Abstract
Gut microbiota are suspected to affect brain functions and behavior as well as lowering inflammation status. Therefore, an effect on depression has already been suggested by recent research. The aim of this randomized double-blind controlled trial was to evaluate the effect of probiotic treatment in depressed individuals. Within inpatient care, 82 currently depressed individuals were randomly assigned to either receive a multistrain probiotic plus biotin treatment or biotin plus placebo for 28 days. Clinical symptoms as well as gut microbiome were analyzed at the begin of the study, after one and after four weeks. After 16S rRNA analysis, microbiome samples were bioinformatically explored using QIIME, SPSS, R and Piphillin. Both groups improved significantly regarding psychiatric symptoms. Ruminococcus gauvreauii and Coprococcus 3 were more abundant and β-diversity was higher in the probiotics group after 28 days. KEGG-analysis showed elevated inflammation-regulatory and metabolic pathways in the intervention group. The elevated abundance of potentially beneficial bacteria after probiotic treatment allows speculations on the functionality of probiotic treatment in depressed individuals. Furthermore, the finding of upregulated vitamin B6 and B7 synthesis underlines the connection between the quality of diet, gut microbiota and mental health through the regulation of metabolic functions, anti-inflammatory and anti-apoptotic properties. Concluding, four-week probiotic plus biotin supplementation, in inpatient individuals with a major depressive disorder diagnosis, showed an overall beneficial effect of clinical treatment. However, probiotic intervention compared to placebo only differed in microbial diversity profile, not in clinical outcome measures.
Highlights
Depression is one of the most common mental disorders and a leading cause of global socioeconomic burden of disease worldwide, as it may result in significant disabilities in affected patients
In a pilot study, our study group could show a significantly reduced cognitive reactivity to sad mood in 27 individuals with euthymic bipolar disorder receiving probiotic treatment over a period of three months, indicating that participants under probiotic supplementation perceived themselves to be less distracted by ruminative thoughts [24]
61 individuals were included in the study and completed at least the baseline study visit (t0, n = 28 probiotics, n = 33 placebo)
Summary
Depression is one of the most common mental disorders and a leading cause of global socioeconomic burden of disease worldwide, as it may result in significant disabilities in affected patients. Inflammation is a major pathophysiological pathway associated with affective disorders [1]. In this context, the microbiota-gut-brain-axis (MGBA) has gained increasing interest as a bidirectional communication system between the gut and brain, especially as microbiota metabolites mediate the inflammatory pathways. The microbiota-gut-brain-axis (MGBA) has gained increasing interest as a bidirectional communication system between the gut and brain, especially as microbiota metabolites mediate the inflammatory pathways Microbiota and their compounds release pro-inflammatory cytokines, change intestinal permeability and alter immune response; changes that may lead to disturbances in mental health [2]. Microbiota are likely to have effects on brain function and behavior, including affect, motivation and higher cognitive functions [3,4,5,6]. Animal-based research found specific intestinal microbes to be beneficial in brain development and microglia [7,8]
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