The gut-brain barrier in major depression: Intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression – Source: Neuro Endocrinology Letters, Feb 18, 2008

There is now evidence that major depression (MDD) is accompanied by an activation of the inflammatory response system (IRS) and that pro-inflammatory cytokines and lipopolysaccharide (LPS) may induce depressive symptoms.

The aim of the present study was to examine whether an increased gastrointestinal permeability with an increased translocation of LPS from gram negative bacteria may play a role in the pathophysiology of MDD. [Many types of gram negative bacteria can cause disease, and this cability is usually associated with LPS – their outer membrane, which triggers immune activation/inflammation.]

Toward this end, the present study examines the serum concentrations of IgM and IgA [antibodies] against LPS of the gram-negative enterobacteria, Hafnia Alvei, Pseudomonas Aeruginosa, Morganella Morganii, Pseudomonas Putida, Citrobacter Koseri, and Klebsielle Pneumoniae in MDD patients and normal controls.

We found that the prevalences and median values for serum IgM and IgA against LPS of enterobacteria are significantly greater in patients with MDD than in normal volunteers.

These differences are significant to the extent that a significant diagnostic performance is obtained; i.e., the area under the ROC curve is 90.1%. The symptom profiles of increased IgM and IgA levels are fatigue, autonomic and gastro-intestinal symptoms, and a subjective feeling of infection.

The results show that intestinal mucosal dysfunction characterized by an increased translocation of gram-negative bacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression.

It is suggested that the increased LPS translocation may mount an immune response and thus IRS activation in some patients with MDD and may induce specific “sickness behaviour” symptoms. It is suggested that patients with MDD should be checked for leaky gut by means of the IgM and IgA panel used in the present study and accordingly should be treated for leaky gut.

Source: Neuro Endocrinology Letters. 2008 Feb 18;29(1) [Epub ahead of print] PMID: 18283240, by Maes M, Kubera M, Leunis JC. M-Care4U Outpatient Clinics, and the Clinical Research Center for Mental Health, Belgium. [E-mail: crc.mh@telenet.be]

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