Probiotics in reducing anxiety and depression symptoms: an integrative review
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Published:
Dec 14, 2020
Keywords:
anxiety, depression, intestinal microbiota, probiotics
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Abstract
Objectives: To summarize studies that evaluated probiotic supplementation as a therapeutic strategy for anxiety and depression symptoms. Methods: An integrative review of articles indexed in the PubMed, SciELO and Virtual Health Library databases published between January 2010 and September 2019. For this purpose, the combination of descriptors: “intestine”, “brain”, “Intestinal microbiota”, “anxiety”, “depression”, “probiotics”, in Portuguese and English. Results: After applying the inclusion and exclusion criteria, 13 randomized clinical trials were selected. The duration of the studies in its majority was 8 or 12 weeks (61.5%; n = 8), and the most offered form of the supplement was the probiotic powder (46.2%; n = 6) and capsule (30.8%; n = 4). Regarding the use of scales as a parameter for assessing symptoms of anxiety and depression, 38.5% (n = 5) used only one scale and 69.2% (n = 8) used the combination of two or three scales. Regarding the genus of bacteria, most studies used Lactobacillus and Bifidobacterium together (53.8%; n = 7). Despite methodological limitations and inconsistent results, most clinical trials (76.92%; n = 10) showed a significant reduction in symptoms related to anxiety and depression through probiotic supplementation. Conclusion: The evidence indicates that supplementation with probiotics has a potential in reducing symptoms of anxiety and depression, however further research is needed on this strategy as an adjunctive therapy in effective treatment for mental health.
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Costa BC, Azevedo GS dos S, Ferreira PHA, Rodrigues Almeida LM. Probiotics in reducing anxiety and depression symptoms: an integrative review. HSJ [Internet]. 2020Dec.14 [cited 2024May18];10(4):97-108. Available from: https://portalrcs.hcitajuba.org.br/index.php/rcsfmit_zero/article/view/1014
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3. Murray E, Sharma R, Smith KB, Mar KD, Barve R, Lukasik M, et al. Probiotic consumption during puberty mitigates LPS-induced immune responses and protects against stress-induced depression- and anxiety-like behaviors in adulthood in a sex-specific manner. Brain Behav Immun. 2019;81:198-212. https://doi.org/10.1016/j.bbi.2019.06.016 PMid:31212008
4. Desbonnet L, Garrett L, Clarke G, Kiely B, Cryan JF, Dinan TG. Effects of the probiotic Bifidobacterium infantis in the maternal separation model of depression. Neuroscience. 2010;170(4):1179-88. https://doi.org/10.1016/j.neuroscience.2010.08.005 PMid:20696216
5. Bravo JA, Forsythe P, Chew MV, Escaravage E, Savignac HM, Dinan TG, et al. Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Proc Natl Acad Sci U S A. 2011;108(38):16050-55. https://doi.org/10.1073/pnas.1102999108 PMid:21876150 PMCid:PMC3179073
6. Cryan JF, Dinan TG. Mindaltering microorganisms: the impact of the gut microbiota on brain and behaviour. Nat Rev Neurosci. 2012;13(10):701-12. https://doi.org/10.1038/nrn3346 PMid:22968153
7. Hooper LV, Littman DR, Macpherson AJ. Interactions between the microbiota and the immune system. Science. 2012;336(6086):1268-73. https://doi.org/10.1126/science.1223490 PMCid:PMC4420145
8. Tremaroli V, Backhed F. Functional interactions between the gut microbiota and host metabolism. Nature. 2012;489(7415):242-9. https://doi.org/10.1038/nature11552 PMid:22972297
9. Sharon G, Garg N, Debelius J, Knight R, Dorrestein PC, Mazmanian SK. Specialized metabolites from the microbiome in health and disease. Cell Metab. 2014;20(5):719-30. https://doi.org/10.1016/j.cmet.2014.10.016 PMid:25440054 PMCid:PMC4337795
10. Food and Agriculture Organization/World Health Organization. Working Group Report on drafting guidelines for the evaluation of probiotics in food [Internet]. London, Ontario, Canada; FAO/WHO; 2002 May [cited 2020 Nov 12]. Avaiable from: https://www.who.int/foodsafety/fs_management/en/probiotic_guidelines.pdf
