Bacterial Translocation Predicts Future Depressive Symptoms in Breast Cancer Survivors and Controls: A Two-Year Observational Study

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2019-03

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Abstract

Purpose: There is cross-sectional evidence of elevated bacterial translocation among depressed individuals; however, it is unclear if depressive symptoms precede bacterial translocation or vice versa. Methods: The current study examined bidirectional longitudinal associations between bacterial translocation markers and depressive symptoms in 315 women (n=209 breast cancer survivors, n=106 non-cancer controls). At three visits, women completed the Center for Epidemiological Studies Depression questionnaire (CES-D) and provided blood samples to assess lipopolysaccharide-binding protein (LBP) and serum soluble CD14 (sCD14), and their ratio, markers of bacterial translocation. Results: After adjusting for key demographic variables, health behaviors, cancer treatment, and baseline depressive symptoms, women with higher baseline LBP (p=0.013) and LBP/sCD14 (p=0.007), but not sCD14 (p=0.85), had greater depressive symptoms at later visit. A woman at the 75th percentile for LBP or LBP/sCD14 at baseline was 18% more likely to report clinically significant depressive symptoms (CES-D ≥16) at follow-up than a woman at the lowest quartile of bacterial translocation. In contrast, baseline depressive symptoms did not predict bacterial translocation at follow-up. Conclusion: These results support the bottom-up pathway, suggesting that bacterial translocation fuels later depressive symptoms among healthy women and breast cancer survivors alike. Thus, interventions that target the gut barrier and microbiota, including dietary changes, probiotics, and prebiotics, may lessen the risk of depression.

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Social and Behavioral Sciences: 2nd Place (The Ohio State University Edward F. Hayes Graduate Research Forum)

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gut-brain axis, depression, cancer, bacterial translocation, leaky gut, CES-D

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