Modified Mediterranean Diet for Enrichment of Short Chain Fatty Acids: Potential Adjunctive Therapeutic to Target Immune and Metabolic Dysfunction in Schizophrenia?
Modified Mediterranean Diet for Enrichment of Short Chain Fatty Acids: Potential Adjunctive Therapeutic to Target Immune and Metabolic Dysfunction in Schizophrenia?
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DOI：
10.3389/fnins.2017.00155
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发表时间：
2017
影响因子：
4.3
通讯作者：
Schmid-Schönbein G
中科院分区：
文献类型：
--
作者：
Joseph J;Depp C;Shih PB;Cadenhead KS;Schmid-Schönbein G
对肠道和消化过程及其与基于脑和外周的炎症或生物行为表型的潜在联系的兴趣日益增长，导致越来越多的基础和转化科学报告关注肠道微生物群在神经精神疾病背景下的作用。然而，饮食调整对特定肠道代谢物的影响，与免疫，代谢和精神病理功能在精神分裂症谱系障碍尚未得到很好的表征。短链脂肪酸（SCFA）乙酸酯、丁酸酯和丙酸酯是肠道微生物发酵膳食纤维的主要代谢产物，与多种免疫和代谢途径相互作用。SCFA被认为是靶向的特定途径在心血管疾病、II型糖尿病和全身性炎症中失调。最值得注意的是，这些疾病一直与精神分裂症的寿命缩短有关。虽然在精神分裂症患者中观察到不健康的饮食摄入模式以及免疫和代谢功能障碍的患病率增加;但饮食干预措施尚未很好地用于针对免疫或代谢疾病。以前的精神分裂症患者试验主要集中在无麸质饮食的影响。这些研究的结果表明，避免麸质的饮食有益于有限的患者子集，患有乳糜泻或非乳糜泻麸质敏感性的个体。因此，替代饮食和营养调整，如高纤维，地中海风格，丰富SCFA生产的饮食，同时与不良事件的可能性最小，可能会改善与精神分裂症过早死亡相关的免疫和心血管结局。随着越来越多的文献表明SCFA可以穿过血脑屏障并靶向关键的炎症和代谢途径，本文强调了丰富SCFA的饮食摄入量作为精神分裂症患者的潜在预防治疗。
Growing interest in gut and digestive processes and their potential link to brain and peripheral based inflammation or biobehavioral phenotypes has led to an increasing number of basic and translational scientific reports focused on the role of gut microbiota within the context of neuropsychiatric disorders. However, the effect of dietary modification on specific gut metabolites, in association with immune, metabolic, and psychopathological functioning in schizophrenia spectrum disorders has not been well characterized. The short chain fatty acids (SCFA) acetate, butyrate, and propionate, major metabolites derived from fermentation of dietary fibers by gut microbes, interact with multiple immune and metabolic pathways. The specific pathways that SCFA are thought to target, are dysregulated in cardiovascular disease, type II diabetes, and systemic inflammation. Most notably, these disorders are consistently linked to an attenuated lifespan in schizophrenia. Although, unhealthy dietary intake patterns and increased prevalence of immune and metabolic dysfunction has been observed in people with schizophrenia; dietary interventions have not been well utilized to target immune or metabolic illness. Prior schizophrenia patient trials primarily focused on the effects of gluten free diets. Findings from these studies indicate that a diet avoiding gluten benefits a limited subset of patients, individuals with celiac disease or non-celiac gluten sensitivity. Therefore, alternative dietary and nutritional modifications such as high-fiber, Mediterranean style, diets that enrich the production of SCFA, while being associated with a minimal likelihood of adverse events, may improve immune and cardiovascular outcomes linked to premature mortality in schizophrenia. With a growing literature demonstrating that SCFA can cross the blood brain barrier and target key inflammatory and metabolic pathways, this article highlights enriching dietary intake for SCFA as a potential adjunctive therapy for people with schizophrenia.