The microbiome-­gut‐brain‐axis in coeliac disease: mechanisms for depression and anxiety co‐morbidity

Abstract

Coeliac disease (CD) is an abundant autoimmune disease of the gastrointestinal (GI) tract. The pathogenesis of CD is triggered by administration of gluten, a common protein group in daily food. The resulting inflammatory reaction leads to lesions and villous atrophy in the small intestine. Besides the gastrointestinal manifestation, increasing awareness has risen on depression and anxiety disorder co-morbidity. Accumulating evidence suggests an important role of the microbiome-gut-brain axis in the development of these psychiatric conditions. In this paper, the recent literature on CD and the microbiome-gut-brain axis is reviewed. Moreover, folate deficiency, microbiome alterations and inflammatory mediators are discussed as causes of depression and anxiety in CD. Lastly, potential therapies against the psychiatric co-morbidity in CD are identified.