The values guiding our project's design

From the beginning of the project's design, all team members have adhered to specific values. Depression is a mental disorder that people of various ages experience all over the world. Approximately 3.8% of the global population suffers from depression, with 5% of adults (4% of men and 6% of women) and 5.7% of adults over 60 being affected. This means around 280 million people worldwide are dealing with depression. Its treatment, often inaccessible globally, frequently leads to multiple side effects, significantly impacting personal, professional, and social lives. Consequently, there is a significant demand for both efficient treatment and prevention methods to address this issue. Considering these factors, it was essential for us to create a distinct, safe, and accessible solution that has minimum side-effects to alleviate these challenges. The principle of beneficence is at the core of our efforts. We are committed to improving the lives of individuals battling depression.

Additionally, it was crucial to ensure that our solution does not further burden the environment or consume additional energy. Therefore, we used Lactobacillus rhamnosus GG, a strain of bacteria from a culture already used in an Applied Microbiology & Biotechnology laboratory at our university. Consumers are familiar with Lactobacillus rhamnosus GG, which is a widely recognized probiotic. It is extensively used and considered safe by the Food and Drug Administration (FDA) for both consumption and addition to various food products.

The second aspect of our project is the app called 'DEPRETECT.' We aimed to make it accessible to as many people as possible, so we decided to upload it on the Play Store and offer it in English. We designed the application to be as simple as possible for users, considering their psychological state, without causing any unpleasant feelings during its use. In addition, to enhance personal data security, we've taken steps to protect user data by creating a local database where their chatbot responses are stored, as opposed to saving them in the cloud.

Furthermore, stigma, prejudice, and discrimination against individuals with mental illness remain significant issues today. It was necessary for us to raise public awareness about mental health issues, reduce stigma, and promote understanding. Through our educational efforts, public engagement, and communication initiatives, we aimed not only to raise awareness but also to translate it into understanding, empathy, and action within our society.

Coming up with the idea

The brainstorming process began by listing the team's skills, interests, and areas of expertise. Our team members come from different scientific fields, including Molecular Biology and Genetics, Medicine, Engineering, and Digital Media and Communication. This diversity brought a wide range of interests, skills, and perspectives, enhancing our ability to explore various aspects of the plan. We then proceeded to identify pressing global challenges and local issues that could be addressed using synthetic biology. During our brainstorming sessions, we focused on problems that have practical, real-world applications and significant social impact and mental health emerged as a top priority on our list. Mental health issues affect millions of people around the world and by addressing them, we could have a direct impact on a large part of the population. So, we started further literature research, and after many discussions and meetings both among ourselves and with our PIs and advisors, we came up with the idea that we would develop.

Documenting our work

To ensure effective communication among our team members and to maintain a comprehensive record of our activities, we implemented several strategies from the beginning, which helped us stay focused and achieve our goals. We utilized digital platforms for real-time collaboration and easy sharing of materials. Additionally, we established a routine of holding weekly team meetings to discuss our progress. During these meetings, we recorded key points discussed, decisions made, and tasks assigned to each member for the upcoming week.

The guidance from our advisors proved invaluable in keeping us organized and documenting the project's societal impact at every stage. One of their valuable suggestions was to maintain a shared calendar accessible to all team members. This calendar contains details of past and upcoming meetings among team members, interactions with experts, and events we plan to attend.

The resources and communities we reached out to during our project's development

After the brainstorming session that led us to the initial idea for the project, we initiated our literature search and began planning our meetings with stakeholders. To ensure a comprehensive understanding of the brain-gut axis and its connection to depression at various levels (scientific, social, etc.), as well as to guide us in selecting the appropriate probiotic and developing the application, we recognize the need to gather feedback from experts spanning a wide range of disciplines. This holistic approach is crucial to ensure that the project aligns with appropriate values and achieves its objectives.

We got in touch with clinicians from different specialties, including psychiatrists, gastroenterologists, and neurologists, who helped us understand how our work could help people in real life and also made sure that what we were doing was safe. We also received advice from doctors on how to talk to people about mental health in a way that everyone can understand.

