Why does health start with the gut? The importance of microbiota and the use of probiotics in the context of maintaining mental health and supportive treatment of mental disorders. Part I Review article
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Published:
Mar 31, 2025
Keywords:
microbiota, probiotics, psychobiotics, depression
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Abstract
In recent decades, there has been growing interest in the influence of gut microbiota on human mental and physical health. Understanding the role of microbiota, including interactions between the digestive system and the central nervous system, is of particular importance in the context of lifestyle diseases, including the increasing prevalence of mental disorders. Research results indicate that the composition of gut microbiota may differ significantly between healthy individuals and those suffering from depressive or anxiety disorders. This fact provides the basis for research on the use of probiotics and psychobiotics as a potential support for standard pharmacotherapy. This article discusses the importance of microbiota, not only in terms of physical health, but also mental health, pointing to key mechanisms of the brain-gut axis and discussing the possibilities of using probiotics in the treatment of depression, schizophrenia and bipolar disorder.
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Antosik-Wójcińska, A., & Jankowska, A. (2025). Why does health start with the gut? The importance of microbiota and the use of probiotics in the context of maintaining mental health and supportive treatment of mental disorders. Part I. Medycyna Faktow (J EBM), 18(1(66), 29-34. https://doi.org/10.24292/01.MF.0125.04
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38. Jani R, Thomason LA, Stanisz AM et al. Magnetic resonance spectroscopy reveals oral Lactobacillus promotion of increases in brain GABA, N-acetyl aspartate and glutamate. Neuroimage. 2016; 125: 988-95.
39. Tillisch K, Labus J, Kilpatrick L et al. Consumption of Fermented Milk Product With Probiotic Modulates Brain Activity. Gastroenterology. 2013; 144(7): 1394-401.
40. Pinto-Sanchez MI, Hall GB, Ghajar K et al. Probiotic Bifidobacterium longum NCC3001 Reduces Depression Scores and Alters Brain Activity: A Pilot Study in Patients With Irritable Bowel Syndrome. Gastroenterology. 2017; 153: 448-59.
2. Turnbaugh PJ, Ley RE, Hamady M et al. The human microbiome project. Nature. 2007; 449(7164): 804-10.
3. Cho I, Blaser MJ. The Human Microbiome: At the interface of health and disease. Nat Rev Genet. 2012; 13(4): 260-70.
4. Grigg JB, Sonnenberg GF. Host-Microbiota Interactions Shape Local and Systemic Inflammatory Diseases. J Immunol. 2017; 198(2): 564-71.
5. Eckburg PB, Bik EM, Bernstein CN et al. Diversity of the Human Intestinal Microbial Flora. Science. 2005; 308(5728): 1635-8.
6. Xu J, Mahowald MA, Ley RL et al. Evolution of symbiotic bacteria in the distal human intestine. PLoS Biol. 2007; 5(7): e156.
7. Kundu P, Blacher E, Elinav E et al. Our Gut Microbiome: The Evolving Inner Self. Cell. 2017; 171(7): 1481-93.
8. Lynch SV, Pedersen O. The Human Intestinal Microbiome in Health and Disease. N Engl J Med. 2016; 375(24): 2369-79.
9. Mazmanian SK, Liu CH, Tzianabos AO et al. An immunomodulatory molecule of symbiotic bacteria directs maturation of the host immune system. Cell. 2005; 122(1): 107-18.
10. Stappenbeck TS, Hooper LV, Gordon JI. Developmental regulation of intestinal angiogenesis by indigenous microbes via Paneth cells. Proc Natl Acad Sci USA. 2002; 99(24): 15451-5.
11. Sudo N, Chida Y, Aiba Y et al. Postnatal microbial colonization programs the hypothalamic-pituitary-adrenal system for stress response in mice. J Physiol. 2004; 558(Pt 1): 263-75.
12. Jandhyala SM, Talukdar R, Subramanyam C et al. Role of the normal gut microbiota. World J Gastroenterol. 2015; 21(29): 8787-803.
13. Konturek PC, Haziri D, Brzozowski T et al. Emerging role of fecal microbiota therapy in the treatment of gastrointestinal and extra-gastrointestinal diseases. J Physiol Pharmacol. 2015; 66(4): 483-91.
14. Weiss GA, Hennet T. Mechanisms and consequences of intestinal dysbiosis. Cell Mol Life Sci. 2017; 74(16): 2959-77.
15. Buffie CG, Bucci V, Stein RR. Precision microbiome reconstitution restores bile acid mediated resistance to Clostridium difficile. Nature. 2015; 517(7533): 205-8.
16. Marlicz W, Ostrowska L, Łoniewski I. Flora bakteryjna jelit i jej potencjalny związek z otyłością. Endokrynol Otył Zab Przem Mat. 2013; 9(1): 20-8.
