首发重性抑郁症患者肠道菌群组成及与胃肠道症状的相关性  

Gut microbiota in patients with first-episode major depressive disorder:composition and correlations with gastrointestinal symptoms

作　　者：刘鹏鸿[1,2] 张克让[1,2] LIU Penghong;ZHANG Kerang(Department of Psychiatry,First Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi,China;The First Clinical Medical College of Shanxi Medical University,Taiyuan 030001,Shanxi,China)

机构地区：[1]山西医科大学第一医院精神卫生科,山西太原030001 [2]山西医科大学第一临床医学院,山西太原030001

出　　处：《微生物学通报》2023年第8期3575-3587,共13页Microbiology China

基　　金：国家自然科学基金(82201691);山西省科技厅自由探索类项目(20210302124193)。

摘　　要：【背景】重性抑郁症(majordepressivedisorder,MDD)是一种常见的重大精神疾病,MDD患者多伴有胃肠道症状,但很少有研究关注MDD患者胃肠道症状发生的机制。【目的】探索首发未治疗MDD患者肠道菌群的特征及其与炎症标志物和胃肠道症状的相关性,为MDD的治疗提供理论依据。【方法】募集符合入组和排除标准的91例首发未服药MDD患者和105名健康对照者(healthy controls,HCs)。采用16S rRNA基因测序技术和生物信息学分析评估粪便菌群组成。采用酶联免疫吸附试验(enzymelinkedimmunosorbentassay,ELISA)检测外周血高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-10(interleukin-10,IL-10)和肿瘤坏死因子-α(tumornecrosis factor-α,TNF-α);采用胃肠症状评定量表(gastrointestinal symptom rating scale,GSRS)和汉密尔顿抑郁量表(Hamiltondepressionscale,HAMD)分别评估胃肠道症状和抑郁症状的严重程度。【结果】所有MDD患者都伴有胃肠道症状,食欲下降、早饱感、恶心呕吐的发生率均高于70%。与HCs相比,MDD患者外周血中hs-CRP水平明显升高(P<0.05);两组受试者肠道菌群α多样性和β多样性存在明显差异(P<0.05)。在属水平上,MDD组中地嗜皮菌属、异斯卡多维亚菌属、双歧杆菌属、布洛特菌属、钩丝菌属、红长菌属、马赛菌属、嗜血杆菌属、CandidatusXiphinematobacter和Chthoniobacter的相对丰度较高,拟杆菌属、副拟杆菌属、SMB53、厌氧菌属、梭菌属、毛梭菌属、罗斯氏菌属、粪杆菌属、瘤胃球菌属、小杆菌属、考拉杆菌属和萨特氏菌属的相对丰度较低。相关性分析发现罗斯氏菌属、萨特氏菌属、副拟杆菌属的相对丰度与hs-CRP、HAMD-17总分、GSRS总分及GSRS部分条目呈负相关(P<0.05)。【结论】MDD患者外周血hs-CRP升高,紊乱的肠道菌群与hs-CRP、抑郁症状和胃�[Background]Major depressive disorder(MDD)is a common major mental disorder and most MDD patients have gastrointestinal(GI)symptoms.However,little is known about the occurrence mechanisms of GI symptoms in MDD.[Objective]To explore the gut microbiota composition and its correlations with inflammation markers and GI symptoms in the patients with first-episode MDD,providing a theoretical basis for the treatment of MDD.[Methods]The participants included 91 first-episode,drug-naive MDD patients and 105 healthy controls(HCs).The 16S rRNA gene sequencing and bioinformatics tools were employed to reveal the composition of fecal microbiota.The levels of high-sensitivity C-reactive protein(hs-CRP),interleukin-1 beta(IL-1β),IL-6,IL-10,and tumor necrosis factor-alpha(TNF-α)in the peripheral blood were measured via enzyme-linked immunosorbent assay(ELISA).Gastrointestinal symptom rating scale(GSRS)and Hamilton depression scale(HAMD)were used to evaluate the severity of GI symptoms and depression symptoms,respectively.[Results]All the MDD patients were accompanied by GI symptoms,and the incidence of anorexia,early satiety,nausea,and vomiting was higher than 70%.Compared with HCs,MDD patients had elevated level of hs-CRP and showed different alpha diversity and beta diversity of gut microbiota(P<0.05).Linear discriminant analysis effect size(LEfSe)showed that MDD patients had higher relative abundance of Geodermatophilus,Alloscardovia,Bifidobacterium,Blautia,Leptothrix,Rubrivivax,Massilia,Haemophilus,Candidatus Xiphinematobacter,and Chthoniobacter and lower relative abundance of Bacteroides,Parabacteroides,SMB53,Anaerostipes,Clostridium,Lachnospira,Roseburia,Faecalibacterium,Ruminococcus,Dialister,Phascolarctobacterium,and Sutterella.Furthermore,the correlation analysis revealed that the relative abundance of Roseburia,Sutterella,and Parabacteroides were negatively correlated with hs-CRP,total score of HAMD-17,and the total score and some item scores of GSRS(P<0.05).[Conclusion]This study demonstrates that compared with HCs,

关 键 词：重性抑郁症 胃肠道症状 肠道菌群 肠-脑轴 高敏C反应蛋白(hs-CRP) 

分 类 号：R749.4[医药卫生—神经病学与精神病学]