Alterações bioquímicas, inflamatórias e sintomatológicas em pacientes com esquizofrenia mediante uso de probióticos

Detalhes bibliográficos
Autor(a) principal: Lima, Ana Patrícia Oliveira Moura
Data de Publicação: 2019
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
Texto Completo: http://www.repositorio.ufc.br/handle/riufc/56269
Resumo: Disturbances in the balance of the gut-brain axis at all stages of life produce changes related to the development of neuropsychiatric diseases, such as schizophrenia, and nutritional supplements, such as probiotics, receive special attention in this matter. This study aimed to analyze biochemical, inflammatory and symptomatological changes in schizophrenic patients hospitalized using probiotics. It is a factorial, double blind, randomized-controlled clinical trial of treatment, with 3 arms, in which the dietary intervention performed was the standardization of the hospital diet and the addition of probiotic (Lactobacillus ssp and Bifidumbacterium sp). Data collection took place from January to March 2019 at a public hospital in Fortaleza - CE, a reference in mental health, with patients of both sexes, aged between 18 and 60 years and diagnosed with schizophrenia. The patients were distributed in a control group (Co), intervention groups using probiotics for 15 days (Prob15) and for 30 days (Prob30), being monitored at the beginning (time zero: at admission), in the middle (time 15 days from hospitalization) and at the end (time 30 days of hospitalization). In the three times, data were collected regarding BMI, AC, blood glucose, triglycerides, cholesterol and fractions, Na, K, Ca, Fe, Vit. B12, PCR, AST, ALT, Urea, creatinine, TBARS, Nitrite, GSH, and symptomatology using the CGI-SCH, BPRS-A, PANSS, ECDE scales. Statistical analysis was performed using the IBM Statistical Package for the Social Sciences- SPSS software version 20.0. with ANOVA test, being considered as statistically significant those analyzes with p < 0.05. The mean age of the patients was 38.5 ± 10.7, with 64.6% male, onset of the disease at a young age of 20.97 ± 9.63, and an average of 5 hospitalizations. There was maintenance of nutritional status in the three study groups, although the mean BMI in the prob30 group increased in the final phase of follow-up. As for CA, the probiotic seems to be related to an increase in both 15 and 30 days of use. In the biochemical markers at 15 days of follow-up, there was a significant change in the groups that took probiotics with reduced iron levels (Co: 109.0; prob15: 62.4 and Prob30: 69.7; p = 0.032) and blood glucose (Co : 86.0; Prob15: 82.0; Prob30: 86.0 p = 0.0002), with both within normal limits. Regarding triglycerides, the probiotic seems to contribute to reductions in the first 15 days of use (Co: 159; Prob15: 82.0 p = 0.035). There was a significant increase in CRP in patients who used the probiotic at 15 days of follow-up (p = 0.0106). As for oxidative stress, there was an increase in GSH levels (p = 0.0361) and a reduction in nitrites (p = 0.0116) at the end of 30 days in those who received probiotics, portraying a possible protective effect of oxidative stress in these patients. For TBARS, there were no significant results in the analysis between the groups. As for symptomatology, in ECDE, the difference in scores between the beginning and end of treatment, showed significant improvement within the prob30 group (p = 0.036), especially in women (p = 0.008). The BPRS showed a significant improvement within each of the three groups (Co, p = 0.004; Prob15, p = 0.029; Prob p = 0.029). When comparing the intervention (Prob) with the control (Co), PANSS did not show a statistically significant change in the subscale of positive (p = 0.408) and negative (0.632) symptoms, however, when analyzing each symptom individually, there was an improvement in the hostility symptom significantly (p = 0.048) within the prob30 group. In CGI there were no significant results (p > 0.05) for the changes presented. The data demonstrate that probiotics could be used as adjuvants in the treatment of schizophrenic patients.
