Changes in Gut Microbiota by Chronic Stress Impair the Efficacy of Fluoxetine

Cell Rep. 2020 Mar 17;30(11):3682-3690.e6. doi: 10.1016/j.celrep.2020.02.099.

Abstract

Major depressive disorders (MDDs) constitute a leading cause of disability worldwide and current pharmacological treatments are partially effective. The gut microbiota (GM) has recently emerged as a target of therapeutic interest for MDDs. In this study, we transfer GM from mice that sustained unpredictable chronic mild stress (UCMS) to healthy recipient mice. The fecal transfer induces despair-like behavior, decreases neurogenesis in the hippocampus (HpC), and impairs the antidepressant and neurogenic effects of a standard selective serotonin (5-HT) reuptake inhibitor, fluoxetine (FLX). These effects are paralleled by deficits in 5-HT bioavailability, biosynthesis, and reuptake in the HpC. Treatment with 5-hydroxytryptophan restores the levels of 5-HT and its precursors in the HpC, improves HpC neurogenesis, and alleviates despair-like symptoms. Our results reveal that stress-induced changes in GM are involved in the pathogenesis of depressive disorders and minimize FLX efficacy via alterations in the serotonergic pathway of Trp metabolism.

Keywords: 5-hydroxytryptophan; adult hippocampal neurogenesis; chronic stress; depression; fluoxetine; gut microbiota; serotonin; tryptophan.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 5-Hydroxytryptophan / metabolism
  • Animals
  • Antidepressive Agents / pharmacology
  • Antidepressive Agents / therapeutic use
  • Cell Differentiation / drug effects
  • Chronic Disease
  • Depression / drug therapy
  • Depression / microbiology
  • Fluoxetine / pharmacology
  • Fluoxetine / therapeutic use*
  • Gastrointestinal Microbiome / drug effects*
  • Hippocampus / drug effects
  • Hippocampus / pathology
  • Male
  • Mice, Inbred C57BL
  • Neural Stem Cells / drug effects
  • Neural Stem Cells / metabolism
  • Neural Stem Cells / pathology
  • Neurogenesis / drug effects
  • Serotonin / biosynthesis
  • Stress, Psychological / blood
  • Stress, Psychological / drug therapy*
  • Stress, Psychological / microbiology*
  • Treatment Outcome
  • Tryptophan / metabolism

Substances

  • Antidepressive Agents
  • Fluoxetine
  • Serotonin
  • Tryptophan
  • 5-Hydroxytryptophan