Psycho-Microbiology
Recent Advances
Dr. Gunjan Priyam
• Probiotics are gradually gaining importance in the field of
psychiatry in the form of psychobiotics.
• Psychobiotics’ studies examine the existing relationship
between gut microbiota and mental phenomena
• intake of certain strains of probiotics, such
as Bifidobacterium and Lactobacillus, for example, allow the gut
microbial system to be modified in order to provide benefits at
the psychic, immune, hormonal, and mental levels.
• Those who suffer from forms of depression, anxiety disorders,
chronic stress, low mood, but also people who do not suffer
from such disorders, can therefore benefit from the use of
psychobiotics.
• probiotics produce neurochemicals within the gut microbiota
and interact with receptors of the enteric nervous system that
innervate the entire gastrointestinal tract.
• Once they enter the portal circulation, these substances go on
to influence components of the nervous system and ultimately
the brain, through what is called the gut–brain axis.
Probiotics
• Probiotics are live and viable microorganisms that,
when administered frequently and in adequate
amounts, benefit the health of the host
They share the following requirements and common
traits :
• They are safe for use in humans;
• They are active and viable in the gut, and present in
sufficient quantity to justify any beneficial effects;
• They have an active metabolism in the human
intestine, and some strains could persist and multiply;
• They confer a demonstrated physiological benefit.
• Probiotics must not carry acquired and/or
transmissible antibiotic resistance; moreover,
it is worth mentioning that their colonization
in the intestine is only temporary in nature
and ends a few days after discontinuation of
their intake.
Gut microbiota
• set of living species that colonize the human
gastrointestinal tract
• considered one of the most densely populated
ecosystems in the world
• estimated 100 trillion microorganisms including bacteria,
yeasts, protozoa, and viruses.
When these communities are in balance with
each other, a condition called eubiosis is
established
• Under these conditions, the microbiota can perform
several essential functions for the host
• including developmental, immunological, nutritional,
infection prevention, nutrient acquisition, and brain and
nervous system functions .
• role that a well-balanced microbiota plays in eubiosis is
critical to the overall health of the body.
• If balance is lacking, a condition called dysbiosis is
established and can cause various diseases, metabolic
disorders, and affect human life.
• Gut microbiota changes throughout the course of life,
providing each individual with a specific “fingerprint.”
• it develops at birth, diversifies by increasing in
composition and becomes stable between the third and
seventh decade of life
• with aging that its microbial diversity tends to decrease.
• Studies have shown the presence of 10 predominant
microbial phyla in the human gut microbiota.
• In particular, the phyla Firmicutes, Bacteroidetes, and
Proteobacteria represent 90% of the total
• the phyla Actinobacteria, Fusobacteria, and
Verrucomicrobia account for the remaining 10%
Gut–brain axis
• Microbiota and the brain are capable of exerting a strong
influence on each other through a bidirectional
connection.
• They communicate through various pathways, including
the immune system, tryptophan metabolism, vagus
nerve, and enteric nervous system,
• involving microbial metabolites such as short-chain fatty
acids, branched-chain amino acids, and peptidoglycans
acting as neurotransmitters
• This connection not only serves to ensure the proper
digestive pathway
• but is involved in a multitude of physiological processes
including satiety, food intake, regulation of glucose and
fat metabolism, hormone secretion and sensitivity
(especially to insulin), and bone metabolism.
• psychobiotics was introduced to define a new class of
probiotics able to produce substances that can affect the
gut–brain connection
• improve mood, decrease anxiety and depression, and
bring many other benefits
• Recent studies, mainly carried out on animal models,
support the role of microbes as signaling components in
the gut–brain axis
• it has been established that the vagus nerve is the main
route for exerting the effects of gut microbiota on the
central nervous system.
• There are many probiotics that have shown a positive
effect in this regard
• treatment with Bifidobacterium spp. can increase the
amount of tryptophan,precursor of serotonin, the
hormone of happiness.
• Some Lactobacillus and related genera species alter
gamma-aminobutyric acid (GABA) metabolism and
change brain GABA receptor expression and behavior.
