The gut-brain barrier in major depression (fwd)

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Maes M, Kubera M, Leunis JC. 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. Neuro

Endocrinol Lett 2008 Feb 24;29(1):117-124 [Epub ahead of print]

PMID: 18283240

Neuro Endocrinol Lett. 2008 Feb 24;29(1):117-124 [Epub ahead of print]

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.

Maes M, Kubera M, Leunis JC.

M-Care4U Outpatient Clinics, and the Clinical Research Center for

Mental Health, Belgium. crc.mh@....

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 lipopolysacharide (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. Toward this end, the present study

examines the serum concentrations of IgM and IgA against LPS of the

gram-negative enterobacteria, Hafnia Alvei, Pseudomonas Aeruginosa,

ella ii, 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.

PMID: 18283240