Oropharyngeal microbiota in patients with psychotic disorders: A scoping review on compositional and functional alterations.

Roberto Rodriguez-Jimenez, Alessandro Serretti, Giuseppe Fanelli, Mauro Scala, María Del Rocío González Soltero, Alberto Bellido Esteban, José Miguel Biscaia Fernández, Verónica Romero-Ferreiro

Journal: Progress in neuro-psychopharmacology & biological psychiatry 2025;137():111288

PMID: 39923913

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Abstract

BACKGROUNDS

Oropharyngeal microbiota may be implicated in the onset and progression of psychotic disorders. This scoping review aims to map the existing evidence concerning the composition, diversity, and metabolic pathways of the oropharyngeal microbiota in patients aged 18 to 65 with a main diagnosis of a psychotic disorder, including individuals at clinical high-risk for psychosis (CHRP) or experiencing first episode psychosis (FEP).

METHODS

The scoping review was performed according to the PRISMA-ScR checklist. The systematic literature search was conducted using PubMed, Web of Science, and CINAHL until February 2024.

RESULTS

Seven cross-sectional studies were included, comprising 43 individuals at CHRP, 13 with FEP, 85 with first-episode of schizophrenia (FES), 171 with schizophrenia, and 8 with another schizophrenia spectrum disorder. The oropharyngeal microbiota showed an increase in Lactobacillus gasseri abundance in schizophrenia, and in Firmicutes/Proteobacteria phylum ratio in patients experiencing CHR-P and FES. In schizophrenia, an altered β-diversity was observed alongside increased metabolic pathways related to metabolite transporters. In FES, higher α-diversity and disruptions in amino acid, carbohydrate, and xenobiotic metabolism pathways were found. Hydrogen sulfide (HS)-producing bacteria were generally enriched in all the stages of disease. Correlations were observed between oropharyngeal microbiota and psychotic symptom domains.

CONCLUSIONS

Potential microbial signatures, such as Lactobacillus gasseri and HS-producing bacteria, were identified in the oropharyngeal microbiota. Alterations in the oropharyngeal microbiota composition and function may be associated with different stages of psychotic disorders, with some overlap between CHR-P and FES.

Address: Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum-University of Bologna, Italy; Health Research Institute Hospital 12 de Octubre, (imas12), Madrid, Spain; Faculty of Biomedical and Health Sciences, European University of Madrid (UEM), Madrid, Spain; Complutense University of Madrid (UCM), Madrid, Spain. Electronic address: [email protected].; Faculty of Biomedical and Health Sciences, European University of Madrid (UEM), Madrid, Spain; Molecular Microbiology Group, Health Research Institute of the University Hospital La Paz (IdiPAZ), Hospital Universitario La Paz, Madrid, Spain. Electronic address: [email protected].; Faculty of Biomedical and Health Sciences, European University of Madrid (UEM), Madrid, Spain.; Health Research Institute Hospital 12 de Octubre, (imas12), Madrid, Spain; Faculty of Biomedical and Health Sciences, European University of Madrid (UEM), Madrid, Spain; CIBERSAM/ISCIII (Biomedical Research Networking Centre in Mental Health), Madrid, Spain.; Department of Medicine and Surgery, Kore University of Enna, Italy; Oasi Research Institute-IRCCS, Troina, Italy.; Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum-University of Bologna, Italy; Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands.; Health Research Institute Hospital 12 de Octubre, (imas12), Madrid, Spain; Complutense University of Madrid (UCM), Madrid, Spain; CIBERSAM/ISCIII (Biomedical Research Networking Centre in Mental Health), Madrid, Spain.

DOI: 10.1016/j.pnpbp.2025.111288