Introduction
More recently, accumulating studies strongly suggest that the imbalance of intestinal microflora could contribute as one of the pivotal factors in the metabolic dysfunctions in SCZ patients [26]. A huge divergence in gut microbiome was also observed between lean and obese individuals, with a 20% higher Firmicute count and a 20% lower Bacteroides count in lean individuals [28]. In addition, these gut bacteria can generate short-chain fatty acids (SCFAs) metabolites and release different neurotransmitters, for instance, acetylcholine, dopamine, serotonin, and norepinephrine can be produced and released by the Lactobacillus, Bacillus, and Enterococcus species, the Candida, Streptococcus, Escherichia, and Saccharomyces species, and the Escherichia and Bacillus species, respectively [29]. It is conceivable that dysbiosis of intestinal flora metabolites, including neurotransmitters, partly contributes to the pathological causes of SCZ. Considering the abovementioned findings, we hypothesized that anomalous intestinal microflora interaction with metabolic adverse events may exacerbate clinical symptoms in patients with SCZ. This study reveals the associations among the gut microbiota, metabolomics, and clinical phenotypes of SCZ, which sheds new light on enhancing the current understanding of etiological mechanisms of SCZ.
Materials and methods
Participants
Clinical assessments
Mini-international neuropsychiatric interview (MINI) 6.0.0
Positive and negative syndrome scale (PANSS)
Fecal sample collection, storage, and processing
16 S rRNA gene sequencing analysis
Liquid chromatography-mass spectrometry
Statistical analysis
Demographic analysis
Microbiome analyses
Results
Clinical characteristics of study participants
Factors | Healthy group(n = 44) | Acute group (n = 41) | Remission group (n = 39) | F/t/χ2 | P |
---|---|---|---|---|---|
Age(years) | 42.61 ± 11.81 | 38.59 ± 11.25 | 39.74 ± 11.17 | 1.406 | 0.249 |
Sex(Males/Females) | 2.363 | 0.307 | |||
Males(proportion%) | 23(52.3) | 17(41.5) | 14(35.9) | ||
Females(proportion%) | 21(47.7) | 24(58.5) | 25(64.1) | ||
BMI (kg/m2) | 22.68 ± 3.06 | 23.66 ± 2.78 | 23.85 ± 3.68 | 1.647 | 0.197 |
Years of education(years) | 10.44 ± 4.38 | 10.51 ± 4.38 | 9.72 ± 3.90 | 0.892 | 0.412 |
Course of disease(years) | 10.60 ± 7.49 | 13.01 ± 8.74 | -1.322 | 0.090 | |
Drugs | |||||
CPZ equivalent doses(mg) | 171.44 ± 121.68 | 227.99 ± 134.99 | -1.970 | 0.181 | |
PANSS | |||||
Positive symptom | 13.63 ± 6.05 | 9.56 ± 2.34 | 3.934 | 0.000 | |
Negative symptom | 17.90 ± 7.85 | 13.54 ± 4.23 | 3.071 | 0.014 | |
Cognitive defect symptom | 10.10 ± 3.53 | 6.69 ± 1.84 | 5.366 | 0.009 | |
Excited symptom | 10.15 ± 3.90 | 5.69 ± 1.10 | 6.091 | 0.000 | |
Depressive symptom | 4.07 ± 2.13 | 3.10 ± 0.68 | 2.721 | 0.001 | |
PANSS-Total | 73.07 ± 11.30 | 45.41 ± 6.82 | 7.279 | 0.002 |