We read with interest the recent work by Uhde et al ,1 which demonstrated that physically asymptomatic non-coeliac gluten/wheat sensitivity involves compromised intestinal epithelium barrier dysfunction in conjunction with systemic immune activation events. We also read with interest the recent work by Marchesi et al ,2 which comprehensively reviewed the role of microbiota in physical disorders of the gut and extra-gut organs. But common to these Gut papers was the lack of accounting for anxiety and depression, comorbidities often experienced in gastroenterology clinics. Patients who are otherwise physically asymptomatic often do not explicitly divulge these mental disorders, or the disorders are unintentionally overlooked, yet they report ‘diminished quality of life’. In response to this gap, we explored roles of dysbiosis and gut barrier integrity in individuals physically asymptomatic for gastrointestinal distress, yet nonetheless experiencing mental distress. We hypothesised that anxiety and depressive disorders are linked to human gut dysbiosis with microbiota that secrete lipopolysaccharide (LPS) endotoxin into plasma, which in conjunction with compromised gut barrier integrity has systemic manifestations including the brain. We further hypothesised that this correlates with altered intestinal epithelium paracellular integrity molecules discharged …

中文翻译：

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人肠道屏障通透性增加的血浆生物标志物 zonulin 和 FABP2 与焦虑或抑郁中的血浆 LPS 和肠道微生物组改变相关

我们饶有兴趣地阅读了 Uhde 等人最近的工作，1 该工作表明，身体上无症状的非腹腔麸质/小麦敏感性涉及受损的肠上皮屏障功能障碍以及全身免疫激活事件。我们还饶有兴趣地阅读了 Marchesi 等人 2 最近的工作，该工作全面回顾了微生物群在肠道和肠外器官的身体疾病中的作用。但这些 Gut 论文的共同点是缺乏对焦虑和抑郁的解释，这是胃肠病诊所经常遇到的合并症。在其他方面没有身体症状的患者通常不会明确透露这些精神障碍，或者无意中忽视了这些障碍，但他们报告说“生活质量下降”。针对这一差距，我们探讨了生态失调和肠道屏障完整性在身体上无胃肠道不适症状但仍经历精神困扰的个体中的作用。我们假设焦虑和抑郁症与人类肠道菌群失调有关，微生物群将脂多糖 (LPS) 内毒素分泌到血浆中，这与肠道屏障完整性受损一起具有包括大脑在内的全身表现。我们进一步假设这与肠道上皮细胞旁细胞完整性分子释放的改变有关…… 这与受损的肠道屏障完整性一起具有包括大脑在内的全身表现。我们进一步假设这与肠道上皮细胞旁细胞完整性分子释放的改变有关…… 这与受损的肠道屏障完整性一起具有包括大脑在内的全身表现。我们进一步假设这与肠道上皮细胞旁细胞完整性分子释放的改变有关……