{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:20:51Z","timestamp":1790742051147,"version":"4.1.0"},"reference-count":82,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Post-traumatic stress disorder (PTSD) and trauma-related disorders are increasingly recognized as complex conditions involving not only psychological and neurobiological factors but also systemic physiological alterations. Among these, growing evidence points to the crucial role of the gut\u2013brain axis in modulating stress responses, emotional regulation, and neuroinflammation. Objective: This narrative review aims to synthesize the emerging literature on the interactions between the gut microbiota and the central nervous system in PTSD and trauma-related disorders, highlighting potential mechanisms and therapeutic implications. Methods: A comprehensive search of the literature was conducted across PubMed and Scopus and Web of Science as primary bibliographic databases, focusing on clinical, preclinical, and translational studies published in the last two decades. Emphasis was placed on studies exploring the microbiota\u2019s influence on neuroendocrine and immune pathways relevant to trauma, as well as intervention studies targeting the gut\u2013brain axis. Results: Evidence suggests that dysbiosis and gut permeability alterations are associated with PTSD symptomatology, possibly via mechanisms involving hypothalamic\u2013pituitary\u2013adrenal (HPA) axis dysregulation, neuroinflammation, vagal signaling, and altered neurotransmitter production. Preclinical models support a bidirectional relationship between early-life stress, trauma, and gut microbiota alterations. Furthermore, preliminary clinical data indicate that interventions such as probiotics, diet modulation, and psychobiotics may exert beneficial effects on trauma-related psychopathology. Conclusions: The gut\u2013brain axis represents a promising framework for understanding the pathophysiology of PTSD and related conditions. Although research is still in its early stages, targeting gut microbiota may offer novel preventive and therapeutic strategies. Further longitudinal and mechanistic studies are needed to validate these findings and guide clinical translation.<\/jats:p>","DOI":"10.3390\/nu18030530","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T11:13:01Z","timestamp":1770289981000},"page":"530","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["From Dysbiosis to Distress: The Gut\u2013Brain Connection in Trauma-Related Disorders"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7058-4927","authenticated-orcid":false,"given":"Giuseppe","family":"Marano","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Head-Neck and Chest, Section of Psychiatry, Fondazione Policlinico Universi-Tario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy"},{"name":"Department of Neuroscience, Section of Psychiatry, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1889-0010","authenticated-orcid":false,"given":"Luca","family":"Lo Giudice","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Head-Neck and Chest, Section of Psychiatry, Fondazione Policlinico Universi-Tario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy"},{"name":"Department of Neuroscience, Section of Psychiatry, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6938-6828","authenticated-orcid":false,"given":"Elettra","family":"Specogna","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Head-Neck and Chest, Section of Psychiatry, Fondazione Policlinico Universi-Tario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy"},{"name":"Department of Neuroscience, Section of Psychiatry, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6060-6509","authenticated-orcid":false,"given":"Luca","family":"Chisari","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Head-Neck and Chest, Section of Psychiatry, Fondazione Policlinico Universi-Tario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy"},{"name":"Department of Neuroscience, Section of Psychiatry, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0491-5051","authenticated-orcid":false,"given":"Caterina","family":"Brisi","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Head-Neck and Chest, Section of Psychiatry, Fondazione Policlinico Universi-Tario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy"},{"name":"Department of Neuroscience, Section of Psychiatry, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6558-2932","authenticated-orcid":false,"given":"Gianandrea","family":"Traversi","sequence":"additional","affiliation":[{"name":"Unit