In consultation with psychologists and social workers, we refined the ethical framework of our work, making it more responsive to the needs of the people it aims to help and the wider communities it aims to serve. The psychologists had expertise in understanding the complexities of mental health issues, including depression, and provided valuable insights into the potential impact of the app on individuals' psychological well-being.Additionally, both psychologists and social workers helped us ensure that the project adheres to the highest standards of respect for individual rights. They assisted us in making the app accessible to more people, and in collaboration with them, we created a questionnaire through which we gathered feedback from the public.

Collaboration with experts in gene expression, plasmid design, and transformation ensured the accuracy and safety of genetic modifications, while researchers focused on the genetic modification of microorganisms provided critical insights into the behavior of engineered bacteria. Collaboration with experts in neurodegenerative diseases and gut-brain communication pathways was crucial, as it directly related to the project's goal of alleviating depression. Additionally, involving experts in microbial processes, especially those with knowledge of Lactobacillus species, ensured a comprehensive understanding of probiotic behavior and its effects on the gut-brain axis.

Furthermore, we met with specialized nutritionists and nutrition experts who explained how to approach mentally ill people to generate a personalized nutrition plan tailored to the person’s needs. They made significant contributions to educational initiatives and helped us explain the science behind microbiome-based nutritional interventions to the wider public, thereby enhancing public understanding and awareness. We also collaborated with them to guarantee that the app's suggested nutritional advice was not only beneficial but also safe.

Find out more in the Integrated Human Practices Page

Below are photos of some of our meetings with these experts:

In addition, we were honored to attend as a team the seminar that was organized by Mr. Kourkoutas the head of the Laboratory of Applied Microbiology and Biotechnology in our Department of Molecular Biology and Genetics. There we had the chance to be introduced to the specific definition of probiotics, the probiotic market size, and the importance of the industry, and we were also introduced to the broad connection between science and the market. The seminar was presented by Mr. George Paraskevakos who is the Executive Director of the International Probiotics Association (IPA) and he is the so-called “Voice of Probiotics” and without a doubt an extremely important touchstone in building our knowledge, experimental, and business foundation of probiotics (as well as most recently prebiotics and postbiotics). He offered valuable and highly important information about the manufacturing aspect of probiotics, the legislation that comes with their production, labeling and promotion.
More specifically we got to discuss the probiotics research, the legislation on safety while they are produced. We discussed how a probiotic should be selected, which are the ideal characteristics of selection and how dosages are applied. Also, we were presented the manufacturing process of probiotics and the legal requirements and issues that should be addressed. We talked about the product delivery forms, which needs should be met and under what conditions (e.g. temperature, pH, CO2 etc.). Ultimately, we reviewed the gut-organ research and the probiotics that could apply in each category of disease. We identified depression amongst them so later on we had a conversation with Mr.Paraskevakos about the scientific research on probiotics and depression and how our project could be implemented into the market.

Effective communication with the general public requires a diverse and inclusive approach, which is vital for the evolution of the project. Our goal was to build trust and understanding by openly listening to their concerns, raising awareness about mental health, and explaining our project's objectives in simple, clear language through our educational and communication activities. We actively encouraged participation and feedback from individuals of diverse age groups, academic backgrounds, and social contexts, valuing their varied perspectives and experiences, and embracing inclusivity and diversity in our communication approach.

Find out more in the Education & Communication Page

The evidence supporting our project's positive influence on the world

Antidepressants can have varying effects on patients. While some individuals experience therapeutic benefits, others may only encounter mild, barely noticeable side effects. However, in some cases, especially among patients with mild depressive disorders, these medications can lead to the development of severe chronic depression. The primary reason for discontinuing antidepressant treatment is the emergence of unwanted side effects that significantly impact patients' daily lives. Depression and anxiety often manifest when individuals stop taking antidepressants, but these symptoms are frequently mistaken for a recurrent episode of depression. Consequently, patients may continue taking the medication, perpetuating a harmful cycle.

