Multisystem pathology in chronic variable stress: gut-liver-brain axis disruption and the therapeutic promise of magnesium-L-theanine.

IF 7.8 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Therapeutic Advances in Endocrinology and Metabolism Pub Date : 2026-05-21 eCollection Date: 2026-01-01 DOI:10.1177/20420188261451345
Kazim Sahin, Gozde Erek
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引用次数: 0

Abstract

Chronic variable stress (CVS) is a well-established translational model that captures the unpredictability, persistence, and cumulative burden of long-term stress exposure. Through repeated application of heterogeneous mild-to-moderate stressors in a non-habituating manner, CVS induces sustained activation of the hypothalamic-pituitary-adrenal (HPA) axis, chronic glucocorticoid excess, oxidative stress, and neuroinflammatory signaling. These processes collectively drive coordinated dysfunction across multiple organ systems. Accumulating evidence now indicates that CVS pathology extends beyond the central nervous system (CNS), engaging the gut-liver-brain axis as a key integrative network linking stress to systemic metabolic and inflammatory outcomes. Stress-induced impairment of intestinal barrier integrity, dysregulation of nutrient transporters, hepatic lipid accumulation, iron dyshomeostasis, and cardiometabolic disturbances synergistically amplify both peripheral and neural vulnerability. Magnesium-L-theanine (MgT), a novel complex combining magnesium with the green tea-derived amino acid L-theanine, has emerged as a promising multi-target intervention against CVS-induced multisystem injury. Preclinical studies demonstrate that MgT preserves epithelial barrier architecture, restores tight junction and mucus-associated proteins, normalizes intestinal nutrient transporter expression, and attenuates hepatic steatosis, oxidative stress, and iron-driven metabolic damage under CVS conditions. These protective effects converge on the reactivation of key metabolic regulators, including nicotinamide adenine dinucleotide (NAD+)/sirtuin 1 (SIRT1) and PPARγ signaling pathways, positioning MgT as a modulator of metabolic flexibility and redox resilience. Co-administration with the NAD+ precursor nicotinamide riboside further potentiates these responses by reinforcing NAD+ availability and downstream metabolic control. In parallel, human studies of magnesium and L-theanine supplementation report anxiolytic, antidepressant, sleep-promoting, and anti-inflammatory benefits, supporting the translational relevance of this combined approach. This review integrates current evidence on CVS-induced multisystem pathology, with a focus on the gut-liver-brain axis, and proposes MgT as a trace-element-based, systems-oriented strategy to mitigate chronic stress-related gastrointestinal, metabolic, and neuropsychiatric complications, while highlighting key mechanistic gaps and translational priorities for clinical advancement.

慢性可变应激的多系统病理:肠-肝-脑轴破坏和镁-l -茶氨酸的治疗前景。
慢性可变压力(CVS)是一个成熟的转化模型,它捕捉了长期压力暴露的不可预测性、持久性和累积性负担。通过以非习惯化的方式反复应用异质性的轻度至中度应激源,CVS诱导下丘脑-垂体-肾上腺(HPA)轴的持续激活、慢性糖皮质激素过量、氧化应激和神经炎症信号。这些过程共同驱动跨多个器官系统的协调功能障碍。现在越来越多的证据表明,CVS病理扩展到中枢神经系统(CNS)之外,参与肠-肝-脑轴作为连接应激与全身代谢和炎症结果的关键综合网络。应激引起的肠屏障完整性损伤、营养转运体失调、肝脂质积累、铁代谢失调和心脏代谢紊乱协同放大了外周和神经易感性。镁- l -茶氨酸(MgT)是一种将镁与绿茶衍生氨基酸l -茶氨酸结合的新型复合物,已成为一种有前景的多靶点干预药物,可用于治疗cvs诱导的多系统损伤。临床前研究表明,MgT保留了上皮屏障结构,恢复了紧密连接和黏液相关蛋白,使肠道营养转运蛋白表达正常化,并减轻了CVS条件下的肝脏脂肪变性、氧化应激和铁驱动的代谢损伤。这些保护作用集中在关键代谢调节因子的再激活上,包括烟酰胺腺嘌呤二核苷酸(NAD+)/sirtuin 1 (SIRT1)和PPARγ信号通路,将MgT定位为代谢灵活性和氧化还原弹性的调节剂。与NAD+前体烟酰胺核苷共给药通过加强NAD+的有效性和下游代谢控制进一步增强了这些反应。同时,镁和l -茶氨酸补充剂的人体研究报告了抗焦虑、抗抑郁、促进睡眠和抗炎的益处,支持了这种联合方法的转化相关性。这篇综述整合了目前关于cvs诱导的多系统病理的证据,重点是肠-肝-脑轴,并提出MgT是一种基于微量元素的、以系统为导向的策略,可以减轻慢性应激相关的胃肠道、代谢和神经精神并发症,同时强调了关键的机制差距和临床进展的转化重点。
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来源期刊
Therapeutic Advances in Endocrinology and Metabolism
Therapeutic Advances in Endocrinology and Metabolism Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
7.70
自引率
2.60%
发文量
42
审稿时长
8 weeks
期刊介绍: Therapeutic Advances in Endocrinology and Metabolism delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of endocrinology and metabolism.
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