Ssris may reduce gut bacterial translocation of lipopolysaccharides in adolescents with internalizing disorders

Disruption in gut barrier integrity may be implicated in internalizing (ie, depressive and anxiety) disorders. We examined the association between lipopolysaccharides (LPS) and lipopolysaccharides binding protein (LPSBP) and internalizing symptom severity in adolescents, before and after treatment with SSRIs. Children (10 to 18 years old) with internalizing disorders were enrolled before starting treatment with SSRIs. Symptom severity was captured with the Children’s Depression Rating Scale-Revised (CDRS-R). A blood sample was obtained aseptically to collect a plasma sample, before and after SSRI treatment, to measure LPS with the limulus amebocyte lysate assay and LPSBP. Mixed regression analysis, using SAS version 9.4 for Windows (SAS Institute Inc, Cary, North Carolina), examined the associations between symptoms severity, LPS and LPSBP concentration, and SSRI effect over time. We enrolled 43 participants (32 females) with a mean age of 14.2 ± 2.0 years. LPS and LPSBP mean plasma level were 0.027 ± 0.027 EU/mL and 7.72 ± 5.91 ug/mL, respectively, while the mean CDRS-R T score was 64.0 ± 12.0. Neither the CDRS-R T score nor treatment with SSRIs (adjusted for adherence) significantly correlated with LPS or LPSBP concentration (all p's > 0.30). Restricting the analyses to patients with a depressive disorder did not alter the findings. In this group of children with internalizing disorders, neither depression severity nor SSRI treatment were appreciably associated with gut bacterial translocation. Future work should examine whether this association would differ depending on gut barrier integrity.