hfbHealth, Food & BiotechnologyHealth, Food & Biotechnology2712-7648РОСБИОТЕХ10.36107/hfb.2025.i2.s254hfb-254Research ArticleЗДОРОВЬЕHEALTHВлияние микробиоты кишечника на развитие шизофрении. Пути фармакологической коррекции (систематический обзор предметного поля)The Influence of Gut Microbiota on the Development of Schizophrenia. Ways of Pharmacologic Correction (Systematic Scoping Review)https://orcid.org/0009-0009-0290-0495АбдуллинаЛилия ХайдяровнаAbdullinaLilia Kh.labdu1lina@yandex.ruhttps://orcid.org/0000-0003-3659-3576МосинаАнна АлексеевнаMosinaAnna A.anna.mosina.99@bk.ruhttps://orcid.org/0000-0001-8430-237XСорокинаЮлия АндреевнаSorokinaYulia A.zwx@inbox.ruhttps://orcid.org/0009-0009-7439-9249СтруеваЕлена ПетровнаStruevaElena P.lenastttt@gmail.comПриволжский исследовательский медицинский университет (ПИМУ)РоссияPrivolzhsky Research Medical University (PIMU)Russian Federation202502072025722130Copyright © Абдуллина Л.Х., Мосина А.А., Сорокина Ю.А., Струева Е.П., 20252025Абдуллина Л.Х., Мосина А.А., Сорокина Ю.А., Струева Е.П.Abdullina L.K., Mosina A.A., Sorokina Y.A., Strueva E.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.hfb-journal.ru/jour/article/view/254Введение

Введение. На развитие шизофрении значительное влияние оказывает состав и качество микрофлоры кишечника. Обобщение знаний о природе заболевания позволяет определить новые эффективные методы лечения психических расстройств путем коррекции микробиоты пациента. 

Цель статьи провести критический анализ, систематизацию и обобщение результатов научных исследований, связанных с изучением влияния микробиоты человека на развитие шизофрении, а также способами фармакологической коррекции заболевания. 

Материалы и методы

Материалы и методы. Обзор включает в себя как российские, так и иностранные публикации, вышедшие на русском и английском языках с 2019 по 2025 годы. Для поиска зарубежных научных работ использовались базы данных eLibrary, Cyberleninka, Scopus и Web of Science. В исследовании была проанализирована 91 статья.

Результаты

Результаты. Микробиота, находясь в симбиотических отношениях с организмом, поддерживает его гомеостаз. Исследования показали, что состав и качество микрофлоры кишечника у здоровых индивидуумов значительно отличаются от пациентов, страдающих шизофренией. Это подчеркивает необходимость поддержания нормального уровня альфа-разнообразия микробиоты. Влияние микрофлоры на развитие шизофрении объясняется существованием оси микробиота-кишечник-мозг. Ряд бактерий производит нейтротрансмиттеры, относящиеся к глутаматергической системе головного мозга, которые играют значительную роль в патогенезе шизофренических расстройств. Некоторые исследования свидетельствуют о том, что изменение состава микробиоты может активировать глутаматергическую гипофункцию. Препаратами первого выбора при лечении шизофрении являются антипсихотические лекарственные средства (ЛС), или нейролептики. Однако они вызывают большое количество побочных эффектов, включая расстройства желудочно-кишечного тракта (ЖКТ), наблюдаемые в 1,5%-60% случаев. Это делает актуальной задачу оптимизации фармакотерапии шизофрении с учетом коррекции микробиоты пациента. В последних рекомендациях предлагается назначение психобиотиков – комбинации пробиотиков и пребиотиков, которые способствуют улучшению терапевтического эффекта медикаментов для лечения психических заболеваний, обогащая микрофлору кишечника.

Выводы

Выводы. Шизофрения требует комплексного подхода к терапии. Исследования показывают связь между составом кишечной микрофлоры и развитием данного заболевания. Это открывает новые стратегии для диагностики и фармакотерапии шизофрении. Учитывая ее связь с осью микробиота-кишечник-мозг, важно исследовать про- и пребиотические добавки. Они могут снизить побочные эффекты нейролептиков и нормализовать состав кишечной микрофлоры.

Introduction

Introduction. The development of schizophrenia is significantly influenced by the composition and quality of the intestinal microflora. Generalization of knowledge about the nature of the disease allows to define new effective methods of treatment of mental disorders by correcting the patient's microbiota. 

Purpose

Purpose. The purpose of the article is to analyze, systematize and summarize the scientific data obtained in studies of the relationship of human microbiota with the development of schizophrenia and methods of treatment of the disease.

Materials and Methods

Materials and Methods. The review includes both Russian and foreign publications published in Russian and English from 2019 to 2025. The databases eLibrary, Cyberleninka, Scopus and Web of Science were used to search for foreign scientific papers. 91 articles were analyzed in the study.

Results

Results. The microbiota, being in a symbiotic relationship with the organism, maintains its homeostasis. Studies have shown that the composition and quality of gut microflora in healthy individuals differ significantly from patients suffering from schizophrenia. This emphasizes the need to maintain normal levels of alpha diversity in the microbiota. The influence of microflora on the development of schizophrenia is explained by the existence of a microbiota-gut-brain axis. A number of bacteria produce neutrotransmitters related to the glutamatergic system of the brain, which play a significant role in the pathogenesis of schizophrenic disorders. Some studies suggest that altered microbiota composition may activate glutamatergic hypofunction. The drugs of first choice in the treatment of schizophrenia are antipsychotic drugs (AD), or neuroleptics. However, they cause a large number of side effects, including gastrointestinal (GI) disorders observed in 1.5%-60% of cases. This makes it urgent to optimize pharmacotherapy of schizophrenia, taking into account the correction of the patient's microbiota. To promote the therapeutic effect of medications, it is recommended to prescribe combinations of pro- and prebiotics, which allow to enrich the intestinal microflora.

Conclusions

Conclusions. Schizophrenia requires a comprehensive approach to therapy. Studies show a link between the composition of the intestinal microflora and the development of the disease. This opens up new strategies for the diagnosis and pharmacotherapy of schizophrenia. Given its association with the microbiota-gut-brain axis, it is important to investigate pro- and prebiotic supplements. They may reduce the side effects of neuroleptics and normalize the composition of the intestinal microflora.

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The authors declare that there are no conflicts of interest present.