Influência de antipsicóticos de segunda geração na composição da microbiota intestinal

Detalhes bibliográficos
Ano de defesa: 2017
Autor(a) principal: Maria Carolina Lobato Machado
Orientador(a): Não Informado pela instituição
Banca de defesa: Não Informado pela instituição
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Universidade Federal de Minas Gerais
UFMG
Programa de Pós-Graduação: Não Informado pela instituição
Departamento: Não Informado pela instituição
País: Não Informado pela instituição
Palavras-chave em Português:
Link de acesso: http://hdl.handle.net/1843/BUOS-B57JL5
Resumo: Introduction: Second generation antipsychotics (SGA) are commonly prescribed as first-line treatment for psychotic disorders. However, they can induce weight gain and metabolic disturbances. Advances in molecular biology techniques enabled a better understand of the gut microbiota (GM), enabling the study of the interaction between SGA and GM, which has been suggested as a potential contributing factor to side effects of SGA. Therefore, considering also the prospect of some future prophylactic intervention, it is interesting to investigate this association. Objective: Conduct a systematic review of the literature to answer the P.I.C.O question (Patient, Intervention, Comparison groups, Outcomes): In patients with schizophrenia or other psychotic disorders, the use of SGA is associated with changes the GM composition? Methods: We searched for studies in the following databases: PubMed, PsycINFO, Web of Science, SCOPUS, Cochrane, LILLACS/BVS, Google Scholar, OpenGrey, OpenThesis, and clinicaltrials.gov. There were no restrictions on the design of study or publication date. Only studies in humans were considered, regardless of age, gender or setting. Two assessors carried out, independently, the search, study selection and data analysis. Results: Two studies fulfilled the eligibility criteria. They were small observational studies, with a high probability of bias and with several methodological differences that precluded meta-analysis of data. One of them assessed 18 male children, in a cross-sectional design, evidencing an increase in alpha diversity (Shannon index) of GM (5.9 x 5.2; p<0.05) and a decrease in the Bacteroidetes: Firmicutes ratio (0.20 x 1.24; p<0.05) after chronic exposure to risperidone. It also had a longitudinal arm with a 10 month follow up of 5 boys starting on risperidone, also showing a decrease in Bacteroidetes: Firmicutes ratio. The other paper showed results of a cross sectional evaluation of 117 adults diagnosed with bipolar disorder, associating the use of SGA to a decrease in alpha diversity (Simpson index) significant only in female subjects (P=0.015), and an increase in Lachnospiraceae genus (p=0,001). It also identified a preferentially abundance of Akkermansia (P=0.03) in the group that was not treated with SGA.