Journal Article

Blood microbiota and metabolomic signature of major depression before and after antidepressant treatment: a prospective case–control study

Perlemuter, Gabriel, Colle, Romain, Ciocan, Dragos, Voican, Cosmin Sebastian, El Asmar, Khalil, Corruble, Emmanuelle, Feve, Bruno, Verstuyft, Céline, Chanson, Philippe, Cassard, Anne-Marie, David, Denis, Becquemont, Laurent, Trabado, Séverine

2021

Overview

The microbiota interacts with the brain through the gut–brain axis, and a distinct dysbiosis may lead to major depressive episodes. Bacteria can pass through the gut barrier and be found in the blood. Using a multiomic approach, we investigated whether a distinct blood microbiome and metabolome was associated with major depressive episodes, and how it was modulated by treatment. In this case–control multiomic study, we analyzed the blood microbiome composition, inferred bacterial functions and metabolomic profile of 56 patients experiencing a current major depressive episode and 56 matched healthy controls, before and after treatment, using 16S rDNA sequencing and liquid chromatography coupled to tandem mass spectrometry. The baseline blood microbiome in patients with a major depressive episode was distinct from that of healthy controls (patients with a major depressive episode had a higher proportion of Janthinobacterium and lower levels of Neisseria) and changed after antidepressant treatment. Predicted microbiome functions confirmed by metabolomic profiling showed that patients who were experiencing a major depressive episode had alterations in the cyanoamino acid pathway at baseline. High baseline levels of Firmicutes and low proportions of Bosea and Tetrasphaera were associated with response to antidepressant treatment. Based on inferred baseline metagenomic profiles, bacterial pathways that were significantly associated with treatment response were related to xenobiotics, amino acids, and lipid and carbohydrate metabolism, including tryptophan and drug metabolism. Metabolomic analyses showed that plasma tryptophan levels are independently associated with response to antidepressant treatment. Our study has some limitations, including a lack of information on blood microbiome origin and the lack of a validation cohort to confirm our results. Patients with depression have a distinct blood microbiome and metabolomic signature that changes after treatment. Dysbiosis could be a new therapeutic target and prognostic tool for the treatment of patients who are experiencing a major depressive episode.

• Publisher: Canadian Medical Association,NRC Research Press,CMA Joule Inc,Cooperative Education Association
• Subject: Adult / Antidepressants / Antidepressive Agents - pharmacology / Antidepressive Agents - therapeutic use / Bacteria / Bacteria - classification / Bacteria - drug effects / Blood / Blood - drug effects / Blood - microbiology / Brain-Gut Axis - drug effects / Carbohydrate metabolism / Carbohydrate Metabolism - drug effects / Case-Control Studies / Depressive Disorder, Major - blood / Depressive Disorder, Major - complications / Depressive Disorder, Major - drug therapy / Depressive Disorder, Major - microbiology / Dosage and administration / Drug metabolism / Drug therapy / Dysbacteriosis / Dysbiosis - blood / Dysbiosis - complications / Dysbiosis - metabolism / Dysbiosis - microbiology / Female / Gastrointestinal Microbiome - drug effects / Gut-brain axis / Health care / Humans / Life Sciences / Lipid metabolism / Lipid Metabolism - drug effects / Liquid chromatography / Major depressive disorder / Male / Mass spectroscopy / Mental depression / Metabolism / Metabolites / Metabolome - drug effects / Metabolomics / Metagenomics / Microbiomes / Microbiota / Microbiota (Symbiotic organisms) / Microbiota - drug effects / Patient outcomes / Patients / Permeability / Physiological aspects / Psychiatric/Mental Health / Psychosis / Psychotropic drugs / Research Paper / rRNA 16S / Standard deviation / Therapeutic targets / Tryptophan / Xenobiotics