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

Abstract

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.