Abstract:Bipolar disorder is a major cause of economic burden and disability worldwide, but its underlying pathogenesis is still poorly understood, treatment is less effective and relapse is more likely. In recent years, more and more attention has been paid to the role of intestinal flora in bipolar disorder. The intestinal flora of patients with bipolar disorder changes, and it has two-way communicate with the brain through a variety of pathways, including immune inflammatory response, neuroendocrinology and nervous system, causing mood, energy levels and behavioral changes. Therefore, this paper reviews the research progress on intestinal flora and the pathogenesis of bipolar disorder, and provides new ideas for exploring the etiology, diagnosis, differential diagnosis and treatment of bipolar disorder.
从痛快 潘苗. 肠道菌群与双相障碍发病机制相关研究进展[J]. 中国医药导报, 2021, 18(18): 48-51.
CONG Tongkuai PAN Miao. Progress in studies on the correlation between intestinal flora and the pathogenesis of bipolar disorder. 中国医药导报, 2021, 18(18): 48-51.
[1] Merikangas KR,Jin R,He JP,et al. Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative [J]. Arch Gen Psychiatry,2011,68(3):241-251.
[2] Benedetti F,Aggio V,Pratesi ML,et al. Neuroinflammation in Bipolar Depression [J]. Front Psychiatry,2020,11:71.
[3] Vieta E,Berk M,Schulze TG,et al. Bipolar disorders [J]. Nat Rev Dis Primers,2018,4:18008.
[4] Cryan JF,O’Riordan KJ,Cowan CSM,et al. The Microbiota-Gut-Brain Axis [J]. Physiol Rev,2019,99(4):1877-2013.
[5] Gondalia S,Parkinson L,Stough C,et al. Gut microbiota and bipolar disorder:a review of mechanisms and potential targets for adjunctive therapy [J]. Psychopharmacology(Berl),2019,236(5):1433-1443.
[6] Sharon G,Sampson TR,Geschwind DH,et al. The Central Nervous System and the Gut Microbiome [J]. Cell,2016, 167(4):915-932.
[7] Human Microbiome Project C. Structure,function and diversity of the healthy human microbiome [J]. Nature,2012, 486(7402):207-214.
[8] Rhee SH,Pothoulakis C,Mayer EA. Principles and clinical implications of the brain-gut-enteric microbiota axis [J]. Nat Rev Gastroenterol Hepatol,2009,6(5):306-314.
[9] Lai WT,Zhao J,Xu SX,et al. Shotgun metagenomics reveals both taxonomic and tryptophan pathway differences of gut microbiota in bipolar disorder with current major depressive episode patients [J]. J Affect Disord,2021, 278:311-319.
[10] Hu S,Li A,Huang T,et al. Gut Microbiota Changes in Patients with Bipolar Depression [J]. Adv Sci(Weinh),2019,6(14):1900752.
[11] Zheng P,Yang J,Li Y,et al. Gut Microbial Signatures Can Discriminate Unipolar from Bipolar Depression [J]. Adv Sci(Weinh),2020,7(7):1902862.
[12] Aizawa E,Tsuji H,Asahara T,et al. Bifidobacterium and Lactobacillus Counts in the Gut Microbiota of Patients With Bipolar Disorder and Healthy Controls [J]. Front Psychiatry,2018,9:730.
[13] 宋月红,江海峰,彭素芳,等.肠道菌群在抑郁症、焦虑症及物质使用障碍中的作用[J].上海交通大学学报:医学版,2019,39(10):1199-1203.
[14] Sudo N,Chida Y,Aiba Y,et al. Postnatal microbial colonization programs the hypothalamic-pituitary-adrenal system for stress response in mice [J]. J Physiol,2004,558(Pt1):263-275.
[15] Belvederi Murri M,Prestia D,Mondelli V,et al. The HPA axis in bipolar disorder:Systematic review and meta-analysis [J]. Psychoneuroendocrinology,2016,63:327-342.
[16] Strandwitz P. Neurotransmitter modulation by the gut microbiota [J]. Brain Res,2018,1693(Pt B):128-133.
[17] Schluter J,Peled JU,Taylor BP,et al. The gut microbiota is associated with immune cell dynamics in humans [J]. Nature,2020,588(7837):303-307.
[18] de Miranda AS,Vieira ELM,Dos Reis Bastos J,et al. Role of gut microbiota in the GBR12909 model of mania-like behavior in mice [J]. J Neuroimmunol,2020,346:577292.
[19] Stevens BR,Goel R,Seungbum K,et al. Increased human intestinal barrier permeability plasma biomarkers zonulin and FABP2 correlated with plasma LPS and altered gut microbiome in anxiety or depression [J]. Gut,2018,67(8):1555-1557.