of Medical Genetics, Department of Laboratory Medicine, Ospedale Isola Tiberina-Gemelli Isola, 00186 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1850-2864","authenticated-orcid":false,"given":"Osvaldo","family":"Mazza","sequence":"additional","affiliation":[{"name":"Spine Surgery Department, Bambino Ges\u00f9 Children\u2019s Hospital IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3007-8162","authenticated-orcid":false,"given":"Marianna","family":"Mazza","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Head-Neck and Chest, Section of Psychiatry, Fondazione Policlinico Universi-Tario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy"},{"name":"Department of Neuroscience, Section of Psychiatry, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1016\/j.biopsych.2025.01.014","article-title":"Grasping Posttraumatic Stress Disorder from the Perspective of Psychoneuroimmunoendocrinology: Etiopathogenic Mechanisms and Relevance for Integrative Management","volume":"98","author":"Presa","year":"2025","journal-title":"Biol. Psychiatry"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1177\/0706743716635535","article-title":"Posttraumatic Stress Disorder: Does the Gut Microbiome Hold the Key?","volume":"61","author":"Leclercq","year":"2016","journal-title":"Can. J. Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1038\/s41398-022-02094-7","article-title":"The role of the immune system in posttraumatic stress disorder","volume":"12","author":"Katrinli","year":"2022","journal-title":"Transl. Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.neubiorev.2021.04.019","article-title":"The self-serving benefits of being a good host: A role for our micro-inhabitants in shaping opioids\u2019 function","volume":"127","author":"Eitan","year":"2021","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/978-1-4939-0897-4_8","article-title":"Microbiome, HPA axis and production of endocrine hormones in the gut","volume":"817","author":"Sudo","year":"2014","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1176\/appi.ajp.2015.15020152","article-title":"Inflammation: Depression fans the flames and feasts on the heat","volume":"172","author":"Derry","year":"2015","journal-title":"Am. J. Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1038\/npp.2011.205","article-title":"Psychoneuroimmunology meets neuropsychopharmacology: Translational implications of the impact of inflammation on behavior","volume":"37","author":"Haroon","year":"2012","journal-title":"Neuropsychopharmacology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"113331","DOI":"10.1016\/j.expneurol.2020.113331","article-title":"PTSD-related neuroimaging abnormalities in brain function, structure, and biochemistry","volume":"330","author":"Harnett","year":"2020","journal-title":"Exp. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Pan, J., Lin, S., Qian, Q., Fu, S., and Liu, X. (2025). Gut-brain axis in post-traumatic stress disorder: Microbial-mediated mechanisms and new therapeutic approaches\u2014A narrative review. Front. Pharmacol., 16.","DOI":"10.3389\/fphar.2025.1621678"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1877","DOI":"10.1152\/physrev.00018.2018","article-title":"The Microbiota-Gut-Brain Axis","volume":"99","author":"Cryan","year":"2019","journal-title":"Physiol. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1172\/JCI76304","article-title":"Gut\/brain axis and the microbiota","volume":"125","author":"Mayer","year":"2015","journal-title":"J. Clin. Investig."},{"key":"ref_12","first-page":"203","article-title":"The gut-brain axis: Interactions between enteric microbiota, central and enteric nervous systems","volume":"28","author":"Carabotti","year":"2015","journal-title":"Ann. Gastroenterol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/j.biopsych.2023.04.025","article-title":"Role of PPAR-Allopregnanolone Signaling in Behavioral and Inflammatory Gut-Brain Axis Communications","volume":"94","author":"Pinna","year":"2023","journal-title":"Biol. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1038\/s41398-024-02765-7","article-title":"Potential causal association between gut microbiome and posttraumatic stress disorder","volume":"14","author":"He","year":"2024","journal-title":"Transl. Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2373","DOI":"10.4103\/0366-6999.190667","article-title":"Gut Microbiota-brain Axis","volume":"129","author":"Wang","year":"2016","journal-title":"Chin. Med. