Tag: 13/1/21

Categories : Mental HealthTags :

Depression May be Influenced by Metabolism

On By ModernMedia

A study by researchers from University of California San Diego School of Medicine and from the Netherlands, has shown that major depressive disorder (MDD) may be predicted by metabolism, in the form of certain metabolites.

MDD is one of the most common disorders, with a lifetime prevalence of 20.6% in the United States. For those with recurrent major depressive disorder (rMDD), the risk is 80% over five years.

MDD is characterised by any combination of feelings of sadness or hopelessness, anger or frustration, loss of interest, sleep disturbances, anxiety, slowed or difficulty thinking, suicidal thoughts and unexplained pain such as backaches.

“This is evidence for a mitochondrial nexus at the heart of depression,” said senior author Prof Robert K Naviaux, at UC San Diego School of Medicine. “It’s a small study, but it is the first to show the potential of using metabolic markers as predictive clinical indicators of patients at greatest risk—and lower risk—for recurring bouts of major depressive symptoms.”

Recruiting 68 participants who were in remission for rMDD and not on antidepressants, the researchers found a range of molecules in participants’ blood that were up to 90% predictive of relapse in 30 months. The most predictive molecules consisted of certain lipids and purines.

Purines are produced from molecules such as ATP and ADP (major cellular energy storage molecules), and also have a role in signalling in stressed cells.The researchers found that in subjects with rMDD, certain metabolites in six metabolic pathways resulted in the alteration of key cellular activities.

“The findings revealed an underlying biochemical signature in remitted rMDD that set diagnosed patients apart from healthy controls,” Naviaux said. “These differences are not visible through ordinary clinical assessment, but suggest that the use of metabolomics—the biological study of metabolites—could be a new tool for predicting which patients are most vulnerable to a recurrence of depressive symptoms.”

Source: Medical Xpress

Journal information: Roel J. T. Mocking et al. Metabolic features of recurrent major depressive disorder in remission, and the risk of future recurrence, Translational Psychiatry (2021). DOI: 10.1038/s41398-020-01182-w

Categories : GastrointestinalTags :

Faecal Transplants Safe in the Long Term for C. Diff Treatment

On By ModernMedia

A new study from the Mayo Clinic has provided more evidence for the safety and efficacy of faecal microbiota transplantation (FMT) in treating Clostridioides difficile infection (CDI).

Recruiting 609 patients diagnosed with CDI, 20% of whom were overweight or obese and 22.8% had inflammatory bowel disease (IBD), FMT was performed with a stool product from a common donor. At a short term follow-up, >60% of patients had diarrhoea, <33% had constipation, and 9.5% reported additional CDI episodes after one year. At long-term follow up (median 3.7 years), there 73 new diagnoses out of 477 patients, 13% had gastrointestinal problems, 10% had weight gain, and 11.8% had new unrelated infections.

However, this was marked by the appearance of additional medical conditions such as weight gain and irritable bowel syndrome, which the authors indicated should be investigated further. The study also did not use a standardised questionnaire for IBS, making those results harder to generalise, and there was no control group. However, administering questionnaires over an extended period to all participants instead of only a brief period shortly after FMT explains why there are fewer symptoms reported compared to other studies.  

A separate study with 207 patients receiving FMT showed 143 new diagnoses after the procedure, with a mean follow-up of 34 months. The researchers conducting this second study attribute the ability of FMT to reduce CDI to enhancements in CD4+ T cell and antibody-mediated immunity to C. difficile toxins such as TcdB.

“These results are important for the design of disease monitoring strategies and highlight that future study of how FMT influences pathogen specific immunity is warranted: specifically, determining if effectively restoring the TcdB specific cellular repertoire to healthy control proportions contributes to treatment success of FMT,” the researchers wrote.

These studies add to the growing body of evidence that show FMT combined with antibiotics is an effective way to treat CDI.

Source: MedPage Today

Journal information (first source): Saha S, et al. Long-term safety of fecal microbiota transplantation for recurrent Clostridioides difficile infection, Gastroenterol 2021; DOI: 10.1053/j.gastro.2021.01.010. 

Journal information (second source): Cook L, et al. Fecal microbiota transplant treatment for recurrent Clostridioides difficile infection enhances adaptive immunity to TcdB, Gastroenterol 2021; DOI: 10.1101/2020.06.05.20114876.