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The microbiome, immunity, and schizophrenia and bipolar disorder.
Open accessAbstract
Schizophrenia and bipolar disorder are serious neuropsychiatric disorders of uncertain etiology. Recent studies indicate that immune activation may contribute to the etiopathogenesis of these disorders. Numerous studies in animal models indicate that the mucosal microbiome may influence cognition and behavior by altering the functioning of the immune system. It is thus likely that the microbiome plays a role in human psychiatric disorders. The study of immune alterations and the microbiome in schizophrenia and bipolar disorder is in its infancy. Two recent investigations of the oro-pharyngeal microbiota in schizophrenia found differences between cases and controls. Other studies have found increased gastrointestinal inflammation in schizophrenia and bipolar disorder based on measures of microbial translocation. Several studies have also found an association between the receipt of antibiotics and an increased incidence of psychiatric disorders, perhaps due to alterations in the microbiome. Studies to characterize the intestinal microbiome of individuals with these disorders are in progress. The ultimate test of the role of the microbiome and immune-mediated pathology in schizophrenia and bipolar disorder will come from clinical trials of therapeutic agents which alter gut microbiota or gastrointestinal inflammation. The successful development of such modalities would represent a novel strategy to prevent and treat serious psychiatric disorders.
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“Patients with SCZ and BD have been consistently shown to present with increased levels of pro-inflammatory cytokines, oxidative stress products, chemokines, and soluble adhesion molecules both in the peripheral blood and the cerebrospinal fluid (14, 15).”
From Investigation of systemic immune-inflammation index, neutrophil/high-density lipoprotein ratio, lymphocyte/high-density lipoprotein ratio, and monocyte/high-density lipoprotein ratio as indicators of inflammation in patients with schizophrenia and bipolar disorder (2022) · cites this paper as [14]
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“Chronic low-level inflammation, characterized by a diminished yet ongoing reaction, is commonly observed in emotional, psychiatric, personality, and neurotic conditions (11).”
From Retrospective evaluation of novel serum inflammatory biomarkers in first-episode psychiatric disorders: diagnostic potential and immune dysregulation (2024) · cites this paper as [11]
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“Furthermore, lower microbiome diversity and global community differences in GI microbiota have been noted in a review looking at schizophrenia and bipolar affective disorders.(39) One study found that the transplantation of fecal content from patients suffering from schizophrenia into rodents, resulted in worsening of…”
BackgroundEpigenetics of the molecular clock and bacterial diversity in bipolar disorder
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Does the microbiome and virome contribute to myalgic encephalomyelitis/chronic fatigue syndrome?
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Opioid system influences gut-brain axis: Dysbiosis and related alterations
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“Furthermore, while depression shows considerable promise in responding to psychobi-otic interventions due to more definitive links between gut health and mood regulation, the complexities increase with disorders like schizophrenia and bipolar disorder [21,87].”
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“Translocation of bacteria and their antigens from the lumen to the circulatory system stimulate the secretion of pro-inflammatory cytokines such as interleukins (IL-6, IL-1b), tumor necrosis factor-alpha (TNF-α), and C-reactive protein [35,50,51].”
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Exploring the microbiome in health and disease
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Self-citationAutoimmune phenotypes in schizophrenia reveal novel treatment targets
Severance, E. G., Dickerson, F., & Yolken, R. H. (2018) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2018.05.005 · Cited by 52
“Results from this and other studies also further documented the effects of parasite exposure on clinical endpoints such as decreased cognition, suicidal behavior and severity of psychotic symptoms (Dickerson et al., 2017; Esshili et al., 2016; Hamdani et al., 2017; Kannan et al., 2017; Lindgren et al., 2018).”
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The gut microbiome in psychiatry: A primer for clinicians
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Khambadkone, S. G., Cordner, Z. A., Dickerson, F., Severance, E. G., Prandovszky, E., Pletnikov, M. V., Xiao, J., Li, Y., Boersma, G. J., Talbot, C. C., et al. (2018) · Molecular Psychiatry · doi:10.1038/s41380-018-0105-6 · Cited by 51
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The oropharyngeal microbiome is altered in individuals with schizophrenia and mania
Yolken, R. H., Prandovszky, E., Severance, E. G., Hatfield, G. S., & Dickerson, F. (2020) · Schizophrenia Research · doi:10.1016/j.schres.2020.03.010 · Cited by 46
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Modification of the gut microbiome to combat neurodegeneration
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From Infection to the Microbiome: An Evolving Role of Microbes in Schizophrenia
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“Converging lines of evidence indicate a link between schizophrenia and immune activation (Dickerson et al., 2017; van Kesteren et al., 2017), a hypothesis that dates back to the 1950s (Severance et al.”
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The Microbiota‐Gut‐Brain Connection: A New Horizon in Neurological and Neuropsychiatric Disorders
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Metadata
- Authors
- Dickerson, F., Severance, E., & Yolken, R.
- Affiliations
- Sheppard Pratt Health System (US)
- Johns Hopkins University (US)
- Corresponding author
- Dickerson, Faith
- Venue
- Brain, Behavior, and Immunity
- Publisher
- Elsevier BV
- Published
- 2017-05
- Volume
- 62
- Pages
- 46-52
- ISSN
- 0889-1591 (ISSN-L)
- PMC
- PMC5503102
- OpenAlex
- W2565906784
- Cited by
- 268
- References
- 62
- Citations by year
- 2026: 9 · 2025: 24 · 2024: 19 · 2023: 30 · 2022: 27 · 2021: 41 · 2020: 43 · 2019: 40 · 2018: 28 · 2017: 7
- FWCI
- 2.26
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Brain Behavior and Immunity (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (P50MH094268)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- microbiome, schizophrenia, bipolar disorder, immune activation, gut microbiota, oral microbiota, gastrointestinal inflammation, microbial translocation, antibiotics, neuropsychiatric disorders, gut-brain axis
- MeSH terms
- Bipolar Disorder, Humans, Immunity, Schizophrenia, Microbiota
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