When Gut Hormones Influence Brain Function in Depression

I. P. Siba, B. Martynhak, Marcela Pereira
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Abstract

The literature on the crosstalk between the brain and the gut has increased considerably in recent years. It is widely accepted now that the microbiome plays a significant role in several brain disorders, neurodevelopment, neurocognitive stages, and physiological functions. However, the mechanisms that influence such crosstalk are still not well elucidated. In this sense, one of the possible mechanisms by which the microbiome could influence brain function is through gut hormones released by enteroendocrine cells: ghrelin, cholecystokinin (CCK), peptide YY (PYY), vasoactive intestinal polypeptide (VIP), glucagon-like peptide (GLP1-2), corticotropin-releasing factor (CRF), glucose-dependent insulinotropic polypeptide (GIP), secretin, serotonin (5-HT), and oxytocin. Especially when one considers that the brain expresses receptors for these hormones in areas important to the neurobiology of brain disorders (e.g., depression), such as the hippocampus, amygdala, hypothalamus, and suprachiasmatic nucleus. To strengthen this hypothesis, gastrointestinal dysfunction (such as altered motility or pain) is relatively common in depressive patients, and changes in diet (low-carbohydrate diets, for example) positively affect mood. Additionally, alterations in the gut microbiome are relatively common in depressive patients and are related to the levels of Akkermansia, Lactobacillus, Bifidobacteria, Faecalibacterium, Roseburia and Clostridium. Finally, concerning the gut-released hormones, the literature reports that ghrelin can be a peripheral marker for the antidepressant treatment success rate and has elevated levels during depression. GLP-1 is tightly correlated with HPA axis activity being decreased by high cortisol levels. CCK seems to be altered in depression due to increased inflammation and activation of Toll-like receptor 4. Such finds allow the postulation that hormones, the microbiome and mood are intertwined and co-dependent. VIP is correlated with circadian rhythms. There is a bidirectional connection of the circadian rhythms between the host and the microbiota. Circadian rhythm disruption is associated with both poor outcomes in mental health and alterations in the microbiota composition. In sum, in the past year, more and more research has been published showing the tight connection between gut and brain health and trying to decipher the feedback in play. Here, we focus on depression.
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当肠道激素影响抑郁症患者的大脑功能
近年来,关于大脑和肠道之间的相互作用的文献大量增加。微生物组在多种脑部疾病、神经发育、神经认知阶段和生理功能中发挥着重要作用,这一点已被广泛接受。然而,影响这种串音的机制仍然没有很好地阐明。从这个意义上说,微生物组影响脑功能的可能机制之一是通过肠内分泌细胞释放的肠道激素:胃饥饿素、胆囊收缩素(CCK)、YY肽(PYY)、血管活性肠多肽(VIP)、胰高血糖素样肽(GLP1-2)、促肾上腺皮质激素释放因子(CRF)、葡萄糖依赖的促胰岛素多肽(GIP)、分泌素、血清素(5-HT)和催产素。特别是当人们考虑到大脑在海马、杏仁核、下丘脑和视交叉上核等对大脑疾病(如抑郁症)的神经生物学重要区域表达这些激素受体时。为了加强这一假设,胃肠道功能障碍(如运动改变或疼痛)在抑郁症患者中相对常见,饮食的改变(例如低碳水化合物饮食)对情绪有积极影响。此外,肠道微生物组的改变在抑郁症患者中相对常见,并且与Akkermansia, Lactobacillus, Bifidobacteria, Faecalibacterium, Roseburia和Clostridium的水平有关。最后,关于肠道释放激素,文献报道胃饥饿素可以作为抗抑郁药物治疗成功率的外周标志物,并且在抑郁症期间水平升高。GLP-1与高皮质醇水平导致HPA轴活性降低密切相关。CCK似乎在抑郁症中由于炎症增加和toll样受体4的激活而改变。这些发现支持了这样的假设:激素、微生物群和情绪是相互交织、相互依赖的。VIP与昼夜节律相关。在宿主和微生物群之间存在着昼夜节律的双向联系。昼夜节律紊乱与心理健康的不良结果和微生物群组成的改变有关。总之,在过去的一年里,越来越多的研究表明肠道和大脑健康之间存在紧密联系,并试图破译其中的反馈。在这里,我们关注抑郁症。
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