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spelling Alterações bioquímicas, inflamatórias e sintomatológicas em pacientes com esquizofrenia mediante uso de probióticosEsquizofreniaEstresse OxidativoProbióticosSaúde MentalDisturbances in the balance of the gut-brain axis at all stages of life produce changes related to the development of neuropsychiatric diseases, such as schizophrenia, and nutritional supplements, such as probiotics, receive special attention in this matter. This study aimed to analyze biochemical, inflammatory and symptomatological changes in schizophrenic patients hospitalized using probiotics. It is a factorial, double blind, randomized-controlled clinical trial of treatment, with 3 arms, in which the dietary intervention performed was the standardization of the hospital diet and the addition of probiotic (Lactobacillus ssp and Bifidumbacterium sp). Data collection took place from January to March 2019 at a public hospital in Fortaleza - CE, a reference in mental health, with patients of both sexes, aged between 18 and 60 years and diagnosed with schizophrenia. The patients were distributed in a control group (Co), intervention groups using probiotics for 15 days (Prob15) and for 30 days (Prob30), being monitored at the beginning (time zero: at admission), in the middle (time 15 days from hospitalization) and at the end (time 30 days of hospitalization). In the three times, data were collected regarding BMI, AC, blood glucose, triglycerides, cholesterol and fractions, Na, K, Ca, Fe, Vit. B12, PCR, AST, ALT, Urea, creatinine, TBARS, Nitrite, GSH, and symptomatology using the CGI-SCH, BPRS-A, PANSS, ECDE scales. Statistical analysis was performed using the IBM Statistical Package for the Social Sciences- SPSS software version 20.0. with ANOVA test, being considered as statistically significant those analyzes with p < 0.05. The mean age of the patients was 38.5 ± 10.7, with 64.6% male, onset of the disease at a young age of 20.97 ± 9.63, and an average of 5 hospitalizations. There was maintenance of nutritional status in the three study groups, although the mean BMI in the prob30 group increased in the final phase of follow-up. As for CA, the probiotic seems to be related to an increase in both 15 and 30 days of use. In the biochemical markers at 15 days of follow-up, there was a significant change in the groups that took probiotics with reduced iron levels (Co: 109.0; prob15: 62.4 and Prob30: 69.7; p = 0.032) and blood glucose (Co : 86.0; Prob15: 82.0; Prob30: 86.0 p = 0.0002), with both within normal limits. Regarding triglycerides, the probiotic seems to contribute to reductions in the first 15 days of use (Co: 159; Prob15: 82.0 p = 0.035). There was a significant increase in CRP in patients who used the probiotic at 15 days of follow-up (p = 0.0106). As for oxidative stress, there was an increase in GSH levels (p = 0.0361) and a reduction in nitrites (p = 0.0116) at the end of 30 days in those who received probiotics, portraying a possible protective effect of oxidative stress in these patients. For TBARS, there were no significant results in the analysis between the groups. As for symptomatology, in ECDE, the difference in scores between the beginning and end of treatment, showed significant improvement within the prob30 group (p = 0.036), especially in women (p = 0.008). The BPRS showed a significant improvement within each of the three groups (Co, p = 0.004; Prob15, p = 0.029; Prob p = 0.029). When comparing the intervention (Prob) with the control (Co), PANSS did not show a statistically significant change in the subscale of positive (p = 0.408) and negative (0.632) symptoms, however, when analyzing each symptom individually, there was an improvement in the hostility symptom significantly (p = 0.048) within the prob30 group. In CGI there were no significant results (p > 0.05) for the changes presented. The data demonstrate that probiotics could be used as adjuvants in the treatment of schizophrenic patients.Perturbações no equilíbrio do eixo cérebro-intestino em todas as fases da vida produz alterações relacionadas ao desenvolvimento de doenças neuropsiquiátricas, como a esquizofrenia, tendo os suplementos nutricionais, como os probióticos, recebido atenção especial. O estudo teve como objetivo analisar alterações bioquímicas, inflamatórias e sintomatológicas em pacientes esquizofrênicos hospitalizados mediante o uso de probióticos. Trata-se de um ensaio clínico de tratamento, fatorial, duplo cego, randomizado-controlado com 3 braços, cuja intervenção dietética realizada foi a padronização da dieta hospitalar e a adição de probiótico (Lactobacillus ssp e Bifidumbacterium sp). A coleta de dados deu-se de janeiro a março de 2019 em um hospital público de Fortaleza –CE, referência em saúde mental, com pacientes de ambos os sexos, idade entre 18 a 60 anos e diagnóstico de esquizofrenia. Os pacientes foram distribuídos em grupo