17. Hold GL, Schwiertz A, Aminov RI et al. Oligonucleotide probes that detect quantitatively significant groups of butyrate-producing bacteria in human faces. Appl Environ Microbiol. 2003; 69(7): 4320-4.
18. Purchiaroni F, Tortora A, Gabrielli M et al. The role of intestinal microbiota and the immune system. Eur Rev Med Pharmacol Sci. 2013; 17(3): 323-33.
19. Wilczek-Rużyczka E. Człowiek w sytuacji zagrożenia zdrowia z perspektywy psychosomatyki. Wydawnictwo Uniwersytetu Jagiellońskiego, Kraków 2020.
20. Bischoff SC, Barbara G, Buurman W et al. Intestinal permeability – a new target for disease prevention and therapy. BMC Gastroenterol. 2014; 14: 189.
21. Cryan JF, Dinan TG. Mind-altering microorganisms: the impact of the gut microbiota on brain and behaviour. Nat Rev Neurosc. 2012; 13(10): 701-12.
22. Foster JA, McVey Neufeld KA. Gut-brain axis: how the microbiome influences anxiety and depression. Trends Neurosci. 2013; 36(5): 305-12.
23. Madore C, Leyrolle Q, Lacabanne C et al. Neuroinflammation in Autism: Plausible Role of Maternal Inflammation, Dietary Omega 3, and Microbiota. Neural Plasticity. 2016; 3: 1-15.
24. Finegold SM, Molitoris D, Song Y et al. Gastrointestinal microflora studies in late-onset autism. Clin Infect Dis. 2002; 35(Suppl 1): S6-16.
25. Kim YK, Shin C. The Microbiota-Gut-Brain Axis in Neuropsychiatric Disorders: Pathophysiological Mechanisms and Novel Treatments. Curr Neuropharmacology. 2018; 16(5): 559-73.
26. Skonieczna-Żydecka K, Łoniewski I, Marlicz W et al. Mikrobiota jelitowa jako potencjalna przyczyna zaburzeń funkcjonowania emocjonalnego człowieka. Medycyna Doświadczalna i Mikrobiologia. 2017; 69(2): 163-76.
27. Misera A, Łoniewski I. Rola mikrobioty jelitowej w kształtowaniu odporności na stres ze szczególnym uwzględnieniem dzieci i młodzieży. Centrum CBT.
28. Jenkins TA, Nguyen JC, Polglaze KE et al. Influence of Tryptophan and Serotonin on Mood and Cognition with a Possible Role of the Gut-Brain Axis. Nutrients. 2016; 8(1): 56.
29. Mayer EA. Gut feelings: the emerging biology of gut–brain communication. Nat Rev Neurosci. 2011; 12: 453-66.
30. Carabotti M, Scirocco A, Maselli MA et al. The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Ann Gastroenterol. 2015; 28(2): 203-9.
31. Rudzki L, Szulc A. Wpływ jelitowej flory bakteryjnej na ośrodkowy układ nerwowy i jej potencjalne znaczenie w leczeniu zaburzeń psychicznych. Farmakoter Psychiatr Neurol. 2013; 29(2): 69-77.
32. Lazarus R, Folkman S. Stress, Appraisal, and Coping. Springer, 1984.
33. Tsigos C, Kyrou I, Kassi E et al. Stress: Endocrine Physiology and Pathophysiology. In: Endotext [Internet]. Feingold KR, Anawalt B, Boyce A et al. (eds.). MDText.com, Inc., South Dartmouth (MA) 2000-2020.
34. Landowski J. Neurobiology of stress. Neuropsych Neuropsychol. 2007; 2(1): 26-36.
35. Greenwood-Van Meerveld B, Johnson AC, Grundy D et al. Gastrointestinal Physiology and Function. Handb Exp Pharmacol. 2017; 239: 1-16.
36. Mayer EA, Aziz Q, Coen S et al. Brain imaging approaches to the study of functional GI disorders: a Rome working team report. Neurogastroenterol Motil. 2009; 21(6): 579-96.
37. Saulnier DM, Riehle K, Mistretta T et al. Gastrointestinal microbiome signatures of pediatric patients with irritable bowel syndrome. Gastroenterology. 2011; 141(5): 1782-91.
38. Jani R, Thomason LA, Stanisz AM et al. Magnetic resonance spectroscopy reveals oral Lactobacillus promotion of increases in brain GABA, N-acetyl aspartate and glutamate. Neuroimage. 2016; 125: 988-95.
39. Tillisch K, Labus J, Kilpatrick L et al. Consumption of Fermented Milk Product With Probiotic Modulates Brain Activity. Gastroenterology. 2013; 144(7): 1394-401.
40. Pinto-Sanchez MI, Hall GB, Ghajar K et al. Probiotic Bifidobacterium longum NCC3001 Reduces Depression Scores and Alters Brain Activity: A Pilot Study in Patients With Irritable Bowel Syndrome. Gastroenterology. 2017; 153: 448-59.