REVIEW ARTICLESStress and the gut microbiota-brain axisMolina-Torres, Guadalupe; Rodriguez-Arrastia, Miguel; Roman, Pablo; Sanchez-Labraca, Nuria; Cardona, DianaAuthor Information Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Spain Correspondence to Pablo Roman, PhD, Department of Nursing Science, Physiotherapy and Medicine, University of Almeria, Carretera del Sacramento, s/n, 04120 La Cañada, Almería, Spain E-mail: firstname.lastname@example.org Behavioural Pharmacology: April 2019 - Volume 30 - Issue 2 and 3 - p 187-200 doi: 10.1097/FBP.0000000000000478 Buy Metrics Abstract Stress is a nonspecific response of the body to any demand imposed upon it, disrupting the body homoeostasis and manifested with symptoms such as anxiety, depression or even headache. These responses are quite frequent in the present competitive world. The aim of this review is to explore the effect of stress on gut microbiota. First, we summarize evidence of where the microbiota composition has changed as a response to a stressful situation, and thereby the effect of the stress response. Likewise, we review different interventions that can modulate microbiota and could modulate the stress according to the underlying mechanisms whereby the gut–brain axis influences stress. Finally, we review both preclinical and clinical studies that provide evidence of the effect of gut modulation on stress. In conclusion, the influence of stress on gut microbiota and gut microbiota on stress modulation is clear for different stressors, but although the preclinical evidence is so extensive, the clinical evidence is more limited. A better understanding of the mechanism underlying stress modulation through the microbiota may open new avenues for the design of therapeutics that could boost the pursued clinical benefits. These new designs should not only focus on stress but also on stress-related disorders such as anxiety and depression, in both healthy individuals and different populations. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.