FMT for psychiatric disorders: Following the brown brick road into the future

Green, Jessica Emily; Berk, Michael; Loughman, Amy; Marx, Wolfgang; McGuinness, Amelia J; Cryan, John F.; Nierenberg, Andrew A.; Athan, Eugene; Hair, Christopher; Jacka, Felice N.

doi:10.1111/bdi.13124

Cited by 8 publications

(6 citation statements)

References 6 publications

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“…Critically, the functional potential of different bacteria is increasingly understood [ 29 , 30 ], meaning that identification of key taxa that are differentially abundant in people with mental disorders and that influence these commonly dysregulated systems is an imperative. Such identification may afford opportunities for both understanding aetiology and identifying clinically useful biomarkers, as well as new targeted treatment strategies, including dietary changes [ 31 – 35 ], antibiotics [ 36 – 42 ], probiotic supplements [ 43 – 49 ] and even faecal microbial transplants [ 50 – 52 ].…”

Section: Introductionmentioning

confidence: 99%

A systematic review of gut microbiota composition in observational studies of major depressive disorder, bipolar disorder and schizophrenia

et al. 2022

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The emerging understanding of gut microbiota as ‘metabolic machinery’ influencing many aspects of physiology has gained substantial attention in the field of psychiatry. This is largely due to the many overlapping pathophysiological mechanisms associated with both the potential functionality of the gut microbiota and the biological mechanisms thought to be underpinning mental disorders. In this systematic review, we synthesised the current literature investigating differences in gut microbiota composition in people with the major psychiatric disorders, major depressive disorder (MDD), bipolar disorder (BD) and schizophrenia (SZ), compared to ‘healthy’ controls. We also explored gut microbiota composition across disorders in an attempt to elucidate potential commonalities in the microbial signatures associated with these mental disorders. Following the PRISMA guidelines, databases were searched from inception through to December 2021. We identified 44 studies (including a total of 2510 psychiatric cases and 2407 controls) that met inclusion criteria, of which 24 investigated gut microbiota composition in MDD, seven investigated gut microbiota composition in BD, and 15 investigated gut microbiota composition in SZ. Our syntheses provide no strong evidence for a difference in the number or distribution (α-diversity) of bacteria in those with a mental disorder compared to controls. However, studies were relatively consistent in reporting differences in overall community composition (β-diversity) in people with and without mental disorders. Our syntheses also identified specific bacterial taxa commonly associated with mental disorders, including lower levels of bacterial genera that produce short-chain fatty acids (e.g. butyrate), higher levels of lactic acid-producing bacteria, and higher levels of bacteria associated with glutamate and GABA metabolism. We also observed substantial heterogeneity across studies with regards to methodologies and reporting. Further prospective and experimental research using new tools and robust guidelines hold promise for improving our understanding of the role of the gut microbiota in mental and brain health and the development of interventions based on modification of gut microbiota.

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Section: Introductionmentioning

confidence: 99%

A systematic review of gut microbiota composition in observational studies of major depressive disorder, bipolar disorder and schizophrenia

et al. 2022

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“…Clearly, there is a need to determine whether the extended FMT program provided to him is necessary, or whether simpler and briefer procedures (e.g., the Canadian protocol) will suffice. Green et al 2 note the lack of consensus about procedural aspects as well as regulatory nuances, safety issues, and side effects which are relevant in considering necessary guidelines for consideration of the procedure by patients and by clinicians.…”

Section: Discussionmentioning

confidence: 99%

“…In separate papers, Green et al 1,2 considered its potential relevance to the management of mood disorders, and the steps in their arguments are now summarised. First, changing the gut microbiota in animals can modulate "depression-like" behaviours.…”

Section: Introductionmentioning

confidence: 99%

“…So far, no trials have been published evaluating FMT for those with depressive or bipolar conditions, but one Canadian placebocontrolled trial for bipolar depression 3 is nearing completion. 2 The only currently published data is one (very brief) case report published by Hinton. 5 The patient was a woman in her late twenties who had been diagnosed with bipolar I disorder.…”

Section: Introductionmentioning

confidence: 99%

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Faecal microbiota transplantation for bipolar disorder: A detailed case study

2022

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“…Although FMT has been anecdotally used in the history of medicine for thousands of years in ancient China, randomized controlled trials (RCTs) are still lacking for individuals with affective disorders to support its use [52] and are currently conducted [53 ▪ ]. However, there is a rationale for using FMT in mood disorders, as FMT was shown to modulate depression like behaviours in animal models and gut microbiota modify pathophysiological processes such as inflammation and immune activation, oxidative stress and neurotransmitter synthesis in affective disorders [54 ▪ ]. In 2022, Doll et al [55 ▪ ] published a case series including two MDD individuals treated with add-on FMT who improved their symptoms 4 weeks after FMT with effects lasting up to 8 weeks.…”

Section: Faecal Microbiota Transplantationmentioning

confidence: 99%

Advances in the gut microbiome and mood disorders

Mörkl

Butler

Lackner

2023

Current Opinion in Psychiatry

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Purpose of reviewThe gut microbiome is in constant bidirectional communication with the brain through the microbiota-gutbrain-axis. Mood disorders are among the most common psychiatric disorders and include major depressive disorder and bipolar disorder. The gut microbiome is altered in individuals with mood disorders and has a role in its inflammatory pathophysiology. In this article, we performed a narrative review of clinical studies, randomized controlled trials and meta-analyses addressing advances in gut microbiome research in mood disorders and included articles that were published between 2021 and 2022. Recent findingsStudies highlight transdiagnostic alterations of microbiota in mood disorders, with reductions of butyrateproducing bacteria. Participants with major depressive disorder showed altered beta-diversity, while participants with bipolar disorder showed reduced alpha-diversity. Both disorders exhibit alterations in the metabolome. Early pilot studies addressed the possibility of using the gut microbiome for the prediction of treatment response and the blood microbiome for the diagnosis of psychiatric disorders. Findings from clinical trials support the use of probiotics as an add-on therapy for major depressive disorder. The second published case report in the literature reported a favourable outcome of a patient with bipolar disorder after faecal microbiota transplantation.

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FMT for psychiatric disorders: Following the brown brick road into the future

Cited by 8 publications

References 6 publications

A systematic review of gut microbiota composition in observational studies of major depressive disorder, bipolar disorder and schizophrenia

A systematic review of gut microbiota composition in observational studies of major depressive disorder, bipolar disorder and schizophrenia

Faecal microbiota transplantation for bipolar disorder: A detailed case study

Advances in the gut microbiome and mood disorders

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