Microbes and mental health: A review.

There is a growing emphasis on the relationship between the microorganisms inhabiting the gut (gastrointestinal microbiota) and human health. The emergence of a microbiota-gut-brain axis to describe the complex networks and relationship between the gastrointestinal microbiota and host reflects the major influence this environment may have in brain health and disorders of the central nervous system (CNS). Bidirectional communication between the microbiota and the CNS occurs through autonomic, neuroendocrine, enteric, and immune system pathways. Potential neurobiological mechanisms through which disruptions in this network may impact health and disease include hypothalamic-pituitary-adrenal (HPA)-axis activation, and altered activity of neurotransmitter and immune systems. Perturbations of the gut microbial community have already been implicated in multiple host diseases such as obesity, diabetes, and inflammation, while recent evidence suggests a potential role of the microbiota-gut-brain axis in neuropsychiatric disorders, such as depression and anxiety. Here, we review the current literature related to the influence of the gut microbial community on central nervous system function, with a specific focus on anxiety and depressive symptoms. The role of stress and stress-mediated changes in autonomic, neuroendocrine, immune, and neurotransmitter systems are examined, followed by a discussion of the role of the microbiota in novel gastrointestinal-based treatment options for the prevention and treatment of brain-based disorders such as anxiety and depression.