Probiotics for the treatment of depressive symptoms: An anti-inflammatory mechanism?

•Numerous studies indicate that probiotics have anti-inflammatory effects.•Immune-inflammatory modulation may mediate the antidepressant effects of probiotics.•Probiotics may be more effective in depressed subgroups with elevated inflammation.•Future studies should parse out the heterogeneous effect...

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Bibliographic Details
Published in:Brain, behavior, and immunity behavior, and immunity, 2018-10, Vol.73, p.115-124
Main Authors: Park, Caroline, Brietzke, Elisa, Rosenblat, Joshua D., Musial, Natalie, Zuckerman, Hannah, Ragguett, Renee-Marie, Pan, Zihang, Rong, Carola, Fus, Dominika, McIntyre, Roger S.
Format: Article
Language:English
Subjects:
Anti-Inflammatory Agents - pharmacology
Depression
Depression - drug therapy
Depressive Disorder, Major - drug therapy
Depressive symptoms
Gastrointestinal Microbiome - drug effects
Gut microbiota
Humans
Immune System
Inflammation
Inflammation - complications
Major depressive disorder
Probiotics
Probiotics - pharmacology
Probiotics - therapeutic use
Treatment
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Summary:•Numerous studies indicate that probiotics have anti-inflammatory effects.•Immune-inflammatory modulation may mediate the antidepressant effects of probiotics.•Probiotics may be more effective in depressed subgroups with elevated inflammation.•Future studies should parse out the heterogeneous effects of different probiotics. During the past decade, there has been renewed interest in the relationship between brain-based disorders, the gut microbiota, and the possible beneficial effects of probiotics. Emerging evidence suggests that modifying the composition of the gut microbiota via probiotic supplementation may be a viable adjuvant treatment option for individuals with major depressive disorder (MDD). Convergent evidence indicates that persistent low-grade inflammatory activation is associated with the diagnosis of MDD as well as the severity of depressive symptoms and probability of treatment response. The objectives of this review are to (1) evaluate the evidence supporting an anti-inflammatory effect of probiotics and (2) describe immune system modulation as a potential mechanism for the therapeutic effects of probiotics in populations with MDD. A narrative review of studies investigating the effects of probiotics on systemic inflammation was conducted. Studies were identified using PubMed/Medline, Google Scholar, and clinicaltrials.gov (from inception to November 2017) using the following search terms (and/or variants): probiotic, inflammation, gut microbiota, and depression. The available evidence suggests that probiotics should be considered a promising adjuvant treatment to reduce the inflammatory activation commonly found in MDD. Several controversial points remain to be addressed including the role of leaky gut, the role of stress exposure, and the role of blood-brain-barrier permeability. Taken together, the results of this review suggest that probiotics may be a potentially beneficial, but insufficiently studied, antidepressant treatment intervention.
ISSN:0889-1591
1090-2139
DOI:10.1016/j.bbi.2018.07.006