Integrative mechanisms and intervention targets of the microbiota–gut–brain axis in depressive disorders: advances across immune, endocrine, and central nervous system pathways

Category	Detail
Condition	Depressive Disorders
Key Mechanisms	Microbiota-gut-brain axis (MGBA) involving mood regulation, immune responses, endocrine function, metabolism, and neuroplasticity.
Target Population	Patients with depressive disorders, particularly those with gastrointestinal symptoms, metabolic abnormalities, or low-grade inflammatory states.
Care Setting	Clinical settings focusing on mental health and gastrointestinal health.

Depressive disorders are heterogeneous, involving mood, cognitive, and gastrointestinal symptoms.
The MGBA framework links gut microbial dysbiosis to depressive symptoms.
Interventions like dietary changes, psychobiotics, and fecal microbiota transplantation show potential but have limited effect sizes.
Current research emphasizes the need for mechanistic integration and clinical translation.
Stratification biomarkers and phenotype-based approaches are essential for targeted therapies.

Consider the heterogeneity of depressive disorders and associated comorbidities.

Explore dietary and lifestyle modifications, psychobiotics, and fecal microbiota transplantation for selected patients.

Assess gastrointestinal symptoms and metabolic status in patients with depressive disorders.

Be aware of the limitations in current interventional evidence and the need for further validation.

Individuals with depressive disorders exhibiting gastrointestinal and metabolic comorbidities.

Interventions targeting the MGBA may be beneficial but require careful patient selection and monitoring.

Integrate assessments of gut microbiota and metabolic pathways in the evaluation of depressive disorders.
Utilize a multidisciplinary approach involving mental health and gastrointestinal specialists.
Encourage lifestyle modifications alongside pharmacological treatments.

Clinical Scorecard: Mechanisms of Integration and Potential Intervention Points in the Microbiota-Gut-Brain Axis Related to Depressive Disorders: Progress in Immune, Endocrine, and Central Nervous System Pathways