Complex gut–brain interactions underlying inflammatory bowel disease-related depression have translational implications in regenerative medicine: a narrative review

Fu, Hua1,3; Liu, Yang2,3

1Department of Gastroenterology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province, China

2Department of Anesthesiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province, China

3Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee, FL, USA

*Correspondence to: Yang Liu, liuyang0216@gmc.edu.cn.

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Regenerative Medicine Reports 1(1):p 59-75, September 2024. | DOI: 10.4103/REGENMED.REGENMED-D-24-00006

Abstract

Inflammatory bowel diseases, including Crohn’s disease and ulcerative colitis, are chronic gastrointestinal disorders characterized by relapsing intestinal inflammation. In addition to gastrointestinal symptoms, patients with inflammatory bowel diseases experience a disproportionately high prevalence of depression and other neuropsychiatric comorbidities. The gut–brain axis, a bidirectional communication system between the gut and brain, has emerged as a potential pathogenic link underlying this aberrant mind–gut interplay. This review synthesizes the growing evidence implicating gut–brain axis dysregulation as a central mechanism bridging intestinal inflammation and the development of depression in patients with inflammatory bowel diseases. Regenerative medicine offers promising new avenues for addressing these complex conditions. By focusing on regenerative therapies that target the gut–brain axis, we explore new approaches that could repair or restore normal function in both the gut and brain. These therapies might alleviate chronic intestinal inflammation and restore proper gut–brain signaling via neural, immune-mediated, endocrine, and microbiome-related pathways, ultimately reversing the neurochemical, structural, and functional brain abnormalities implicated in depressive neuropathology. Unraveling the complex gut–brain interactions underlying inflammatory bowel disease-related depression through regenerative medicine has profound translational implications, paving the way for transformative diagnostic and therapeutic paradigms that address the multisystemic burden of these chronic debilitating conditions holistically.

炎性肠病相关抑郁症背后复杂的肠脑相互作用在再生医学中具有转化意义：叙述性综述

摘要

炎症性肠病包括克罗恩病和溃疡性结肠炎，是一种以复发性肠道炎症为特征的慢性胃肠道疾病。除胃肠道症状外，炎症性肠病患者的抑郁症和其他神经精神并发症的发病率也特别高。肠脑轴是肠道和大脑之间的双向交流系统，它已成为这种异常的心肠相互作用的潜在致病环节。此综述总结的证据表明，肠脑轴失调是肠道炎症和炎症性肠病抑郁症发生的核心机制。再生医学为解决这些复杂问题提供了前景广阔的新途径。通过关注针对肠脑轴的再生疗法，探索了可能修复或恢复肠道和大脑正常功能的新方法。这些疗法可能会缓解慢性肠道炎症，并通过神经、免疫介导、内分泌和微生物相关途径恢复正常的肠脑信号传导，最终逆转抑郁性神经病理学所涉及的神经化学、结构和功能性大脑异常。揭示炎症性肠病相关抑郁症背后复杂的肠脑相互作用，在再生医学方面具有深远的转化意义，为变革性诊断和治疗范式铺平了道路，从而全面解决这些慢性衰弱病症的多系统负担。