Common side effects associated with SSRIs, Selective Serotonin Reuptake Inhibitors, the most prescribed group of antidepressants today, include anxiety, restlessness, insomnia, dry mouth, weight gain, nausea, diarrhea, excessive sweating, headaches, dizziness, tremors, and sexual dysfunction.

In our solution, we use Lactobacillus rhamnosus GG, a widely used probiotic naturally present in the human gut. This fact, in addition, makes the solution we propose safe. Consequently, our project is not expected to cause significant side effects. It's important, though, to note that our research for the competition was limited to in vitro experiments.

Find out more in the Safety Page

In collaboration with the Group of Psychologists and Social Workers of the Society of Social Psychiatry P. Sakellaropoulos, we have developed an anonymous survey to gather public feedback. The questions and results are presented below:

Based on the above graph, we can conclude that there is indeed a significant percentage of people who suffered from the side effects of the antidepressants they were taking.

From the answers from these questions we understand that an application like ours would be very useful for someone that suffers or suspects that he suffers from depression.

From the feedback that we got from this question it is obvious that our app should encourage the users to visit a mental health expert, as most of them seem to be hesitant. That’s why DEPRETECT allows users to share their chatbot conversations with an expert, through a friendly e-mail interface that the app offers.

The last question of the survey was free type and asked the participant what he would expect from this application. Lots of participants expressed their concerns about the accuracy of the machine learning model that we use. For this reason, we collected a very large dataset with depressive or non-depressive texts from multiple scientific sources. In this way we managed to train our model more effectively. What is more, regarding some concerns about personal data security, we secured the users' data by developing a local database in order to store their answers to the chatbot, instead of storing them to the cloud. In addition to this, despite the difficulties we faced and the practices that are more commonly used, we deployed our neural network locally and did not use any cloud platforms, so that the leak of personal data is impossible.

The impact of our project

The intended users for DEPREGUT include patients dealing with depression, as well as individuals experiencing depressive or anxious symptoms. Mental health specialists supervising patients can also benefit from using the application. DEPRETECT functions as a valuable tool for monitoring the effectiveness of our probiotic. It allows for the observation and recording of depression symptoms during probiotic consumption. In the interim between appointments with mental health specialists, DEPRETECT offers patients the opportunity to interact with an AI-powered chatbot. Users can review their previous conversations with the chatbot and share them with experts via the app's user-friendly email interface.

DEPREGUT will be readily available in drug stores without the need for a prescription, like other probiotics. We propose two methods of administration for our probiotic. Firstly, it can be taken as a dietary supplement, available in various forms like capsules and tablets. Patients can acquire it after consulting their doctors to determine the appropriate dosage following a depression diagnosis.

Secondly, it can be integrated into fermented foods such as kefir, yogurt, and cheese. Combining the probiotic with the recommended foods, snacks, and meals suggested in the application can yield the best outcomes for patients. It's important to note that these suggested meals also promote gastrointestinal health and general well-being. However, individuals with intolerances or allergies to any of these foods should avoid them.

DEPREGUT redefines mental health support by offering an accessible, personalized solution with limited side effects and DEPRETECT is a tool for both mental health experts and people with depression. This holistic approach aims to ease the journey for individuals but also revolutionize mental health care.

References

· Ibrahim, S. A., Yeboah, P. J., Ayivi, R. D., Eddin, A. S., Wijemanna, N. D., Paidari, S., & Bakhshayesh, R. V. (2023). A review and comparative perspective on health benefits of probiotic and fermented foods. International Journal of Food Science & Technology, 58(10), 4948-4964.

· Parvez, S., Malik, K. A., Ah Kang, S., & Kim, H. Y. (2006). Probiotics and their fermented food products are beneficial for health. Journal of applied microbiology, 100(6), 1171-1185.

· Ramic, E., Prasko, S., Gavran, L., & Spahic, E. (2020). Assessment of the antidepressant side effects occurrence in patients treated in primary care. Materia socio-medica, 32(2), 131.

· World Health Organization (https://www.who.int/news-room/fact-sheets/detail/depression)