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1016\/j.bpsgos.2023.03.005","article-title":"Repeated Social Defeat Stress Induces an Inflammatory Gut Milieu by Altering the Mucosal Barrier Integrity and Gut Microbiota Homeostasis","volume":"3","author":"Yadav","year":"2023","journal-title":"Biol. Psychiatry Glob. Open Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1111\/j.1365-2982.2012.01906.x","article-title":"Microbes and the gut-brain axis","volume":"24","author":"Bercik","year":"2012","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"117080","DOI":"10.1016\/j.ecoenv.2024.117080","article-title":"Causal effect of air pollution on the risk of brain health and potential mediation by gut microbiota","volume":"285","author":"Zhou","year":"2024","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1080\/07853890.2020.1808239","article-title":"Gut microbes in neurocognitive and mental health disorders","volume":"52","author":"Halverson","year":"2020","journal-title":"Ann. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.bbi.2023.08.003","article-title":"The interactions between host genome and gut microbiome increase the risk of psychiatric disorders: Mendelian randomization and biological annotation","volume":"113","author":"Xiao","year":"2023","journal-title":"Brain Behav. Immun."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"5127157","DOI":"10.1155\/2023\/5127157","article-title":"The Role of Gut Microbiota in Various Neurological and Psychiatric Disorders-An Evidence Mapping Based on Quantified Evidence","volume":"2023","author":"Zang","year":"2023","journal-title":"Mediat. Inflamm."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Petakh, P., Duve, K., Oksenych, V., Behzadi, P., and Kamyshnyi, O. (2024). Molecular mechanisms and therapeutic possibilities of short-chain fatty acids in posttraumatic stress disorder patients: A mini-review. Front. Neurosci., 18.","DOI":"10.3389\/fnins.2024.1394953"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Petakh, P., Oksenych, V., Kamyshna, I., Boisak, I., Lyubomirskaya, K., and Kamyshnyi, O. (2024). Exploring the interplay between posttraumatic stress disorder, gut microbiota, and inflammatory biomarkers: A comprehensive meta-analysis. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1349883"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/gbb.12109","article-title":"Microbial genes, brain & behaviour\u2014Epigenetic regulation of the gut-brain axis","volume":"13","author":"Stilling","year":"2014","journal-title":"Genes Brain Behav."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.ynstr.2017.03.001","article-title":"Stress & the gut-brain axis: Regulation by the microbiome","volume":"7","author":"Foster","year":"2017","journal-title":"Neurobiol. Stress"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1159\/000504495","article-title":"Gut Microbiota: A Perspective for Psychiatrists","volume":"79","author":"Rea","year":"2020","journal-title":"Neuropsychobiology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1038\/nrn3346","article-title":"Mind-altering microorganisms: The impact of the gut microbiota on brain and behaviour","volume":"13","author":"Cryan","year":"2012","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"G61","DOI":"10.1152\/ajpgi.00066.2022","article-title":"Abnormal intestinal milieu in posttraumatic stress disorder is not impacted by treatment that improves symptoms","volume":"323","author":"Voigt","year":"2022","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"G661","DOI":"10.1152\/ajpgi.00194.2019","article-title":"Posttraumatic stress disorder is associated with altered gut microbiota that modulates cognitive performance in veterans with cirrhosis","volume":"317","author":"Bajaj","year":"2019","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Sugden, S.G., and Merlo, G. (2024). Using lifestyle interventions and the gut microbiota to improve PTSD symptoms. Front. Neurosci., 18.","DOI":"10.3389\/fnins.2024.1488841"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1016\/j.biopsych.2013.05.001","article-title":"Psychobiotics: A novel class of psychotropic","volume":"74","author":"Dinan","year":"2013","journal-title":"Biol. Psychiatry"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1038\/s41579-020-00460-0","article-title":"The gut microbiota\u2013brain axis in behaviour and brain disorders","volume":"19","author":"Morais","year":"2021","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Balmus, I.M., Ilie, O.D., Ciobica, A., Cojocariu, R.O., Stanciu, C., Trifan, A., Cimpeanu, M., Cimpeanu, C., and Gorgan, L. (2020). Irritable Bowel Syndrome between Molecular Approach and Clinical Expertise-Searching for Gap Fillers in the Oxidative Stress Way of Thinking. Medicina, 56.","DOI":"10.3390\/medicina56010038"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"S301","DOI":"10.21037\/jgo-2019-gi-04","article-title":"The brain-gut axis in gastrointestinal cancers","volume":"12","author":"Alpert","year":"2021","journal-title":"J. Gastrointest. Oncol."