[20] Wang LY,Chen SF,Chiang JH,et al. Systemic autoimmune diseases are associated with an increased risk of obsessive-compulsive disorder:a nationwide population-based cohort study [J]. Soc Psychiatry Psychiatr Epidemiol,2019,54(4):507-516.
[21] Severance EG,Yolken RH,Eaton WW. Autoimmune diseases,gastrointestinal disorders and the microbiome in schizophrenia:more than a gut feeling [J]. Schizophr Res,2016,176(1):23-35.
[22] Dai C,Zheng CQ,Meng Fj,et al. VSL#3 probiotics exerts the anti-inflammatory activity via PI3k/Akt and NF-κB pathway in rat model of DSS-induced colitis [J]. Molecular and Cellular Biochemistry,2012,374(1/2):1-11.
[23] Prinz M,Priller J. Microglia and brain macrophages in the molecular age:from origin to neuropsychiatric disease [J]. Nat Rev Neurosci,2014,15(5):300-312.
[24] Haarman BC,Riemersma Van der Lek RF,de Groot JC,et al. Neuroinflammation in bipolar disorder-A[(11)C]-(R)-PK11195 positron emission tomography study [J]. Brain Behav Immun,2014,40:219-225.
[25] Cryan JF,Dinan TG. Mind-altering microorganisms:the impact of the gut microbiota on brain and behavior [J]. Nat Rev Neurosci,2012,13(10):701-712.
[26] Stasi C,Sadalla S,Milani S. The Relationship Between the Serotonin Metabolism,Gut-Microbiota and the Gut-Brain Axis [J]. Curr Drug Metab,2019,20(8):646-655.
[27] Foster JA,McVey Neufeld KA. Gut-brain axis:how the microbiome influences anxiety and depression [J]. Trends Neurosci,2013,36(5):305-312.
[28] Baik JH. Dopamine Signaling in reward-related behaviors [J]. Front Neural Circuits,2013,7:152.
[29] González-Arancibia C,Urrutia-Pi?觡ones J,Illanes-González J,et al. Do your gut microbes affect your brain dopamin-e? [J]. Psychopharmacology,2019,236(5):1611-1622.
[30] Duman RS,Aghajanian GK. Synaptic dysfunction in depression:potential therapeutic targets [J]. Science,2012, 338(6103):68-72.
[31] MacQueen G,Frodl T. The hippocampus in major depression:evidence for the convergence of the bench and bedside in psychiatric research? [J]. Mol Psychiatry,2011, 16(3):252-264.
[32] Li N,Liu RJ,Dwyer JM,et al. Glutamate N-methyl-D-aspartate Receptor Antagonists Rapidly Reverse Behavioral and Synaptic Deficits Caused by Chronic Stress Exposure [J]. Biological Psychiatry,2011,69(8):754-761.
[33] Tian P,Wang G,Zhao J,et al. Bifidobacterium with the role of 5-hydroxytryptophan synthesis regulation alleviates the symptom of depression and related microbiota dysbiosis [J]. J Nutr Biochem,2019,66:43-51.
[34] O’Leary OF,Ogbonnaya ES,Felice D,et al. The vagus nerve modulates BDNF expression and neurogenesis in the hippocampus [J]. Eur Neuropsychopharmacol,2018, 28(2):307-316.
[35] Fernandes BS,Molendijk ML,Kohler CA,et al. Peripheral brain-derived neurotrophic factor(BDNF)as a biomarker in bipolar disorder:a meta-analysis of 52 studies [J]. BMC Med,2015,13:289.
[36] Post RM. Role of BDNF in bipolar and unipolar disorder:clinical and theoretical implications [J]. J Psychiatr Res,2007,41(12):979-990.
[37] Bengesser SA,Morkl S,Painold A,et al. Epigenetics of the molecular clock and bacterial diversity in bipolar disorder [J]. Psychoneuroendocrinology,2019,101:160-166.
[38] Bengesser SA,Reininghaus EZ,Lackner N,et al. Is the molecular clock ticking differently in bipolar disorder?Methylation analysis of the clock gene ARNTL [J]. World J Biol Psychiatry,2016,19(S2):S21-S29.
[39] Ong IM,Gonzalez JG,McIlwain SJ,et al. Gut microbiome populations are associated with structure-specific changes in white matter architecture [J]. Transl Psychiatry,2018, 8(1):6.
[40] Janik R,Thomason LAM,Stanisz AM,et al. Magnetic resonance spectroscopy reveals oral Lactobacillus promotion of increases in brain GABA,N-acetyl aspartate and glutamate [J]. NeuroImage,2016,125:988-995.
[41] Liu P,Peng G,Zhang N,et al. Crosstalk Between the Gut Microbiota and the Brain:An Update on Neuroimaging Findings [J]. Frontiers in Neurology,2019,10:883.