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Role of Substance Use on Intestinal Permeability in Schizophrenia

— Tobacco, but not alcohol or cannabis, had an inverse impact, researcher reports

Ƶ MedicalToday

A cross-sectional study presented at the American Psychiatric Association (APA) annual meeting was designed to analyze the impact of tobacco, cannabis, and alcohol consumption on intestinal permeability and inflammation in patients with schizophrenia.

In this exclusive Ƶ video, investigator Leticia González-Blanco, MD, PhD, of the University of Oviedo in Spain, details the .

Following is a transcript of her remarks:

My name is Leticia González-Blanco. I'm one of the co-authors of this scientific communication, which is titled "Impact of Substance Use on Intestinal Permeability in Patients With Schizophrenia."

The objective of this study was to analyze the impact of tobacco, cannabis, and alcohol use on intestinal permeability and inflammation in patients with schizophrenia. This was a cross-sectional study that included outpatients with the diagnosis of schizophrenia. The patients were evaluated with ad-hoc questionnaires, with clinical ancestry, demographic information, and clinical severity assessed with a clinical global impression scale. Indirect markers of bacterial translocation in plasma were determined, like soluble CD14 [sCD14] and lipopolysaccharide binding protein, LBP.

There were a total of 80 patients evaluated, with a minimum age of nearly 43 years old -- mostly men, 59%. And 35% of the sample were smokers, with a mean cigarette use of 14 cigarettes per day, and 18.5% used alcohol weekly, at least one unit per week, and 7.5% used cannabis in the last month.

There were statistically significant differences between smokers and non-smokers in the marker sCD14, with higher plasma levels in non-smoker patients. But there were no statistically significant differences in the marker LBP.

Also a negative correlation, close to significance, was found between the number of cigarettes per day and the marker sCD14. Regarding alcohol and cannabis, no statistically significant differences were found between groups -- neither in sCD14 nor LBP, either of the markers.

We also divided the sample in three groups -- most were non-smokers, and in smokers, most of the sample were heavy smokers; only five patients were light smokers. It didn't reach statistical significance among these groups.

Then a logistic regression was performed, considering tobacco use as a dependent variable, and those variables with statistically significant differences and also sex. It was found that sCD14 and length of illness were variables associated with tobacco use in the model; these were the only variables that entered in the model. This means tobacco was associated with lower plasma levels of sCD14 after adjustment for covariates.

As a conclusion, smoking had an inverse impact on systemic immune activation of intestinal microbial translocation measured with plasma levels of sCD14. In contrast, alcohol and cannabis use were not associated with the degree of intestinal permeability in patients with schizophrenia.

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