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Winder, C., Lodhia, A., Basso, M., and Cohen Kadosh, K. (2025). Gut microbiome differences in individuals with PTSD compared to trauma-exposed controls: A systematic review. Front. Neurosci., 19.","DOI":"10.3389\/fnins.2025.1540180"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1111\/j.1365-2036.2011.04624.x","article-title":"Altered peripheral toll-like receptor responses in the irritable bowel syndrome","volume":"33","author":"McKernan","year":"2011","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"eaar2016","DOI":"10.1126\/science.aar2016","article-title":"Microbiota and the social brain","volume":"366","author":"Sherwin","year":"2019","journal-title":"Science"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1038\/s41564-018-0337-x","article-title":"The neuroactive potential of the human gut microbiota in quality of life and depression","volume":"4","author":"Falony","year":"2019","journal-title":"Nat. Microbiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1017\/neu.2019.43","article-title":"Association of maternal prenatal psychological stressors and distress with maternal and early infant faecal bacterial profile","volume":"32","author":"Botha","year":"2020","journal-title":"Acta Neuropsychiatr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.neuroscience.2015.09.068","article-title":"Early-life adversity and brain development: Is the microbiome a missing piece of the puzzle?","volume":"342","author":"Clarke","year":"2017","journal-title":"Neuroscience"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1113\/JP273106","article-title":"Gut instincts: Microbiota as a key regulator of brain development, ageing and neurodegeneration","volume":"595","author":"Dinan","year":"2017","journal-title":"J. Physiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1858","DOI":"10.1016\/j.psyneuen.2013.06.008","article-title":"The three-hit concept of vulnerability and resilience: Toward understanding adaptation to early-life adversity outcome","volume":"38","author":"Daskalakis","year":"2013","journal-title":"Psychoneuroendocrinology"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1196\/annals.1314.014","article-title":"An animal model of posttraumatic stress disorder: The use of cut-off behavioral criteria","volume":"1032","author":"Cohen","year":"2004","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Galley, J.D., Nelson, M.C., Yu, Z., Dowd, S.E., Walter, J., Kumar, P.S., Lyte, M., and Bailey, M.T. (2014). Exposure to a social stressor disrupts the community structure of the colonic mucosa-associated microbiota. BMC Microbiol., 14.","DOI":"10.1186\/1471-2180-14-189"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2654","DOI":"10.1111\/ejn.13291","article-title":"Adult microbiota-deficient mice have distinct dendritic morphological changes: Differential effects in the amygdala and hippocampus","volume":"44","author":"Luczynski","year":"2016","journal-title":"Eur. J. Neurosci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1111\/nmo.12295","article-title":"Probiotic gut effect prevents the chronic psychological stress-induced brain activity abnormality in mice","volume":"26","author":"Colom","year":"2014","journal-title":"Neurogastroenterol. Motil."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Bharwani, A., Mian, M.F., Surette, M.G., Bienenstock, J., and Forsythe, P. (2017). Oral treatment with Lactobacillus rhamnosus attenuates behavioural deficits and immune changes in chronic social stress. BMC Med., 15.","DOI":"10.1186\/s12916-016-0771-7"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"559","DOI":"10.2174\/1570159X15666170915141036","article-title":"The Microbiota-Gut-Brain Axis in Neuropsychiatric Disorders: Pathophysiological Mechanisms and Novel Treatments","volume":"16","author":"Kim","year":"2018","journal-title":"Curr. Neuropharmacol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"16050","DOI":"10.1073\/pnas.1102999108","article-title":"Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve","volume":"108","author":"Bravo","year":"2011","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1097\/PSY.0000000000000512","article-title":"The Microbiome in Posttraumatic Stress Disorder and Trauma-Exposed Controls: An Exploratory Study","volume":"79","author":"Hemmings","year":"2017","journal-title":"Psychosom. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1038\/s41398-023-02643-8","article-title":"Association between microbiome and the development of adverse posttraumatic neuropsychiatric sequelae after traumatic stress exposure","volume":"13","author":"Zeamer","year":"2023","journal-title":"Transl. Psychiatry"},{"key":"ref_52","first-page":"1","article-title":"The saNeuroGut Initiative: Investigating the Gut Microbiome and Symptoms of Anxiety, Depression, and Posttraumatic Stress","volume":"32","author":"Swart","year":"2025","journal-title":"Neuroimmunomodulation"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1038\/s41398-024-03122-4","article-title":"Probing the oral-brain connection: Oral microbiome patterns in a large community cohort with anxiety, depression, and trauma symptoms, and periodontal outcomes","volume":"14","author":"Vidal","year":"2024","journal-title":"Transl. Psychiatry"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"4590","DOI":"10.1038\/s41380-022-01704-6","article-title":"Oral microbiota signatures in post-traumatic stress disorder (PTSD) veterans","volume":"27","author":"Shapira","year":"2022","journal-title":"Mol. Psychiatry"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/S2468-1253(17)30147-4","article-title":"The microbiota-gut-brain axis in obesity","volume":"2","author":"Schellekens","year":"2017","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.plefa.2018.03.006","article-title":"Mechanisms underlying the effects of n-3 polyunsaturated fatty acids on fear memory processing and their hypothetical effects on fear of cancer recurrence in cancer survivors","volume":"131","author":"Okubo","year":"2018","journal-title":"Prostaglandins Leukot. Essent. Fat. Acids"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Marano, G., Mazza, M., Lisci, F.M., Ciliberto, M., Traversi, G., Kotzalidis, G.D., De Berardis, D., Laterza, L., Sani, G., and Gasbarrini, A. (2023). The Microbiota-Gut-Brain Axis: Psychoneuroimmunological Insights. Nutrients, 15.","DOI":"10.3390\/nu15061496"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"5945","DOI":"10.3748\/wjg.v29.i45.5945","article-title":"Gut microbiota in women: The secret of psychological and physical well-being","volume":"29","author":"Marano","year":"2023","journal-title":"World J. Gastroenterol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1016\/j.bbi.2011.07.229","article-title":"Omega-3 supplementation lowers inflammation and anxiety in medical students: A randomized controlled trial","volume":"25","author":"Belury","year":"2011","journal-title":"Brain Behav. Immun."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.tim.2011.06.005","article-title":"Investigating the biological and clinical significance of human dysbioses","volume":"19","author":"Frank","year":"2011","journal-title":"Trends Microbiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.tins.2013.01.005","article-title":"Gut-brain axis: How the microbiome influences anxiety and depression","volume":"36","author":"Foster","year":"2013","journal-title":"Trends Neurosci."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1038\/mp.2016.50","article-title":"From gut dysbiosis to altered brain function and mental illness: Mechanisms and pathways","volume":"21","author":"Rogers","year":"2016","journal-title":"Mol. Psychiatry"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1908","DOI":"10.1038\/s41380-022-01479-w","article-title":"The gut microbiome and mental health: Advances in research and emerging priorities","volume":"27","author":"Shoubridge","year":"2022","journal-title":"Mol. Psychiatry"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.jad.2012.02.023","article-title":"Increased IgA and IgM responses against gut commensals in chronic depression: Further evidence for increased bacterial translocation or leaky gut","volume":"141","author":"Maes","year":"2012","journal-title":"J. Affect. Disord."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/j.tins.2016.09.002","article-title":"Psychobiotics and the Manipulation of Bacteria-Gut-Brain Signals","volume":"39","author":"Sarkar","year":"2016","journal-title":"Trends Neurosci."