. 12836, 2021.
DU, X.; PANG, T. Y. Is Dysregulation of the HPA-Axis a Core Pathophysiology Mediating Co-Morbid Depression in Neurodegenerative Diseases? Frontiers in Psychiatry, v. 6, p. 32, 2015.
FAN, Y.; PEDERSEN, O. Gut microbiota in human metabolic health and disease. Nature reviews. Microbiology, v. 19, n. 1, p. 55-71, 2021.
FLEMING 2nd., M. A.; EHSAN, L.; MOORE, S. R.; LEVIN, D. E. The Enteric Nervous System and Its Emerging Role as a Therapeutic Target. Gastroenterology research and practice, 8024171, 2020.
FLESHNER, M.; FRANK, M.; MAIER, S. F. Danger Signals and Inflammasomes: Stress-Evoked Sterile Inflammation in Mood Disorders. Neuropsychopharmacology, v. 42, n. 1, p. 36-45, 2017.
FRANKIENSZTAJN, L. M.; ELLIOTT, E.; KOREN, O. The microbiota and the hypothalamus-pituitary-adrenocortical (HPA) axis, implications for anxiety and stress disorders. Current opinion in neurobiology, v. 62, p. 76-82, 2020.
FRIED, S.; WEMELLE, E.; CANI, P. D.; KNAUF, C. Interactions between the microbiota and enteric nervous system during gut-brain disorders. Neuropharmacology, v. 197, p. 108721, 2021.
FURMAN, D.; CAMPISI, J.; VERDIN, E.; CARRERA-BASTOS, P.; TARG, S.; FRANCESCHI, C.; FERRUCCI, L.; GILROY, D. W.; FASANO, A.; MILLER, G. W.; MILLER, A. H.; MANTOVANI, A.; WEYAND, C. M.; BARZILAI, N.; GORONZY, J. J.; RANDO, T. A.; EFFROS, R. B.; LUCIA, A.; KLEINSTREUER, N.; SLAVICH, G. M. Chronic inflammation in the etiology of disease across the life span. Nature medicine, v. 25, p. 1822-1832, 2019.
GENG, Z. H.; ZHU, Y.; LI, Q. L.; ZHAO, C.; ZHOU, P. Enteric Nervous System: The Bridge Between the Gut Microbiota and Neurological Disorders. Frontiers in aging neuroscience, v. 14, p. 810483, 2022.
GERBE, F.; LEGRAVEREND, C.; JAY, P. The intestinal epithelium tuft cells: specification and function. Cellular and molecular life science, v. 69, p. 2907-2917, 2012.
GÓRALCZYK-BINKOWSKA, A.; SZMAJDA-KRYGIER, D.; KOZŁOWSKA, E. The Microbiota-Gut-Brain Axis in Psychiatric Disorders. International Journal of Molecular Sciences, v. 23, n. 19, p. 11245, 2022.
GUO, B.; ZHANG, M.; HAO, W.; WANG, Y.; ZHANG, T.; LIU, C. Neuroinflammation mechanisms of neuromodulation therapies for anxiety and depression. Translational psychiatry, v. 13, n. 1, p. 5, 2023a.
GUO, Y.; LIU, Y.; RUI, B.; LEI, Z.; NING, X.; LIU, Y.; LI, M. Crosstalk between the gut microbiota and innate lymphoid cells in intestinal mucosal immunity. Frontiers in immunology, v. 14, p. 1171680, 2023b.
HAROON, E.; DAGUANNO, A. W.; WOOLWINE, B. J.; GOLDSMITH, D. R.; BAER, W. M.; WOMMACK, E. C.; FELGER, J. C.; MILLER, A. H. Antidepressant treatment resistance is associated with increased inflammatory markers in patients with major depressive disorder. Psychoneuroendocrinology, v. 95, p. 43-49, 2018.
HASSAMAL S. Chronic stress, neuroinflammation, and depression: an overview of pathophysiological mechanisms and emerging anti-inflammatories. Frontiers in psychiatry, v. 14, p. 1130989, 2023.
HESTAD, K.; ALEXANDER, J.; ROOTWELT, H.; AASETH, J. O. The Role of Tryptophan Dysmetabolism and Quinolinic Acid in Depressive and Neurodegenerative Diseases. Biomolecules, v. 12, n. 7, p. 998, 2022.
