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The Role of the Adrenal-Gut-Brain Axis on Comorbid Depressive Disorder Development in Diabetes

Diabetic patients are more affected by depression than non-diabetics, and this is related to greater treatment resistance and associated with poorer outcomes. This increase in the prevalence of depression in diabetics is also related to hyperglycemia and hypercortisolism. In diabetics, the hyperacti...

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Published in:Biomolecules (Basel, Switzerland) Switzerland), 2023-10, Vol.13 (10), p.1504
Main Authors: Mázala-de-Oliveira, Thalita, Silva, Bruna Teixeira, Campello-Costa, Paula, Carvalho, Vinicius Frias
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description Diabetic patients are more affected by depression than non-diabetics, and this is related to greater treatment resistance and associated with poorer outcomes. This increase in the prevalence of depression in diabetics is also related to hyperglycemia and hypercortisolism. In diabetics, the hyperactivity of the HPA axis occurs in parallel to gut dysbiosis, weakness of the intestinal permeability barrier, and high bacterial-product translocation into the bloodstream. Diabetes also induces an increase in the permeability of the blood-brain barrier (BBB) and Toll-like receptor 4 (TLR4) expression in the hippocampus. Furthermore, lipopolysaccharide (LPS)-induced depression behaviors and neuroinflammation are exacerbated in diabetic mice. In this context, we propose here that hypercortisolism, in association with gut dysbiosis, leads to an exacerbation of hippocampal neuroinflammation, glutamatergic transmission, and neuronal apoptosis, leading to the development and aggravation of depression and to resistance to treatment of this mood disorder in diabetic patients.
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subjects Adrenal glands
Animals
Apoptosis
Bacteria
Blood-brain barrier
Brain-Gut Axis
Care and treatment
Chronic illnesses
Comorbidity
Complications and side effects
Cushing Syndrome
depression
Depression, Mental
Depressive Disorder
Development and progression
Diabetes
Diabetes mellitus
Diabetes Mellitus, Experimental
Diabetics
Digestive system
Disease
Dysbacteriosis
Dysbiosis
Emotional disorders
Enzymes
Expenditures
Feedback
Gastrointestinal tract
glucocorticoids
Glutamatergic transmission
gut microbiota
Hippocampus
Homeostasis
Hormones
Humans
Hyperactivity
Hyperglycemia
Hypothalamic-pituitary-adrenal axis
Hypothalamo-Hypophyseal System - physiology
Hypothalamus
Inflammation
Lipopolysaccharides
Membrane permeability
Mental depression
Metabolism
Metabolites
Mice
Microbiota
Mood disorders
Neuroinflammatory Diseases
Permeability
Pituitary gland
Pituitary-Adrenal System - physiology
Probiotics
Proteins
Psychological aspects
Review
Risk factors
TLR4
TLR4 protein
Toll-like receptors
Treatment resistance
treatment-resistant depression
title The Role of the Adrenal-Gut-Brain Axis on Comorbid Depressive Disorder Development in Diabetes
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