Psikiyatrik Hastalıklarda Bağırsak Mikrobiyotası
Özet
İnsan vücudundaki mikroorganizma yaşamını temsil eden mikrobiyota, özellikle bakterilerin çoğunlukta olduğu bağırsak bölgesinde büyük bir hacme sahiptir ve dengeli bir bağırsak mikrobiyotası, enterik sistemin yanı sıra sağlıklı beyin işlevleri, bağışıklık sistemi ve stres yönetimi için kilit bir rol oynamaktadır. Bağırsak mikrobiyotası ile beyin arasında sinir sistemi, kortizol aracılı endokrin yolaklar ve mikrobiyal yan ürünler üzerinden çift yönlü bir iletişim bulunmaktadır; bu etkileşim neticesinde mikrobiyotadaki disbiyoz adı verilen homeostaz bozulmaları anksiyete bozuklukları, şizofreni, duygudurum bozuklukları, yeme bozuklukları, otizm spektrum bozukluğu (OSB), dikkat eksikliği ve hiperaktivite bozukluğu (DEHB) ile travma sonrası stres bozukluğu (TSSB) gibi birçok psikiyatrik hastalığın patogenezinde ve semptomatolojisinde kritik görevler üstlenmektedir. Hücresel boyutta kısa zincirli yağ asitlerinin üretimi ve nörotransmiter sentezi gibi mekanizmalar ruh sağlığı süreçlerini doğrudan modüle ederken, probiyotikler, prebiyotikler ve fekal mikrobiyota transplantasyonu (FMT) gibi mikrobiyom odaklı müdahaleler psikiyatrik tedavilerde "psikobiyotik" adı altında yeni tedavi pencereleri açmaktadır. Ayrıca psikotrop ilaçlar ile mikrobiyom arasında da çift yönlü bir etkileşim mevcut olup, antipsikotik ve antidepresan gibi ajanların güçlü antimikrobiyal aktiviteleri nedeniyle bağırsak florasının bileşimini ve bağırsak geçirgenliğini belirgin şekilde değiştirdiği gösterilmiştir.
Human microbiota represents the microorganism life in the human body, and the gut microbiota, where bacteria constitute the majority, has a large volume and a balanced gut microbiota plays a key role for healthy brain functions, the immune system, and stress management in addition to the enteric system. There is a bidirectional communication between the gut microbiota and the brain through the nervous system, cortisol-mediated endocrine pathways, and microbial by-products; as a result of this interaction, disruptions in homeostasis called dysbiosis in the microbiota play critical roles in the pathogenesis and symptomatology of many psychiatric disorders such as anxiety disorders, schizophrenia, mood disorders, eating disorders, autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD). While mechanisms such as the production of short-chain fatty acids and neurotransmitter synthesis at the cellular level directly modulate mental health processes, microbiome-targeted interventions like probiotics, prebiotics, and fecal microbiota transplantation (FMT) open new therapeutic windows in psychiatric treatments under the name of "psychobiotics". Additionally, a bidirectional interaction exists between psychotropic drugs and the microbiome, and it has been demonstrated that agents like antipsychotics and antidepressants significantly alter the composition of the gut flora and intestinal permeability due to their potent antimicrobial activities.
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