Anxiety, Depression, and the Microbiome: A Role for Gut Peptides

Neurotherapeutics. 2018 Jan;15(1):36-59. doi: 10.1007/s13311-017-0585-0.


The complex bidirectional communication between the gut and the brain is finely orchestrated by different systems, including the endocrine, immune, autonomic, and enteric nervous systems. Moreover, increasing evidence supports the role of the microbiome and microbiota-derived molecules in regulating such interactions; however, the mechanisms underpinning such effects are only beginning to be resolved. Microbiota-gut peptide interactions are poised to be of great significance in the regulation of gut-brain signaling. Given the emerging role of the gut-brain axis in a variety of brain disorders, such as anxiety and depression, it is important to understand the contribution of bidirectional interactions between peptide hormones released from the gut and intestinal bacteria in the context of this axis. Indeed, the gastrointestinal tract is the largest endocrine organ in mammals, secreting dozens of different signaling molecules, including peptides. Gut peptides in the systemic circulation can bind cognate receptors on immune cells and vagus nerve terminals thereby enabling indirect gut-brain communication. Gut peptide concentrations are not only modulated by enteric microbiota signals, but also vary according to the composition of the intestinal microbiota. In this review, we will discuss the gut microbiota as a regulator of anxiety and depression, and explore the role of gut-derived peptides as signaling molecules in microbiome-gut-brain communication. Here, we summarize the potential interactions of the microbiota with gut hormones and endocrine peptides, including neuropeptide Y, peptide YY, pancreatic polypeptide, cholecystokinin, glucagon-like peptide, corticotropin-releasing factor, oxytocin, and ghrelin in microbiome-to-brain signaling. Together, gut peptides are important regulators of microbiota-gut-brain signaling in health and stress-related psychiatric illnesses.

Keywords: Anxiety; Depression; Gut microbiota; Gut peptides; Gut–brain axis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anxiety / metabolism
  • Anxiety / microbiology*
  • Brain / metabolism
  • Brain / microbiology*
  • Cholecystokinin / metabolism
  • Corticotropin-Releasing Hormone / metabolism
  • Depression / metabolism
  • Depression / microbiology*
  • Endocrine System / metabolism
  • Endocrine System / microbiology
  • Gastrointestinal Microbiome*
  • Ghrelin / metabolism
  • Glucagon-Like Peptide 1 / metabolism
  • Humans
  • Neuropeptide Y / metabolism
  • Oxytocin / metabolism
  • Peptide Hormones / metabolism*


  • Ghrelin
  • Neuropeptide Y
  • Peptide Hormones
  • Oxytocin
  • Glucagon-Like Peptide 1
  • Cholecystokinin
  • Corticotropin-Releasing Hormone