A microbiota intestinal e a esquizofrenia: uma revisão sistemática

• Autor(a) principal: Cabral, Lucas Moraes
• Data de Publicação: 2018
• Tipo de documento: Trabalho de conclusão de curso
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
• Texto Completo: http://www.repositorio.ufc.br/handle/riufc/69024
• topic: Microbiota intestinal; Eixo intestino-cérebro; Esquizofrenia; Antipsicóticos

Recently, several preclinical and clinical studies have linked changes in the composition of the intestinal microbiota and its effects on the gut-brain axis to different pathologies, from metabolic to neuropsychiatric diseases. The populations of the intestinal microbiota are fundamental for the development of the immune system, the metabolism of brain development. In addition, certain genera of bacteria such as Akkermansia and Roseburia are closely linked to the health of the body. For example, the reduction of abundance of this first one is related to a greater risk of obesity while the second produces butyrate which has neuroprotective action and improves insulin sensitivity. Schizophrenia is a disease known to be caused both by genetic factors and by environmental factors, but the antipsychotics used in the treatment of schizophrenia have a reductionist focus, thus ignoring the disease’s several pathophysiologic aspects. In addition, first generation or typical antipsychotics cause serious adverse effects. Many patients also have treatment resistant schizophrenia (TRS). Even second-generation or atypical antipsychotics are only moderately effective despite reducing adverse effects. Several preclinical and clinical studies have linked changes in the composition of the gut microbiota and its effects on the gut-brain axis to different pathologies, from metabolic to neuropsychiatric diseases. It is plausible that changes in the gut microbiota influence the development of schizophrenia, the resistance to antipsychotics and its adverse effects. Therefore, the objective of this work was systematically reviewing original studies adressing the influence of the microbiota or gut-brain axis in schizophrenia and the influence of antipsychotics in the microbiota. For this purpose, a systematic search was conducted using the PubMed, Science Direct and MEDLINE databases. The following keywords were used: "gut microbiota, gut-brain axis, gastrointestinal microbiome, schizophrenia, treatment-resistant schizophrenia, treatment-responsive schizophrenia, refractory schizophrenia, first episode schizophrenia, antipsychotics, antipsychotic agents." The total number of references found after automatic and manual removal of duplicates was 165 articles. Then, primary and secondary screening were performed where 32 articles met the inclusion criteria and were reviewed. Concerning schizophrenia, preclinical and clinical studies associate behavioral, inflammatory and changes in metabolic pathways relevant to the disease. In this review, it was possible to see that the study of the influence of gut microbiota in schizophrenia and mental health is in its infancy, but there is enormous potential in its future study.