HOROWITZ, A.; CHANEZ-PAREDES, S. D.; HAEST, X.; TURNER, J. R. Paracellular permeability and tight junction regulation in gut health and disease. Nature reviews. Gastroenterology & Hepatology, v. 20, n. 7, p. 417-432, 2023.
HOU, K.; WU, Z. X.; CHEN, X. Y.; WANG, J. Q.; ZHANG, D.; XIAO, C.; ZHU, D.; KOYA, L. B.; WEI, L.; LI, J.; CHEN, Z. S. Microbiota in health and diseases. Signal transduction and targeted therapy, v. 7, n. 1, p. 135, 2022.
HUNT, C.; MACEDO, E; CORDEIRO, T.; SUCHTING, R.; DE DIOS, C.; CUELLAR LEAL, V. A.; SOARES, J. C.; DANTZER, R.; TEIXEIRA, A. L.; SELVARAJ, S. Effect of immune activation on the kynurenine pathway and depression symptoms - A systematic review and meta-analysis. Neuroscience and biobehavioral reviews, v. 118, p. 514-523, 2020.
KAELBERER, M. M.; RUPPRECHT, L. E.; LIU, W. W.; WENG, P.; BOHÓRQUEZ, D. V. Neuropod Cells: The Emerging Biology of Gut-Brain Sensory Transduction. Annual review of neuroscience, v. 43, p. 337-353, 2020.
KANES, S. J.; DENNIE, L.; PERERA, P. Targeting the Arginine Vasopressin V1b Receptor System and Stress Response in Depression and Other Neuropsychiatric Disorders. Neuropsychiatric disease and treatment, v. 19, p. 811-828, 2023.
KASARELLO, K.; CUDNOCH-JEDRZEJEWSKA, A.; CZARZASTA, K. Communication of gut microbiota and brain via immune and neuroendocrine signaling. Frontiers in microbiology, v. 14, p. 1118529, 2023.
KNOX, E. G.; ABURTO, M. R.; CLARKE, G.; CRYAN, L. F.; O’DRISCOLL, C. M.;. The blood-brain barrier in aging and neurodegeneration. Molecular psychiatry, v. 27, n. 6, p. 2659-2673, 2022.
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 cytokine and chemokine alterations in depression: a meta-analysis of 82 studies. Acta psychiatrica Scandinavica, v. 135, n. 5, p. 373-387, 2017.
LEVY, M.; KOLODZEIJCZYK, A.; THAISS, C.; ELINAV, E. Dysbiosis and the immune system. Nature reviews. Immunology, v. 17, n. 4, p. 219-232, 2017.
LIU, J. J.; WEI, Y. B.; STRAWBRIDGE, R.; BAO, Y.; CHANG, S.; SHI, L.; QUE, J.; GADAD, B. S.; TRIVEDI, M. H.; KELSOE, J. R.; LU, L. Peripheral cytokine levels and response to antidepressant treatment in depression: a systematic review and meta-analysis. Molecular psychiatry, v. 25, n. 2, p. 339-350, 2020.
LUO, Y.; ZENG, B.; ZENG, L.; DU, X.; LI, B.; HUO, R.; LIU, L.; WANG, H.; DONG, M.; PAN, J.; ZHENG, P.; ZHOU, C.; WEI, H.; XIE, P. Gut microbiota regulates mouse behaviors through glucocorticoid receptor pathway genes in the hippocampus. Translational psychiatry, v. 8, n. 1, p. 187, 2018.
MALHI, G. S.; MANN, J. J. Depression. Lancet, v. 392, n. 10161, p. 2299-2312, 2018.
MAYDYCH, V. The Interplay Between Stress, Inflammation, and Emotional Attention: Relevance for Depression. Frontiers in neuroscience, v. 13, p. 384, 2019.
MAYER, E. A.; NANCE, K.; CHEN, S. The Gut-Brain Axis. Annual review of medicine, v. 73, p. 439-453, 2022.
MAYER, E. A.; RYU, H. J.; BHATT, R. R. The neurobiology of irritable bowel syndrome. Molecular psychiatry, v. 28, n. 4, p. 1451-1465, 2023.