controle (Co), grupos de intervenção com uso de probiótico por 15 dias (Prob15) e por 30 dias (Prob30) sendo monitorados no início (tempo zero: na admissão), no meio (tempo 15 dias de internação) e no fim (tempo 30 dias de internação). Nos três tempos foram coletados dados referente ao IMC, CA, glicemia, triglicerídeos, colesterol e frações, Na, K, Ca, Fe, Vit. B12, PCR, AST, ALT, Ureia, creatinina, TBARS, Nitrito, GSH, e sintomatologia pelas escalas CGI-SCH, BPRS-A, PANSS, ECDE. A análise estatística foi realizada pelo software IBM Statistical Package for the Social Sciences- SPSS versão 20.0. com teste ANOVA, sendo consideradas como estatisticamente significantes aquelas análises com p<0,05. A média de idade dos pacientes foi de 38,5 ± 10,7, com 64,6% do gênero masculino, início da doença em idade ainda jovem de 20,97 ± 9,63 e média de 5 internações. Verificou-se manutenção do estado nutricional nos três grupos de estudo, embora a média de IMC no grupo prob30 tenha aumentado na fase final do acompanhamento. Quanto à CA o probiótico parece ter relação de aumento tanto aos 15 como aos 30 dias de utilização. Nos marcadores bioquímicos aos 15 dias de acompanhamento houve alteração significativa nos grupos que tomaram probiótico com redução dos níveis de ferro (Co: 109,0; prob15: 62,4 e Prob30: 69,7; p=0,032) e da glicemia (Co: 86,0; Prob15: 82,0; Prob30: 86,0 p=0,0002), com ambos dentro da normalidade. Em relação aos triglicerídeos parece o probiótico contribuir para reduções dos nos primeiro 15 dias de utilização (Co: 159; Prob15: 82,0 p=0,035). Na PCR houve aumento significante nos pacientes que usaram o probiótico aos 15 dias de seguimento (p=0,0106). Quanto ao estresse oxidativo, verificou-se ao final de 30 dias um aumento nos níveis de GSH (p=0,0361) e redução de nitritos (p=0,0116) nos que receberam probióticos, retratando um possível efeito protetor de estresse oxidativo nestes pacientes. Para TBARS não houve resultados significativos na análise entre os grupos. Quanto à sintomatologia, na ECDE, a diferença de escores entre o início e fim do tratamento, mostrou melhora significativa dentro do grupo prob30 (p=0,036), sobretudo em mulheres (p=0,008). A BPRS apresentou melhora significativa dentro de cada um dos três grupos (Co, p=0,004; Prob15, p=0,029; Prob p=0,029). Ao realizar comparação entre a intervenção (Prob) e o controle (Co), a PANSS não mostrou alteração estatisticamente significativa na subescala de sintomas positivo (p=0,408) e negativa (0,632), porém ao analisar individualmente cada sintoma, verificou-se melhora no sintoma de hostilidade significativamente (p=0,048) dentro do grupo de prob30. Na CGI não houve resultados significativos (p>0,05) para as alterações apresentadas. Os dados demonstram que os probióticos poderiam ser utilizados como adjuvantes no tratamento de pacientes esquizofrênicos.Sousa, Francisca Clea FlorençoCarvalho, Alyne Mara RodriguesLima, Ana Patrícia Oliveira Moura2021-02-01T13:11:23Z2021-02-01T13:11:23Z2019-01-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisapplication/pdfLIMA, A. P. O. M. Alterações bioquímicas, inflamatórias e sintomatológicas em pacientes com esquizofrenia mediante uso de probióticos. 2019. 161 f. Tese (Doutorado em Ciências Morfofuncionais) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2019.http://www.repositorio.ufc.br/handle/riufc/56269porreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccess2021-02-01T13:13:55Zoai:repositorio.ufc.br:riufc/56269Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2024-09-11T18:17:36.226591Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false
dc.title.none.fl_str_mv Alterações bioquímicas, inflamatórias e sintomatológicas em pacientes com esquizofrenia mediante uso de probióticos
title Alterações bioquímicas, inflamatórias e sintomatológicas em pacientes com esquizofrenia mediante uso de probióticos
spellingShingle Alterações bioquímicas, inflamatórias e sintomatológicas em pacientes com esquizofrenia mediante uso de probióticos
Lima, Ana Patrícia Oliveira Moura
Esquizofrenia
Estresse Oxidativo
Probióticos
Saúde Mental
title_short Alterações bioquímicas, inflamatórias e sintomatológicas em pacientes com esquizofrenia mediante uso de probióticos
title_full Alterações bioquímicas, inflamatórias e sintomatológicas em pacientes com esquizofrenia mediante uso de probióticos
title_fullStr Alterações bioquímicas, inflamatórias e sintomatológicas em pacientes com esquizofrenia mediante uso de probióticos
title_full_unstemmed Alterações bioquímicas, inflamatórias e sintomatológicas em pacientes com esquizofrenia mediante uso de probióticos
title_sort Alterações bioquímicas, inflamatórias e sintomatológicas em pacientes com esquizofrenia mediante uso de probióticos
author Lima, Ana Patrícia Oliveira Moura
author_facet Lima, Ana Patrícia Oliveira Moura
author_role author
dc.contributor.none.fl_str_mv Sousa, Francisca Clea Florenço
Carvalho, Alyne Mara Rodrigues
