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1.11 Antidepressants and the Gut Microbiota

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1.11 Antidepressants and the Gut Microbiota UCC Library and UCC researchers have made this item openly available. Please let us know how this has helped you. Thanks! Title Effects of psychotropic drugs on the microbiota-gut-liver-brain axis Author(s) Cussotto, Sofia Publication date 2019 Original citation Cussotto, S. 2019. Effects of psychotropic drugs on the microbiota-gut- liver-brain axis. PhD Thesis, University College Cork. Type of publication Doctoral thesis Rights © 2019, Sofia Cussotto. http://creativecommons.org/licenses/by-nc-nd/3.0/ Item downloaded http://hdl.handle.net/10468/9468 from Downloaded on 2021-09-23T15:30:09Z Ollscoil na hÉireann, Corcaigh National University of Ireland, Cork Department of Anatomy and Neuroscience Head of Dept. John F. Cryan Effects of Psychotropic Drugs on the Microbiota-Gut-Liver-Brain Axis Thesis presented by Sofia Cussotto, MPharm Under the supervision of Prof. John F. Cryan Prof. Timothy G. Dinan For the degree of Doctor of Philosophy June 2019 Table of Contents Declaration ......................................................................................................... IV Author Contributions .......................................................................................... IV Acknowledgments ............................................................................................... V Publications and presentations ........................................................................... VI Abstract ............................................................................................................ VIII Chapter 1 General Introduction ......................................................................... 1 1.1 Gut Microbiota ..................................................................................................... 2 1.2 Microbiota-Gut-Brain Axis..................................................................................... 3 1.2.1 Afferent Signalling................................................................................................................ 4 1.2.2 Efferent Signalling ................................................................................................................ 5 1.3 Microbiota-Gut-Liver Axis ..................................................................................... 6 1.3.1 Enterohepatic circulation of bile acids................................................................................. 7 1.3.2 Intestinal permeability in the microbiota-gut-liver axis ...................................................... 8 1.3.3 Systemic circulation in the microbiota-gut-liver axis ........................................................... 9 1.4 Bile Acid Synthesis, Metabolism and Microbiota .................................................. 11 1.4.1 Bile acids synthesis ............................................................................................................ 12 1.4.2 Bile acids metabolism: gut microbiota as a key player ...................................................... 13 1.4.3 Bile acids shape the structure of the gut microbiota ......................................................... 16 1.5 Intestinal Barrier Integrity and the Gut Microbiota .............................................. 16 1.5.1 Regulators of intestinal permeability ................................................................................ 18 1.5.2 Measuring intestinal permeability ex-vivo ......................................................................... 19 1.6 Drugs and the Gut Microbiota ............................................................................. 23 1.7 Drugs Affect the Gut Microbiota.......................................................................... 24 1.8 The Gut Microbiota Affects the Pharmacokinetics of Drugs .................................. 25 1.8.1 The gut microbiota affects drug absorption ...................................................................... 26 1.8.2 The gut microbiota affects drug metabolism .................................................................... 26 1.9 Psychotropic Drugs and the Gut Microbiota ......................................................... 32 1.10 Antipsychotics and the Gut Microbiota .............................................................. 33 1.10.1 Typical antipsychotics and the gut microbiota ................................................................ 35 1.10.2 Atypical antipsychotics and the gut microbiota .............................................................. 36 1.11 Antidepressants and the Gut Microbiota ........................................................... 39 1.11.1 Tricyclic antidepressants (TCAs) and the gut microbiota ................................................. 40 I 1.11.2 Selective serotonin-reuptake inhibitors (SSRIs) and the gut microbiota ......................... 41 1.11.3 Other antidepressants and the gut microbiota ............................................................... 42 1.12 Antianxiety Drugs and the Gut Microbiota ......................................................... 43 1.13 Anticonvulsants/Mood Stabilisers and the Gut Microbiota ................................ 43 1.14 Opioid Analgesics and the Gut Microbiota ......................................................... 44 1.15 Drugs of Abuse, Alcohol, Nicotine and the Gut Microbiota ................................. 46 1.16 Xanthines and the Gut Microbiota ..................................................................... 50 1.17 The Gut Microbiota in Psychiatric Disorders ...................................................... 52 1.17.1 The microbiome in schizophrenia .................................................................................... 52 1.17.2 The microbiome in depression ........................................................................................ 54 1.17.3 The microbiome in bipolar disorder ................................................................................ 55 1.18 Aims and Objectives.......................................................................................... 58 Aim 1: Do psychotropic medications affect the microbiome composition and intestinal permeability? .............................................................................................................................. 58 Aim 2: Do psychotropic medications affect the composition and biotransformation of bile acids? .......................................................................................................................................... 59 Aim 3: Do modifications of the gut microbiota influence the pharmacokinetics of psychotropic medications? ............................................................................................................................... 59 Aim 4: Do psychotropic medications affect the composition of the human gut microbiota?.... 59 Chapter 2 ........................................................................................................... 61 Abstract ................................................................................................................... 62 Introduction ............................................................................................................. 63 Methods .................................................................................................................. 65 Results ..................................................................................................................... 70 Discussion ................................................................................................................ 80 Supplemental Material ............................................................................................. 86 Chapter 3 ........................................................................................................... 95 Abstract ................................................................................................................... 96 Introduction ............................................................................................................. 97 Methods ................................................................................................................ 100 Results ................................................................................................................... 104 Discussion .............................................................................................................. 115 Supplemental Material ........................................................................................... 121 Chapter 4 ......................................................................................................... 135 Abstract ................................................................................................................. 136 Introduction ........................................................................................................... 137 Methods ................................................................................................................ 140 Results ................................................................................................................... 145 Discussion .............................................................................................................. 155 Supplemental Material ........................................................................................... 160 II Chapter 5 ........................................................................................................
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