MENARD, C.; PFAU, M. L.; HODES, G. E.; KANA, V.; WANG, V. X.; BOUCHARD, S.; TAKAHASHI, A.; FLANIGAN, M. E.; ALEYASIN, H.; LECLAIR, K. B.; JANSSEN, W. G.; LABONTÉ, B.; PARISE, E. M.; LORSCH, Z. S.; GOLDEN, S. A.; HESHMATI, M.; TAMMINGA, C.; TURECKI, G.; CAMPBELL, M.; FAYAD, Z. A.; TANG, C. Y.; MERAD, M.; RUSSO, S. J. Social stress induces neurovascular pathology promoting depression. Nature neuroscience, v. 20, n. 12, p. 1752-1760, 2017.
MISIAK, B.; ŁONIEWSKI, I.; MARLICZ, W.; FRYDECKA, D.; SZULC, A.; RUDZKI, L.; SAMOCHOWIEC, J. The HPA axis dysregulation in severe mental illness: Can we shift the blame to gut microbiota? Progress in neuro-psychopharmacology & biological psychiatry, v. 102, p. 109951, 2020.
MŁYNARSKA, E.; GADZINOWSKA, J.; TOKAREK, J.; FORYCKA, J.; SZUMAN, A.; FRANCZYK, B.; RYSZ, J. The Role of the Microbiome-Brain-Gut Axis in the Pathogenesis of Depressive Disorder. Nutrients, v. 14, n. 9, p. 1921, 2022.
MORAIS, L. H.; SCHREIBER, H. L.; MAZMANIAN, S. K. The gut microbiota-brain axis in behavior and brain disorders. Nature reviews. Microbiology, v. 19, n. 4, p. 241-255, 2021.
MÖRBE, U. M.; JORGENSEN, P. B.; FENTON, T. M.; VON BURG, N.; RIIS, L. B.; SPENCER, J.; AGACE, W. W. Human gut-associated lymphoid tissues (GALT); diversity, structure, and function. Mucosal Immunology, v. 14, n. 4, p. 793-802, 2021.
MOU, Y.; DU, Y.; ZHOU, L.; YUE, J.; HU, X.; LIU, Y.; CHEN, S.; LIN, X.; ZHANG, G.; XIAO, H.; DONG, B. Gut Microbiota Interact With the Brain Through Systemic Chronic Inflammation: Implications on Neuroinflammation, Neurodegeneration, and Aging. Frontiers in immunology, v. 13, p. 796288, 2022.
MOYLAN, S.; BERK, M.; DEAN, O. M.; SAMUNI, Y.; WILLIAMS, L. J.; O'NEIL, A.; HAYLEY, A. C.; PASCO, J. A.; ANDERSON, G.; JACKA, F. N.; MAES, M. Oxidative & nitrosative stress in depression: why so much stress?. Neuroscience and biobehavioral reviews, v. 45, p. 46-62, 2014.
MOWAT, A. M.; AGACE, W. W. Regional specialization within the intestinal immune system. Nature reviews. Immunology, v. 14, n. 10, p. 667-685, 2014.
MUHAMMAD, N.; ULLAH, S. R.; NAGI, T. K.; YOUSAF, R. A. Factors associated with non-adherence to anti-depressant medication in adults: a systematic review and meta-analysis. Cureus, v. 15, n. 4, p. e37828, 2023.
NAUGHTON, M.; DINAN, T. G.; SCOTT, L. V. Corticotropin-releasing hormone and the hypothalamic-pituitary-adrenal axis in psychiatric disease. Handbook of Clinical Neurology, v. 124, p. 69-91, 2014.
O'CONNOR, J. C.; ANDRÉ, C.; WANG, Y.; LAWSON, M. A.; SZEGEDI, S. S.; LESTAGE, J.; CASTANON, N.; KELLEY, K. W.; DANTZER, R. Interferon-gamma and tumor necrosis factor-alpha mediate the upregulation of indoleamine 2,3-dioxygenase and the induction of depressive-like behavior in mice in response to bacillus Calmette-Guerin. The Journal of neuroscience, v. 29, n. 13, p. 4200-4209, 2009.
