As widely discussed over the review, the immune system plays a crucial role in the gut–brain axis communications since immune mediators are important messengers of this complex dialogue and, consequently, it mechanistically links the function’s impairments in both brain and gut, as shown by the association between chronic gut inflammation and psychological morbidity
[98][99][100][101]. The immune system plays a key role in obesity and correlated pathologies, such as in the colorectal cancer
[102]. In obese patients, a chronic low-grade inflammatory state is maintained
[103][104] and the peripheral inflammation, with the activation of innate immune components (like TLRs) and the loss of intestinal barrier integrity, can lead to neuro-inflammation. Interestingly, recent studies have demonstrated that dysbiosis and inflammation may concur to the development of various diseases, including obesity and depression disorders
[105]. In addition, numerous studies have now clearly confirmed that the gut microbiome can, qualitatively and quantitatively, shape the host immune responses, both in the gut and in systemic tissues. In this way, the GM influences the concentration and profile of cytokines present in any given individual and, in turn, differentially affects the brain function. For example, GF mice show numerous immune abnormalities, including impaired antibody responses, diminished numbers of T and B lymphocytes and a defective production of cytokines (such as IL-10, TNF-alfa, IL-6 and IL-1)
[106][107]. Moreover, selective GM constituents shape specific aspects of adaptive and innate immunity, including the differentiation of particular effector T-cell lineages
[108][109][110]. The obesity-associated dysbiosis is characterized by a remarkable inflammatory potential of microbiota
[111][112], which is able to activate innate and adaptive immunity in the gut and beyond, increasing the inflammatory tone by TLRs activation and production of pro-inflammatory cytokines
[113]. Sen and colleagues have demonstrated that a dysbiotic microbiota (high sugar diet-associated) alters the vagal gut–brain communication
[114], producing an inflammatory state that increases gut permeability. The result is the passage of LPS and pro-inflammatory cytokines from the lumen to the lamina propria (triggering an inflammatory response) and so, microglia activation in the nodose ganglion and finally leading to vagal remodeling
[111]. Moreover, a microbiota with enhanced pro-inflammatory activity has been demonstrated to be able to promote intestinal inflammation, inducing colitis and metabolic syndrome
[35][113]. The loss of intestinal barrier integrity, seems to be a crucial step in the obesity pathogenesis and related diseases, including neurological disorders
[106][115] (
Figure 2). In fact, the leaky gut allows the translocation of Gram-negative bacteria’s components into the mesenteric lymph nodes and the circulation, boosting the release of pro-inflammatory cytokines (especially TNF-alpha), via TLR2/4 direct or indirect activation
[115][116][117][118], and increasing the production of IgA and IgM
[119][120]. In general the gut permeability can be considered the direct consequence of the dysbiotic microbiota-driven local gastrointestinal inflammation
[121][122], and notably, in obese mice, the prebiotics’ supplementation can improve the gut integrity, reducing the weight gain
[123]. The leaky gut and the associated-inflammation lead to peripheral insulin resistance and hyperglycemia, supporting the obesity establishment; moreover, the increased inflammatory cytokines in the peripheral system can affect the BBB integrity, contributing to the development of mood disorders
[122]. Bruce-Keller and colleagues have linked obesity, microbiome, and neurologic dysfunction, demonstrating the ability of HF diet-dysbiotic microbiota to increase inflammatory gene expression in the medial prefrontal cortex associated with anxiety and memory impairment
[124]. Moreover, the inflammation generated by HF diet-dysbiotic microbiota can activate the microglia
[125], a process observed in various neurological disorders
[125][126][127][128] and associated with weight gain and bacteria-driven hyperphagia
[129].