Synthesis and release of neurotransmitters from bacteria
have been reported:
• Lactobacillus and Bifidobacterium species can produce
GABA
• Saccharomyces spp., Escherichia, and Bacillus can
produce noradrenaline
• Streptococcus, Enterococcus spp., Escherichia,
and Candida can produce serotonin.
• Bacillus can produce dopamine; and Lactobacillus can
produce acetylcholine
• in current practice, the treatment of anxiolytic and
antidepressive-like behavior has been mediated
with Lacticaseibacillus rhamnosus JB-1 oral therapy
through the gut–brain axis.
• Moreover, from numerous studies it was found that a
quantifiable set of microbial markers was consistently
present in the feces of depressed subjects.
• These markers can also be used to determine the severity
of disease progression.
• Tran et al. [1] conducted their assessments on college
students (n = 86), healthy young adults aged 18 to 31
without severe psychological disturbances.
• They were asked to consume a daily mix of probiotics for
28 days; the mix was composed of multiple strains
of Bifidobacterium spp., Lactobacillus spp., Streptococcus
salivarius subsp. thermophilus, Bacillus coagulans,
and Lactococcus lactis, with concentrations ranging from
1 × 1010 to 5 × 1010 CF
• before and after the trial, they completed: BAI (Beck Anxiety
Inventory), a self-report tool, to evaluate the severity of
anxiety
• A multiple regression approach on the results pointed out
that probiotics reduced panic anxiety in 35.41% of cases.
• An important outcome of the research was that a ceiling
effect of probiotics was found in some subjects; thus, the
authors concluded that anxiety was reduced only in people
with a high level of stress, with promising results in all
volunteers in terms of worry, negative affect, mood
regulation, and anxiety control.
• Lew et al. [2] conducted a 12-week randomized, double-
blind, placebo-controlled study on the effects
of Lactiplantibacillus plantarum strain P8 (10 log
CFU/day) in 103 stressed adults.
• Cortisol and cytokine levels in plasma were evaluated,
and participants completed CogState tests to evaluate
cognition and cognitive functions
• The data obtained showed a reduction in some
inflammatory cytokines, and enhanced memory and
cognitive traits.
• Probiotics were to treat schizophrenia .
• In the study of Okubo et al. [3] B. breve A-1 was
administered to a group composed of 30 volunteer
patients.
• after 4 weeks evaluation, a higher number
of Parabacteroides in the feces and a reduction in
symptoms were recorded in responders.
• Kazemi et al. [4] evaluated the effect of probiotics on
patients with major depressive disorder (MDD)
• using the Beck Depression Inventory (BDI) score, on the
kynurenine–tryptophan ratio and on the tryptophan–
branch chain ratio (BCAA).
• Patients (n = 110) were randomly assigned a probiotic
(L. helveticus and B. longum), prebiotic (galacto-
oligosaccharide), or placebo for eight weeks.
• Overall, eight weeks of probiotic supplements in
subjects with MDD resulted in an improvement in the
BDI score compared to placebo, while no significant
effect of the prebiotic was recorded.
Conclusion
• The outcomes of studies on the use of psychobiotics
appear to be very promising.
• Gut microbiota is not a silent organ, and the microbial
communities that populate it are active participants in
determining the well-being of the host, and for mental
health through the bidirectional gut–brain axis.
• Some strains or mixes could positively contribute to
situations involving reduction in anxiety, sleep-related
disorders, improvement of cognitive function, reduction
in stress and thus cortisol levels, or reduction in mental
fatigue.
• However, there is a long way to go; some benefits are
documented, while others are only postulated. Moreover, it
is important to understand the exact mechanisms by which
probiotics could act as psychobiotics.
• the possible effects of psychobiotics and the trends for
future research : regulation of neuroendocrine response to
stress; improvement of memory and learning ability; mood
improvement; and reduction in risk of depression, sleep
disturbance, and stress, linked to a physiological effect on
some inflammation markers.
•
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