Intestinal permeability and low-grade chronic inflammation in schizophrenia: A multicentre study on biomarkers. Rationale, objectives, protocol and preliminary results

Gerard Anmella , Silvia Amoretti , Gemma Safont , Ana Meseguer , Eduard Vieta , Maria Teresa Pons-Cabrera , Miqueu Alfonso , Carla Hernández , Monica Sanchez-Autet , Ferran Pérez-Baldellou , Leticia González-Blanco , Maria Paz García-Portilla , Miquel Bernardo , Belén Arranz
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Abstract

Background

Altered intestinal permeability and low-grade chronic inflammation disrupt the integrity of the blood–brain barrier (microbiota–gut–brain axis), probably playing a role in the pathophysiology of schizophrenia-spectrum disorders. However, studies assessing the microbiota–gut–brain axis are inconsistent. This article describes the rationale, objectives, protocol, and presents descriptive results for a new project.

Methods

The sample of this study came from an observational, cross-sectional and multisite study including four centers in Spain (PI17/00246) recruiting adult patients with DSM-5 schizophrenia-spectrum disorders at any stage of the disease. The aims of the project are to assess the interrelation between intestinal permeability and low-grade chronic inflammation in schizophrenia-spectrum disorders and the role of peripheral biomarkers, diet, exercise, metabolic syndrome, disease severity and functioning as well as cognition. Assessments included the following variables: (1) anthropometric, (2) intestinal permeability, diet, and physical exercise, (3) clinical and functional, (4) neuropsychological and cognitive reserve, and (5) peripheral biomarkers from blood.

Results

A total of 646 patients were enrolled (257, 39.7% female). Mean age was 43.2 ± 13.6 years, illness duration 15.1 ± 11.5 years. 55.8% consumed tobacco. Positive PANSS score was 13.68 ± 6.55, and 20.38 ± 8.69 in the negative symptoms. CGI was 4.16 ± 2.22 and GAF was 60.00 ± 14.84.

Conclusion

The results obtained by this project are expected to contribute toward the understanding of the physiopathology of schizophrenia-spectrum disorders. This will likely aid to personalize treatments in real-world clinical practice, potentially including variables related to intestinal permeability and inflammation.
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精神分裂症患者肠通透性和低级别慢性炎症:一项多中心生物标志物研究。基本原理、目标、方案和初步结果
肠道通透性受损和低级别慢性炎症破坏血脑屏障(微生物-肠-脑轴)的完整性,可能在精神分裂症谱系障碍的病理生理中起作用。然而,评估微生物-肠-脑轴的研究并不一致。本文描述了一个新项目的基本原理、目标、协议,并给出了描述性的结果。方法本研究的样本来自一项观察性、横断面和多地点研究,包括西班牙的四个中心(PI17/00246),招募患有DSM-5精神分裂症谱系障碍任何阶段的成年患者。该项目的目的是评估肠道通透性与精神分裂症谱系障碍低级别慢性炎症之间的相互关系,以及外周生物标志物、饮食、运动、代谢综合征、疾病严重程度和功能以及认知的作用。评估包括以下变量:(1)人体测量,(2)肠道通透性,饮食和体育锻炼,(3)临床和功能,(4)神经心理和认知储备,(5)血液外周生物标志物。结果共纳入646例患者(257例,女性39.7%)。平均年龄43.2±13.6岁,病程15.1±11.5年。55.8%的人吸烟。PANSS阳性评分为13.68±6.55分,阴性评分为20.38±8.69分。CGI为4.16±2.22,GAF为60.00±14.84。结论本课题的研究结果有望为进一步认识精神分裂症谱系障碍的生理病理机制做出贡献。这可能有助于在现实世界的临床实践中个性化治疗,可能包括与肠通透性和炎症相关的变量。
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