11. Dinan TG, Stanton C, Cryan JF. Psychobiotics: a novel class of psychotropic. Biol Psychiatry. 2013;74(10):720-6. https://doi.org/10.1016/j.biopsych.2013.05.001 PMid:23759244
12. Schousboe A, Waagepetersen HS. GABA: Homeostatic and pharmacological aspects. Prog Brain Res. 2007;160:9-19. https://doi.org/10.1016/S0079-6123(06)60002-2
13. Lyte M. Probiotics function mechanistically as delivery vehicles for neuroactive compounds: Microbial endocrinology in the design and use of probiotics. Bioessays. 2011;33(8):574-81. https://doi.org/10.1002/bies.201100024 PMid:21732396
14. Health Canada [Internet site]. Accepted claims about the nature of probiotic microorganisms in food. Health Canada; 2009 Apr 16 [cited 2020 Nov 12]. Avaiable from: https://bit.ly/32BfhyA
15. Savignac HM, Kiely B, Dinan TG, Cryan JF. Bifidobacteria exert strain-specific effects on stress-related behavior and physiology in BALB/c mice. Neurogastroenterol Motil. 2014;26(11):1615-27. https://doi.org/10.1111/nmo.12427 PMid:25251188
16. Savignac HM, Tramullas M, Kiely B, Dinan TG, Cryan JF. Bifidobacteria modulate cognitive processes in an anxious mouse strain. Behav Brain Res. 2015;287:59-72. https://doi.org/10.1016/j.bbr.2015.02.044 PMID: 25794930
17. Mulder IE, Schmidt B, Lewis M, Delday M, Stokes CR, Bailey M, et al. Restricting microbial exposure in early life negates the immune benefits associated with gut colonization in environments of high microbial diversity. PLoS One 2011;6(12):e28279. https://doi.org/10.1371/journal.pone.0028279 PMid:22216092 PMCid:PMC3245219
18. Lewis MC, Inman CF, Patel D, Schmidt B, Mulder I, Miller B, et al. Direct experimental evidence that early-life farm environment influences regulation of immune responses. Pediatr Allergy Immunol. 2012;23(3):265-9. https://doi.org/10.1111/j.1399-3038.2011.01258.x PMid:22300455
19. Butler JE, Weber P, Sinkora M, Baker D, Schoenherr A, Mayer B, et al. Antibody repertoire development in fetal and neonatal piglets. VIII. Colonization is required for newborn piglets to make serum antibodies to T-dependent and type 2 T-independent antigens. J Immunol. 2002;169(12):6822-30. https://doi.org/10.4049/jimmunol.169.12.6822 PMid:12471114
20. National Collaborating Centre for Methods and Tools [Internet]. Effective Public Health Practice Project. Quality assessment tool for quantitative studies. Hamilton, Ontario: Effective Public Health Practice Project; 1998 [cited 2002 Nov 12]. Avaiable from: https://merst.ca/ephpp/
21. Wang L, Zhang J, Guo Z, Kwok L, Ma C, Zhang W, et al. Effect of oral consumption of probiotic Lactobacillus planatarum P-8 on fecal microbiota, SIgA, SCFAs, and TBAs of adults of different ages. Nutrition. 2014;30(7-8):776-83.e1. https://doi.org/10.1016/j.nut.2013.11.018 PMid:24984992
22. Wikoff WR, Anfora AT, Liu J, Schultz PG, Lesley SA, Peters EC. Metabolomics analysis reveals large effects of gut microflora on mammalian blood metabolites. Proc Natl Acad Sci U S A. 2009;106(10):3698-03. https://doi.org/10.1073/pnas.0812874106 PMid:19234110 PMCid:PMC2656143
23. Tolhurst G, Heffron H, Lam YS, Parker HE, Habib AM, Diakogiannaki E, et al. Short-chain fatty acids stimulate glucagon-like peptide-1 secretion via the G-protein-coupled receptor FFAR2. Diabetes. 2012;61(2):364-71. https://doi.org/10.2337/db11-1019 PMid:22190648 PMCid:PMC3266401
24. Yano JM, Yu K, Donaldson GP, Shastri GG, Ann P, Ma L, et al. Indigenous bacteria from the gut microbiota regulate host serotonin biosynthesis. Cell. 2015;161(2):264-76. https://doi.org/10.1016/j.cell.2015.02.047 PMid:25860609 PMCid:PMC4393509
25. Thayer JF, Sternberg EM. Neural concomitants of immunity: focus on the vagus nerve. Neuroimage. 2009;47(3):908-10. https://doi.org/10.1016/j.neuroimage.2009.05.058 PMid:19481613 PMCid:PMC2860274
26. Spalding TW, Jeffers LS, Porges SW, Hatfield BD. Vagal and cardiac reactivity to psychological stressors in trained and untrained men. Med Sci Sports Exerc. 2000;32(3):581-91. https://doi.org/10.1097/00005768-200003000-00006 PMid:10730999
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