O'MAHONY, S. M.; MARCHESI, J. R.; SCULLY, P.; CODLING, C.; CEOLHO, A. M.; QUIGLEY, E. M.; CRYAN, J. F.; DINAN, T. G. Early life stress alters behavior, immunity, and microbiota in rats: implications for irritable bowel syndrome and psychiatric illnesses. Biological psychiatry, v. 65, n. 3, p. 263-267, 2009.
ÖZTÜRK, M.; YALIN SAPMAZ, Ş.; KANDEMIR, H.; TANELI, F.; AYDEMIR, Ö. The role of the kynurenine pathway and quinolinic acid in adolescent major depressive disorder. International journal of clinical practice, v. 75, n. 4, p. e13739, 2021.
PEREZ-BURGOS, A.; MAO, Y. K.; BIENENSTOCK, J.; KUNZE, W. A. The gut-brain axis rewired: adding a functional vagal nicotinic "sensory synapse". FASEB journal, v. 28, n. 7, p. 3064-3074, 2014.
RUSCH, J. A.; LAYDEN, B. T.; DUGAS, L. R. Signalling cognition: the gut microbiota and hypothalamic-pituitary-adrenal axis. Frontiers in endocrinology, v. 14, p. 1130689, 2023.
SFORZINI, L.; WORRELL, C.; KOSE, M.; ANDERSON, I. M.; AOUIZERATE, B.; AROLT, V.; BAUER, M.; BAUNE, B. T.; BLIER, P.; CLEARE, A. J.; COWEN, P. J.; DINAN, T. G.; FAGIOLINI, A.; FERRIER, I. N.; HEGERL, U.; KRYSTAL, A. D.; LEBOYER, M.; MCALLISTER-WILLIAMS, R. H.; MCINTYRE, R. S.; MEYER-LINDENBERG, A.; … PARIANTE, C. M. A. Delphi-method-based consensus guideline for definition of treatment-resistant depression for clinical trials. Molecular psychiatry, v. 27, n. 3, p. 1286-1299, 2022.
SHIN, H. C.; JO, B. G.; LEE, C. Y.; NAMGUNG, U. Hippocampal activation of 5-HT1B receptors and BDNF production by vagus nerve stimulation in rats under chronic restraint stress. The European journal of neuroscience, v. 50, n. 1, p. 1820-1830, 2019.
SILVA, Y. P.; BERNARDI, A.; FROZZA, R. L. The role of short-chain fatty acids from gut microbiota in gut-brain communication. Frontiers in endocrinology, v. 11, p. 25, 2020.
SIMON, M. S.; ARTEAGA-HENRÍQUEZ, G.; FOUAD ALGENDY, A.; SIEPMANN, T.; ILLIGENS, B. M. W. Anti-inflammatory treatment efficacy in major depressive disorder: a systematic review of meta-analyses. Neuropsychiatric disease and treatment, v. 19, p. 1-25, 2023.
SIOPI, E.; GALERNE, M.; RIVAGORDA, M.; SAHA, S.; MOIGNEU, C.; MORICEAU, S.; BIGOT, M.; OURY, F.; LLEDO, P. M. Gut microbiota changes require vagus nerve integrity to promote depressive-like behaviors in mice. Molecular Psychiatry, 2023.
SLAVICH, G. M. Psychoneuroimmunology of stress and mental health. In. HARKNESS, K.; HAYDEN, E. P. (Eds.) The Oxford handbook of stress and mental health. New York: Oxford University Press, 2020, p 519-546.
SLAVICH, G. M.; IRWIN, M. R. From stress to inflammation and major depressive disorder: a social signal transduction theory of depression. Psychological bulletin, v. 140, n. 3, p. 774-815, 2014.
SOCAŁA, K.; DOBOSZEWSKA, U.; SZOPA, A.; SEREFKO, A.; WŁODARCZYK, M.; ZIELINSKA, A.; POLESZAK, E.; FICHNA, J.; WLAZ, P. The role of microbiota-gut-brain axis in neuropsychiatric and neurological disorders. Pharmacological research, v. 172, p. 105840, 2021.
SONALI, S.; RAY, B.; AHMED TOUSIF, H.; RATHIPRIYA, A. G., SUNANDA, T.; MAHALAKSHMI, A. M.; RUNGRATANAWANICH, W.; ESSA, M. M.; QORONFLEH, M. W.; CHIDAMBARAM, S. B.; SONG, B. J. Mechanistic insights into the link between gut dysbiosis and major depression: an extensive review. Cells, v. 11, n. 8, p. 1362, 2022.
