The Effects of Probiotic Supplementation on Depressive Symptoms: A Systematic Review
[1]
Paige Nicole Belanger, Department of Nutrition and Dietetics Graduate Program, Central Michigan University, Mount Pleasant, United States.
[2]
Susan Joyce Hewlings, Department of Nutrition and Dietetics Graduate Program, Central Michigan University, Mount Pleasant, United States.
Major depressive disorder (MDD) is a common life-disrupting, highly recurrent mental disorder that is a leading source of disability worldwide. The connection between the gut-brain axis as it relates to neurological function, specifically depression, has increasingly become a topic of interest. Recent studies have confirmed that the microbial composition in MDD patients differs from that of non-depressed individuals. For the purpose of this review, probiotics are defined as “live microorganisms which when administered in adequate amounts confer a health benefit on the host.” The beneficial effects not only localize in the gut but reach the whole microbiota-gut-brain axis. The purpose of this review was to evaluate randomized controlled trials (RCTs) assessing the effects of probiotic supplementation on depressive symptoms and depressive mood in healthy and clinically diagnosed patients. Specifically, to evaluate the hypothesis that probiotic supplementation in humans will lead to reduced depressive symptoms and a reduction in depressive mood occurrences. A systematic literature search was carried out using PubMed and MEDLINE databases. Of the final 4 RCTs selected, 2 evaluated the effect of probiotic supplementation on depressive symptoms or mood in healthy adults and 2 evaluated depressive symptoms or mood in clinical diagnosed samples (diagnosis of major depressive disorder). In each of the studies, the probiotic species administered were from Lactobacillus or Bifidobacterium strains (single strain and multi-strain). Results of these studies showed strong statistical significance for reductions in depressive symptoms across all 4 RCTs included. Additional research and increased sample size are required to confirm further and enhance the understanding of probiotic use to treat and prevent depression.
Microbiome, Probiotic, Major Depressive Disorder, Gut-Brain Axis, Systematic Review
[1]
Jiang H, Ling Z, Zhang Y, et al. Altered fecal microbiota composition in patients with major depressive disorder. Brain Behav Immun. 2015; 48: 186-194.
[2]
Naseribafrouei A, Hestad K, Avershina E, et al. Correlation between the human fecal microbiota and depression. Neurogastroenterol Motil. 2014; 26 (8): 1155-1162.
[3]
Zhao ZX, Fu J, Ma SR, et al. Gut-brain axis metabolic pathway regulates antidepressant efficacy of albiflorin. Theranostics. 2018; 8 (21): 5945-5959.
[4]
Lucas G. Gut thinking: the gut microbiome and mental health beyond the head. Microb Ecol Health Dis. 2018; 29 (2): 1548250.
[5]
Belmaker RH, Agam G. Major Depressive Disorder. In. Vol 358: N. Engl. J. Med.; 2008: 55-68.
[6]
Corfield EC, Yang Y, Martin NG, Nyholt DR. A Continuum of Genetic Liability for Minor and Major Depression. In. Vol 7: Transl. Psychiatry; 2017.
[7]
Chen Z, Li J, Gui S, et al. Comparative metaproteomics analysis shows altered fecal microbiota signatures in patients with major depressive disorder. Neuroreport. 2018; 29 (5): 417-425.
[8]
Liu B, Liu J, Wang M, Zhang Y, Li L. From Serotonin to Neuroplasticity: Evolvement of Theories for Major Depressive Disorder. In. Vol 11: Front. Cell. Neuroscience; 2017.
[9]
Chaudhury D, Liu H, Han MH. Neuronal Correlates of Depression. In. Vol 72: Cell. Mol. Life Sci.; 2015: 4825-4848.
[10]
Gulas E, Wysiadecki G, Strzelecki D, Gawlik-Kotelnicka O, Polguj M. Can microbiology affect psychiatry? A link between gut microbiota and psychiatric disorders. Psychiatr Pol. 2018; 52 (6): 1023-1039.
[11]
Lach G, Schellekens H, Dinan TG, Cryan JF. Anxiety, Depression, and the Microbiome: A Role for Gut Peptides. Neurotherapeutics. 2018; 15 (1): 36-59.
[12]
Foster JA, McVey Neufeld KA. Gut-brain axis: how the microbiome influences anxiety and depression. Trends Neurosci. 2013; 36 (5): 305-312.
[13]
Huang Y, Shi X, Li Z, et al. Possible association of Firmicutes in the gut microbiota of patients with major depressive disorder. Neuropsychiatr Dis Treat. 2018; 14: 3329-3337.
[14]
Ogbonnaya E, Clarke G, Shanahan F, Dinan T, Cryan J, O'Leary O. Adult Hppocampal Neurogenesis is Regulated by the Microbiome. In. Vol 78: Biol Psychiatry; 2015: e7-e9.
