The Impact Of The Gut Microbiota On Acute Exacerbation Of Schizophrenia:Based On Cohort Population

Background:The high relapse rate is the characteristic of schizophrenia,it imposes a heavy burden on patients and society.However,the pathogenesis of recurrence is still unclear,and the microbiota–gut–brain axis provides a new direction for the study of the pathogenesis of mental illness.Recent studies have reported changes in the gut microbiota of patients with schizophrenia,but most of them are cross-sectional studies,and it is unable to determine whether the gut microbiota plays a role in the relapse of schizophrenia.Objective:?1?Horizontal comparison of intestinal microbiome between schizophrenia patients and healthy people;?2?Longitudinal analysis for the changes of gut microbiota in schizophrenia patients from remission to attack;?3?To analyze the correlation between gut microbiota and symptoms,gut microbiota and metabolic index;?4?Discuss the effect of gut microbiota on acute episodes of schizophrenia.Methods:Based on the cohort of schizophrenia patients in remission stage,the stool samples were collected from remission stage and corresponding episode stage,respectively.The healthy people in the same area were selected as controls by matching sex,age and BMI.The difference of gut microbiota between remission stage and episode etage of schizophrenia,patients and healthy people was analyzed by 16S rRNA high-throughput sequencing technique.Results:In the study,29 schizophrenia patients and 41 healthy controls were enrolled.Twenty-nine fecal specimens were collected from remission and episodes,respectively.A total of 70 subjects and 99 fecal specimens were included.There is no significant difference in the general demographic characteristics between schizophrenia patients and healthy people.Alpha diversity analysis showed chao index,ace index,sobs index,simpson index,shannon index and coverage index between patients with schizophrenia in episode,remission and healthy people were no statistically different;Beta diversity analysis showed that the community composition of intestinal microbiota in episodes of schizophrenia was similar to that in remission,but different from that in healthy people.The results of species composition analysis showed that the relative abundances of Bacilli?P=0.038?,Deltaproteobacteria?P=0.003?,Lactobacillales?P=0.040?,Parabacteroides?P=0.044?,Intestinibacter?P=0.007?and Turicibacter?P<0.001?in intestinal microbiota of schizophrenia patients were higher than those of healthy people,while the relative abundances of Butyricicoccus?P=0.012?were lower than those of healthy people.On the level of genus,the relative abundance of unclassified_fPeptostreptococcaceae?P=0.039?,Clostridium_sensu_stricto₁?P=0.018?and Prevotella?P=0.007?in gut microbiota of schizophrenia patients in the onset stage was lower than that in patients in the remission stage.Relative abundance of unclassified_fPeptostreptococcaceae,Clostridium_sensu_stricto₁ and Prevotella was negatively correlated with PANSS score?r_s=-0.196,P=0.140;r_s=-0.318,P=0.015;r_s=-0.176,P=0.190?.Conclusion:The diversity and species richness of gut microbiota in schizophrenia patients during onset,remission and healthy people are similar.At the genus level,the gut microbiota of schizophrenia patients is different from that of healthy people.Turicibacter,Parabacteroides,Intestinibacter and Butyricicoccus may be the characteristic markers of schizophrenia.In addition,there were differences in gut microbiota before and after onset in schizophrenia patients,and gut microbiota disorder may be a risk factor for the onset of schizophrenia.Decreased relative abundance of unclassified_fPeptostreptococcaceae,Clostridium_sensu_stricto₁ and Prevotella may cause schizophrenia attack,and increasing their content may improve the symptoms of schizophrenia.