SUDA, K.; MATSUDA, K. How Microbes Affect Depression: Underlying Mechanisms via the Gut-Brain Axis and the Modulating Role of Probiotics. International Journal of Molecular Sciences, v. 23, n. 3, p. 1172, 2022.
SUDO, N.; CHIDA, Y.; AIBA, Y.; SONODA, J.; OYAMA, N.; YU, X. N.; KUBO, C.; KOGA, Y. Postnatal microbial colonization programs the hypothalamic-pituitary-adrenal system for stress response in mice. The Journal of Physiology, v. 558, p. 263-275, 2004.
TAN, C.; YAN, Q.; MA, Y.; FANG, J.; YANG, Y.. Recognizing the role of the vagus nerve in depression from microbiota-gut brain axis. Frontiers in neurology, v. 13, p. 1015175, 2022.
TAN, H. E. The microbiota-gut-brain axis in stress and depression. Frontiers in neuroscience, v. 17, p. 1151478, 2023.
THOO, L.; NOTI, M.; KREBS, P. Keep calm: the intestinal barrier at the interface of peace and war. Cell Death & Disease, v. 10, n. 11, p. 1-13, 2019.
TIMMERMANS, S.; SOUFFRIAU, J.; LIBERT, C. A General Introduction to Glucocorticoid Biology. Frontiers in immunology, v. 10, p. 1545, 2019.
TROUBAT, R.; BARONE, P.; LEMAN, S.; DESMIDT, T.; CRESSANT, A.; ATANASOVA, B.; BRIZARD, B.; EL HAGE, W.; SURGET, A.; BELZUNG, C.; CAMUS, V. Neuroinflammation and depression: A review. The European journal of neuroscience, v. 53, n. 1, p. 151-171, 2021.
VALASSI, E.; MANICHANH, C.; AMODRU, V.; FERNANDÉZ, P. G.; GAZTAMBIDE, S.; YAÑEZ, F.; MARTEL-DUGUECH, L.; PUIG-DOMINGO, M.; WEBB, S. M. Gut microbial dysbiosis in patients with Cushing's disease in long-term remission. Relationship with cardiometabolic risk. Frontiers in endocrinology, v. 14, p. 1074757, 2023.
VANUYTSEL, T.; VAN WANROOY, S.; VANHEEL, H.; VANORMELINGEN, C.; VERCHUEREN, S.; HOUBEN, E.; SALIM RASOEL, S.; TÓTH, J.; HOLVOET, L.; FARRÉ, R.; VAN OUDENHOVE, L.; BOECKXSTAENS, G.; VERBEKE, K.; TACK, J. Psychological stress and corticotropin-releasing hormone increase intestinal permeability in humans by a mast cell-dependent mechanism. Gut, v. 63, n. 8, p. 1293-1299, 2014.
VICENTINI, F. A.; KEENAN, C. M.; WALLACE, L. E.; WOODS, C.; CAVIN, J. B.; FLOCKTON, A. R.; MACKLIN, W. B.; BELKIND-GERSON, J.; HIROTA, S. A.; SHARKEY, K. A. Intestinal microbiota shapes gut physiology and regulates enteric neurons and glia. Microbiome, v. 9, n. 1, p. 210, 2021.
VOINESKOS, D.; DASKALAKIS, Z. J.; BLUMBERGER, D. M. Management of Treatment-Resistant Depression: Challenges and Strategies. Neuropsychiatric Disease and Treatment, v. 16, p. 221-234, 2020.
WANG, S.; CAI, Q.; XU, L.; Sun, Y., WANG, M.; WANG, Y.; ZHANG, L.; LI, K.; NI, Z. Isoalantolactone relieves depression-like behaviors in mice after chronic social defeat stress via the gut-brain axis. Psychopharmacology, v. 240, n. 8, p. 1775-1787, 2023.
WHO - WORLD HEALTH ORGANIZATION. Depression and Other Common Mental Disorders: Global Health Estimates. Genebra: World Health Organization, 2017. Disponível em: <https://apps.who.int/iris/handle/10665/254610>. Acesso em: 17 Jul 2023a.
