Gutsy Moves: The Amygdala as a Critical Node in Microbiota to Brain Signaling

The amygdala is a key brain area regulating responses to stress and emotional stimuli, so improving our understanding of how it is regulated could offer novel strategies for treating disturbances in emotion regulation. As we review here, a growing body of evidence indicates that the gut microbiota may contribute to a range of amygdala‐dependent brain functions from pain sensitivity to social behavior, emotion regulation, and therefore, psychiatric health. In addition, it appears that the microbiota is necessary for normal development of the amygdala at both the structural and functional levels. While further investigations are needed to elucidate the exact mechanisms of microbiota‐to‐amygdala communication, ultimately, this work raises the intriguing possibility that the gut microbiota may become a viable treatment target in disorders associated with amygdala dysregulation, including visceral pain, post‐traumatic stress disorder, and beyond. Also see the video abstract here: https://youtu.be/O5gvxVJjX18     

基于脑肠轴理论探讨健脾化痰方联合针刺治疗卒中后抑郁的随机对照研究

摘要 目的：基于脑肠轴理论探讨健脾化痰方联合针刺治疗卒中后抑郁（PSD）的治疗效果。方法：选取石家庄市中医院2018年4月~2022年5月期间收治的113例PSD患者。按照双色球随机分组法将患者分为对照组（n=56，基于脑肠轴理论，常规治疗联合健脾化痰方治疗）和研究组（n=57，在对照组基础上联合针刺治疗）。对比两组疗效、中医证候积分、美国国立卫生研究院卒中量表（NIHSS)评分、汉密尔顿抑郁量表-17（HAMD-17）评分、日常生活活动能力（ADL）评分、P物质（SP）和神经肽Y（NPY），观察两组治疗期间不良反应发生情况。结果：研究组的临床总有效率高于对照组（P<0.05）。与对照组相比，研究组治疗4周后中医证候积分总分、NIHSS评分、HAMD-17评分和血清SP水平更低，ADL评分和血清NPY水平更高（P<0.05）。两组均未见明显的不良反应发生。结论：基于脑肠轴理论采用健脾化痰方联合针刺治疗PSD患者，可改善患者的临床症状、生活自理能力，同时还可减轻神经缺损状况，调节血清SP、NPY水平。     

Chronic Physical Illness: A Psychophysiological Approach for Chronic Physical Illness

Growing evidence demonstrates that psychological risk variables can contribute to physical disease. In an effort to thoroughly investigate potential etiological origins and optimal interventions, this broad review is divided into five sections: the stress response, chronic diseases, mind-body theoretical models, psychophysiological interventions, and integrated health care solutions. The stress response and its correlation to chronic disorders such as cardiovascular, gastrointestinal, autoimmune, metabolic syndrome, and chronic pain are comprehensively explored. Current mind-body theoretical models, including peripheral nerve pathway, neurophysiological, and integrative theories, are reviewed to elucidate the biological mechanisms behind psychophysiological interventions. Specific interventions included are psychotherapy, mindfulness meditation, yoga, and psychopharmacology. Finally, the author advocates for an integrated care approach as a means by which to blur the sharp distinction between physical and psychological health. Integrated care approaches can utilize psychiatric nurse practitioners for behavioral assessment, intervention, research, advocacy, consultation, and education to optimize health outcomes.     

Uridine Nucleotide Receptors and Their Ligands: Structural,Physiological, and Pathophysiological Aspects,with Special Emphasis on the Nervous System

This review presents data on metabotropic uridine nucleotide receptor subtypes (P2UR) activated by UTP, sometimes also by UDP and/or ATP. Some chemical details of receptor subtypes and ligand interactions are described. Ligand-activated P2UR subtypes may couple to different second messengers, yet little is known about the nature of the coupling G-proteins. Data evaluating UTP as a physiological ligand include UTP origin, release and metabolism and illuminate especially roles for P2UR in the nervous system. No evidence shows UTP as a synaptic transmitter; sympathetic neurons may, however, carry P2UR allowing UTP-stimulation of norepinephrine release. UTP and derivatives act as therapeutic agents in several diseases involving mutated genes of transepithelial conductance regulators, including cystic fibrosis. This focuses interest to the synthesis of new compounds. Further, therapeutically used pyrimidine and pyrimidine analogues are suspected to have CNS-pathological effects. The presently scarce information in these areas strongly underlines the need for and importance of intense research on the suspected pyrimidine derivative triggered pathology as well as on the role of P2UR receptors in physiology and pathophysiology.