[15]
Maes M, Kubera M, Leunis J. The Gut-Brain Barrier in Major Depression: Intestinal Mucosal Dysfunction with an Increased Translocation of LPS from Gram Negative Enterobacteria Plays a Role in the Inflammatory Pathophysiology of Depression. In. Vol 29: Neuroendocrinol Lett.; 2008: 117-124.
[16]
Dinar TG, Cryan JF, Dinan TG. The impact of gut microbiota on brain and behaviour: implications for psychiatry. Current Opinion in Clinical Nutrition & Metabolic Care. 2015; 18 (6): 552-558.
[17]
Lv F, Chen S, Wang L, et al. The role of microbiota in the pathogenesis of schizophrenia and major depressive disorder and the possibility of targeting microbiota as a treatment option. Oncotarget. 2017; 8 (59): 100899-100907.
[18]
Hooks KB, Konsman JP, O'Malley MA. Microbiota-gut-brain research: a critical analysis. Behav Brain Sci. 2018: 1-40.
[19]
Dinan TG, Cryan JF. Melancholic microbes: a link between gut microbiota and depression? Neurogastroenterol Motil. 2013; 25 (9): 713-719.
[20]
Macpherson AJ, Harris NL. Interactions Between Commensal Intestinal Bacteria and the Immune System. In. Vol 4: Nat. Rev. Immunol; 2004: 478-485.
[21]
Hooper LV. Molecular Analysis of Commensal Host - Microbial. Relationships in the Intestine. In. Vol 291: Science; 2001: 881-884.
[22]
Tlaskalova-Hogenova H. Commensal Bacteria (Normal Microflora), Mucosal Immunity and Chronic Inflammatory and Autoimmune Diseases. In. Vol 93: Immunol. Lett.; 2004: 97-108.
[23]
Horne R, Foster JA. Metabolic and Microbiota Measures as Peripheral Biomarkers in Major Depressive Disorder. Front Psychiatry. 2018; 9: 513.
[24]
Ng QX, Peters C, Ho CYX, Lim DY, Yeo WS. A meta-analysis of the use of probiotics to alleviate depressive symptoms. J Affect Disord. 2018; 228: 13-19.
[25]
Roca-Saavedra P, Mendez-Vilabrille V, Miranda JM, et al. Food Additives, Contaminants and Other Minor Components: Effects of Human Gut Microbiota - A Review. In. Vol 71: J. Physiol. Biochem.; 2017: 69-83.
[26]
Evrensel A, Ceylan ME. The Gut-Brain Axis: The Missing Link in Depression. Clin Psychopharmacol Neurosci. 2015; 13 (3): 239-244.
[27]
Dinan TG, Quigley EM. Probiotics in the treatment of depression: science or science fiction? Australian & New Zealand Journal of Psychiatry. 2011; 45 (12): 1023-1025.
[28]
Liang S, Wu X, Hu X, Wang T, Jin F. Recognizing Depression from the Microbiota⁻Gut⁻Brain Axis. Int J Mol Sci. 2018; 19 (6).
[29]
FAO. Properties of Probiotics in Food Including Powder Milk with Live Lactic Acid Bacteria. In. FAO: Rome, Italy WHO: Geneva, Switzerland 2001.
[30]
Moher D, Liberati A, Altman D, Group TP. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. In. Vol 6: PLoS Med; 2009.
[31]
Mohammadi AA, Jazayeri S, Khosravi-Darani K, et al. The effects of probiotics on mental health and hypothalamic–pituitary–adrenal axis: A randomized, double-blind, placebo-controlled trial in petrochemical workers. In. Vol 19: Nutritional Neuroscience; 2016: 387-395.
[32]
Kazemi A, Noorbala AA, Azam K, Eskandari MH, Djafarian K. Effect of probiotic and prebiotic vs placebo on psychological outcomes in patients with major depressive disorder: A randomized clinical trial. Clin Nutr. 2018.
[33]
Akkasheh G, Kashani-Poor Z, Tajabadi-Ebrahimi M, et al. Clinical and metabolic response to probiotic administration in patients with major depressive disorder: A randomized, double-blind, placebo-controlled trial. Nutrition. 2016; 32 (3): 315-320.
[34]
Steenbergen L, Sellaro R, van Hemert S, Bosch JA, Colzato LS. A randomized controlled trial to test the effect of multispecies probiotics on cognitive reactivity to sad mood. Brain Behav Immun. 2015; 48: 258-264.
[35]
David L, Maurice C, Carmody R, et al. Diet Rapidly and Reproducibly Alters the Human Gut Microbiome. In. Vol 505: Nature; 2014: 559-563.
[36]
Bates M. Gut Feeling: Researchers Are Discovering a Link Between Depression and Gut Bacteria. IEEE Pulse. 2017; 8 (6): 15-18.