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"100732","DOI":"10.1016\/j.ynstr.2025.100732","article-title":"Can the gut-brain axis provide insight into psilocybin\u2019s therapeutic value in reducing stress?","volume":"36","author":"Kit","year":"2025","journal-title":"Neurobiol. Stress"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Huang, R., Wang, K., and Hu, J. (2016). Effect of Probiotics on Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients, 8.","DOI":"10.3390\/nu8080483"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1007\/s13668-020-00313-5","article-title":"Probiotics and the Microbiota-Gut-Brain Axis: Focus on Psychiatry","volume":"9","author":"Butler","year":"2020","journal-title":"Curr. Nutr. Rep."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"glaf038","DOI":"10.1093\/gerona\/glaf038","article-title":"Age-Related Cognitive Decline and Dementia: Interface of Microbiome-Immune-Neuronal Interactions","volume":"80","author":"Prajapati","year":"2025","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.jcmgh.2018.04.003","article-title":"The Brain-Gut-Microbiome Axis","volume":"6","author":"Martin","year":"2018","journal-title":"Cell. Mol. Gastroenterol. Hepatol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/S1474-4422(19)30356-4","article-title":"The gut microbiome in neurological disorders","volume":"19","author":"Cryan","year":"2020","journal-title":"Lancet Neurol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1523\/JNEUROSCI.0733-19.2019","article-title":"Revisiting the Stress Concept: Implications for Affective Disorders","volume":"40","author":"McEwen","year":"2020","journal-title":"J. Neurosci."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/j.it.2017.08.002","article-title":"Exosomes, DAMPs and miRNA: Features of Stress Physiology and Immune Homeostasis","volume":"38","author":"Fleshner","year":"2017","journal-title":"Trends Immunol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1002\/wps.20568","article-title":"Intergenerational transmission of trauma effects: Putative role of epigenetic mechanisms","volume":"17","author":"Yehuda","year":"2018","journal-title":"World Psychiatry"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"105859","DOI":"10.1016\/j.neubiorev.2024.105859","article-title":"Psychosocial and neurobiological aspects of the worldwide refugee crisis: From vulnerability to resilience","volume":"165","author":"Anisman","year":"2024","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1093\/emph\/eot004","article-title":"Microbial \u2018Old Friends\u2019, immunoregulation and stress resilience","volume":"2013","author":"Rook","year":"2013","journal-title":"Evol. Med. Public Health"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Marano, G., Rossi, S., Sfratta, G., Traversi, G., Lisci, F.M., Anesini, M.B., Pola, R., Gasbarrini, A., Gaetani, E., and Mazza, M. (2025). Gut Microbiota: A New Challenge in Mood Disorder Research. Life, 15.","DOI":"10.3390\/life15040593"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1097\/PSY.0000000000000519","article-title":"Brain-Gut-Microbiota Axis and Mental Health","volume":"79","author":"Dinan","year":"2017","journal-title":"Psychosom. Med."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Kelly, J.R., Minuto, C., Cryan, J.F., Clarke, G., and Dinan, T.G. (2017). Cross Talk: The Microbiota and Neurodevelopmental Disorders. Front. Neurosci., 11.","DOI":"10.3389\/fnins.2017.00490"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"987","DOI":"10.4081\/cp.2017.987","article-title":"Gut microbiota\u2019s effect on mental health: The gut-brain axis","volume":"7","author":"Clapp","year":"2017","journal-title":"Clin. Pract."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Rudzki, L., and Szulc, A. (2018). \u201cImmune Gate\u201d of Psychopathology\u2014The Role of Gut Derived Immune Activation in Major Psychiatric Disorders. Front. Psychiatry, 9.","DOI":"10.3389\/fpsyt.2018.00205"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1093\/ijnp\/pyy067","article-title":"Making Sense of \u2026 the Microbiome in Psychiatry","volume":"22","author":"Bastiaanssen","year":"2019","journal-title":"Int. J. Neuropsychopharmacol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/3\/530\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T11:20:46Z","timestamp":1770290446000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/3\/530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,5]]},"references-count":82,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["nu18030530"],"URL":"https:\/\/doi.org\/10.3390\/nu18030530","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,5]]}}}