WHO - WORLD HEALTH ORGANIZATION. Depressive Disorder (Depression), 2023. Disponível em: <https://www.who.int/news-room/fact-sheets/detail/depression>. Acesso em: 17 Jun 2023b.
WU, Q., XU, Z., SONG, S.; ZHANG, H.; ZHANG, W.; LIU, L.; CHEN, Y.; SUN, J. Gut microbiota modulates stress-induced hypertension through the HPA axis. Brain research bulletin, v. 162, p. 49-58, 2020.
WU, S. I.; WU, C. C.; CHENG, L. H.; NOBLE, S. W.; LIU, C. J.; LEE, Y. H.; LIN, C. J.; HSU, C. C.; CHEN, W. L.; TSAI, P. J.; KUO, P. H.; Tsai, Y. C. Psychobiotic supplementation of HK-PS23 improves anxiety in highly stressed clinical nurses: a double-blind randomized placebo-controlled study. Food & function, v. 13, n. 17, p. 8907-8919, 2022.
WU, W. L.; ADAME, M. D.; LIOU, C. W.; BARLOW, J. T.; LAI, T. T.; SHARON, G.; SCHERETTER, C. E.; NEEDHAM, B. D.; WANG, M. I.; TANG, W.; OUSEY, J.; LIN, Y. Y.; YAO, T. H.; ABDELl-HAQ, R.; BEADLE, K.; GRADINARU, V.; ISMAGILOV, R. F.; MAZMANIAN, S. K. Microbiota regulate social behaviour via stress response neurons in the brain. Nature, v. 595, n. 7867, p. 409-414, 2021.
YAMAOKA, K.; UOTSU, N.; HOSHIRO, E. Relationship between psychosocial stress-induced prefrontal cortex activity and gut microbiota in healthy Participants - A functional near-infrared spectroscopy study. Neurobiology of Stress, v. 20, p. 100479, 2022.
YANG, J.; RAN, M.; LI, H.; MA, K.; YANG, Y.; FU, X.; YANG, S. New insight into neurological degeneration: Inflammatory cytokines and blood–brain barrier. Frontiers in molecular neuroscience, v. 15, p. 1013933, 2022.
YARANDI, S. S.; KULKARNI, S.; SAHA, M.; SYLVIA, K. E.; SEARS, C. L.; PASRICHA, P. J. Intestinal Bacteria Maintain Adult Enteric Nervous System and Nitrergic Neurons via Toll-like Receptor 2-induced Neurogenesis in Mice. Gastroenterology, v. 159, n. 1, p. 200-213, 2020.
ZHANG, J.; MA, L; CHANG, L.; PU, Y; QU, Y.; HASHIMOTO, K. A key role of the subdiaphragmatic vagus nerve in the depression-like phenotype and abnormal composition of gut microbiota in mice after lipopolysaccharide administration. Translational psychiatry, v. 10, p. 186, 2020a.
ZHANG, N.; ZHANG, Y.; LI, M.; WANG, W.; LIU, Z.; XI, C.; HUANG, X.; LIU, J.; HUANG, J.; TIAN, D.; MU, J.; LIAO, X.; ZHAI, S. Efficacy of probiotics on stress in healthy volunteers: A systematic review and meta-analysis based on randomized controlled trials. Brain and behavior, v. 10, n. 9, 2020b.
ZHANG, Q.; CHEN, B.; ZHANG, J. et al. Effect of prebiotics, probiotics, synbiotics on depression: results from a meta-analysis. BMC Psychiatry, 23, 477, 2023a.
ZHANG, Q.; HU, W. M.; DENG, Y. L.; WAN, J. J.; WANG, Y. J.; JIN, P. Dysbiosis of gut microbiota and decreased propionic acid associated with metabolic abnormality in Cushing's syndrome. Frontiers in endocrinology, v. 13, p. 1095438, 2023b.
ZHENG, D.; LIWINSKI, T.; ELINAV, E. Interaction between microbiota and immunity in health and disease. Cell Research, v. 30, n. 6, 492-506, 2020.
ZIJLMANS, M. A.; KORPELA, K.; RIKSEN-WALRAVEN, J. M.; DE VOS, W. M.; DE WEERTH, C. Maternal prenatal stress is associated with the infant intestinal microbiota. Psychoneuroendocrinology, v. 53, p. 233-245, 2015.