Abstract

Cumulative evidence shows a linkage between gut microbiota pattern and depression through the brain-gut microbiome axis. The aim of this systematic review was to identify the alterations of the gut microbiota patterns in people with depression compared to healthy controls. A comprehensive literature search of human studies, published between January 2000 and June 2019, was reviewed. The key words included gastrointestinal microbiome, gut microbiome, microbiota, depression, depressive symptoms, and depressive disorder. The systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Nine articles met the eligibility criteria. Disparities in α-diversity and β-diversity of the microbiota existed in people with depression compared to healthy controls. At the phylum level, there were inconsistencies in the abundance of Firmicutes, Bacteroidetes, and Proteobacteria. However, high abundance in Actinobacteria and Fusobacteria phyla were observed in people with depression. On the family level, high abundance of Actinomycineae, Coriobacterineae, Bifidobacteriaceae, Clostridiales incertae sedis XI, Porphyromonadaceae, Clostridiaceae, Lactobacillaceae, Streptococcaceae, Eubacteriaceae, Thermoanaerobacteriaceae, Fusobacteriaceae, Nocardiaceae, Streptomycetaceae, and low abundance of Veillonellaceae, Prevotellaceae, Bacteroidaceae, Sutterellaceae, Oscillospiraceae, Marniabilaceae, and Chitinophagaceae were observed in people with depression. On the genus level, high abundance of Oscillibacter, Blautia, Holdemania, Clostridium XIX, Anaerostipes, Anaerofilum, Streptococcus, Gelria, Turicibacter, Parabacteroides, Eggerthella, Klebsiella, Paraprevotella, Veillonella, Clostridium IV, Erysipelotrichaceae incertae sedis, Eubacterium, Parvimonas, Desulfovibrio, Parasutterella, Actinomyces, Asaccharobacter, Atopobium, Olsenella and low abundance of Coprococcus, Lactobacillus, Escherichia/Shigella, Clostridium XlVa, Dialister, Howardella, Pyramidobacter, and Sutterella were found in people with depression. Alteration of gut microbiome patterns was evident in people with depression. Further evidence is warranted to allow for the translation of microbiome findings toward innovative clinical strategies that may improve treatment outcomes in people with depression.

Highlights

  • Depression affects more than 300 million people of all ages globally [1], and is one of the leading causes of psychiatric disability [2]

  • Depression severity was assessed with a variety of standardly accepted instruments including Hamilton Depression Rating Scale (HDRS), Montgomery–Åsberg Depression Rating Scale (MADRS), or Beck Depression Inventory

  • The systematic review revealed some differences in the gut microbiota diversity, the richness and evenness of microbes were different in people living with depression as compared to healthy adults

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Summary

Introduction

Depression affects more than 300 million people of all ages globally [1], and is one of the leading causes of psychiatric disability [2]. Outcomes of current depression psychotherapies are suboptimal with treatment failures common [3]. Failure to enhance the treatment outcomes reflects the need for further research related to the pathophysiology of depression. The monoaminergic system plays an important role in depression with multiple interactions in the central nervous system (CNS) function [6]. The gut microbiota has been introduced as a novel area of investigation of depression pathophysiology [2]. Gut microbes in the brain-gut axis communicate to the CNS via endocrine, nervous, and immune signaling mechanisms. The brain may affect the community pattern and function of the gut microbiota throughout the autonomic nervous system (ANS) through modulation of the intestinal transit via secretion, regional gut motility, and gut permeability [11] (Figure 1)

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