dc.contributor.author.fl_str_mv Lima, Ana Patrícia Oliveira Moura
dc.subject.por.fl_str_mv Esquizofrenia
Estresse Oxidativo
Probióticos
Saúde Mental
topic Esquizofrenia
Estresse Oxidativo
Probióticos
Saúde Mental
description Disturbances in the balance of the gut-brain axis at all stages of life produce changes related to the development of neuropsychiatric diseases, such as schizophrenia, and nutritional supplements, such as probiotics, receive special attention in this matter. This study aimed to analyze biochemical, inflammatory and symptomatological changes in schizophrenic patients hospitalized using probiotics. It is a factorial, double blind, randomized-controlled clinical trial of treatment, with 3 arms, in which the dietary intervention performed was the standardization of the hospital diet and the addition of probiotic (Lactobacillus ssp and Bifidumbacterium sp). Data collection took place from January to March 2019 at a public hospital in Fortaleza - CE, a reference in mental health, with patients of both sexes, aged between 18 and 60 years and diagnosed with schizophrenia. The patients were distributed in a control group (Co), intervention groups using probiotics for 15 days (Prob15) and for 30 days (Prob30), being monitored at the beginning (time zero: at admission), in the middle (time 15 days from hospitalization) and at the end (time 30 days of hospitalization). In the three times, data were collected regarding BMI, AC, blood glucose, triglycerides, cholesterol and fractions, Na, K, Ca, Fe, Vit. B12, PCR, AST, ALT, Urea, creatinine, TBARS, Nitrite, GSH, and symptomatology using the CGI-SCH, BPRS-A, PANSS, ECDE scales. Statistical analysis was performed using the IBM Statistical Package for the Social Sciences- SPSS software version 20.0. with ANOVA test, being considered as statistically significant those analyzes with p < 0.05. The mean age of the patients was 38.5 ± 10.7, with 64.6% male, onset of the disease at a young age of 20.97 ± 9.63, and an average of 5 hospitalizations. There was maintenance of nutritional status in the three study groups, although the mean BMI in the prob30 group increased in the final phase of follow-up. As for CA, the probiotic seems to be related to an increase in both 15 and 30 days of use. In the biochemical markers at 15 days of follow-up, there was a significant change in the groups that took probiotics with reduced iron levels (Co: 109.0; prob15: 62.4 and Prob30: 69.7; p = 0.032) and blood glucose (Co : 86.0; Prob15: 82.0; Prob30: 86.0 p = 0.0002), with both within normal limits. Regarding triglycerides, the probiotic seems to contribute to reductions in the first 15 days of use (Co: 159; Prob15: 82.0 p = 0.035). There was a significant increase in CRP in patients who used the probiotic at 15 days of follow-up (p = 0.0106). As for oxidative stress, there was an increase in GSH levels (p = 0.0361) and a reduction in nitrites (p = 0.0116) at the end of 30 days in those who received probiotics, portraying a possible protective effect of oxidative stress in these patients. For TBARS, there were no significant results in the analysis between the groups. As for symptomatology, in ECDE, the difference in scores between the beginning and end of treatment, showed significant improvement within the prob30 group (p = 0.036), especially in women (p = 0.008). The BPRS showed a significant improvement within each of the three groups (Co, p = 0.004; Prob15, p = 0.029; Prob p = 0.029). When comparing the intervention (Prob) with the control (Co), PANSS did not show a statistically significant change in the subscale of positive (p = 0.408) and negative (0.632) symptoms, however, when analyzing each symptom individually, there was an improvement in the hostility symptom significantly (p = 0.048) within the prob30 group. In CGI there were no significant results (p > 0.05) for the changes presented. The data demonstrate that probiotics could be used as adjuvants in the treatment of schizophrenic patients.
publishDate 2019
dc.date.none.fl_str_mv 2019-01-30
2021-02-01T13:11:23Z
2021-02-01T13:11:23Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
format doctoralThesis
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dc.identifier.uri.fl_str_mv LIMA, A. P. O. M. Alterações bioquímicas, inflamatórias e sintomatológicas em pacientes com esquizofrenia mediante uso de probióticos. 2019. 161 f. Tese (Doutorado em Ciências Morfofuncionais) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2019.
http://www.repositorio.ufc.br/handle/riufc/56269
identifier_str_mv LIMA, A. P. O. M. Alterações bioquímicas, inflamatórias e sintomatológicas em pacientes com esquizofrenia mediante uso de probióticos. 2019. 161 f. Tese (Doutorado em Ciências Morfofuncionais) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2019.
url http://www.repositorio.ufc.br/handle/riufc/56269
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