The gut-brain-axis and associated gut microbiome have increasingly received attention from researchers; investigations are ongoing regarding mechanisms in modulation of various vital physiological activities including synthesizing metabolites, fermentation of indigestible carbohydrates, and regulation of the immune and nervous systems. This review from researchers at Harvard Medical School describes how the complex communication between the brain and gut microbiota is mediated by several pathways including the immune system, neuroendocrinesystem, and circulatory system, and discusses the implications of various neuroactive compounds along these pathways including microbial-derived metabolites, microbial-derived products, peptides, gut hormones, and other neuroactive substances. The authors hypothesize that the microbiome may be a key contributor to the prevention, development, treatment, and management of CNS diseases, and also recognize that changes to diet through regulation or use of dietary supplements may pose significant therapeutic potential, especially when synergized with existing therapies. This review urges the continued considerable consideration of the many gut-resident bacteria and of microbiota-gut-brain-axis to achieve a better understanding of microbiota-mediated pathogenesis, and explore avenues for leveraging microbiota-gut-brain-axis modulations.
The recent revelation that the gut microbiome, home to approximately 100 trillion microorganisms, is implicated in the development of both health and disease has spurred an exponential increase in interdisciplinary research involving gut microbiology. In all this hype, there is a need to better understand and contextualize the emerging evidence for the role of the gut microbiota in neurodegenerative and neurodevelopmental diseases, including central nervous system (CNS) malignancies. In this review, we aim to unravel the complex interactions of the microbiota-gut-brain-axis to pave a better understanding of microbiota-mediated pathogenesis, avenues for noninvasive prognosis, and therapeutic possibilities leveraging microbiota-gut-brain-axis modulations. We further provide insights of the ongoing transition from bench to bedside and discuss limitations of current approaches. Ultimately, we urge the continued development of synergistic therapeutic models with considerable consideration of the many gut-resident bacteria that will enable significant progress for the treatment of many neurological diseases.
