The Gut Metagenome Research of Schizophrenia

Study Overview
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Brief Summary
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Research already found that patients with autistic spectrum disorders lack of Prevotella intestinal type, then schizophrenia patients may also show the specific intestinal type, so investigators want to detect the gut metagenome of schizophrenia patients by high-throughput DNA sequencing to find specific intestinal type, so as to achieve the purpose of schizophrenia diagnosis. According to the detection of inflammatory factors in the blood, nerve growth factor in the cerebrospinal fluid, to find the mechanism of the gut-microbes-brain axis. Furthermore, investigators want to identify intestinal strains involved in weight gain and metabolic disorders such as blood glucose and lipids induced by antipsychotic drugs.

Detailed Description
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A prospective observational study will be conducted and cases will be recruited by multi-center cooperation. Investigators plan to collect 100 schizophrenic patients as case group, 100 healthy people as control group. Investigators will observe schizophrenia patients who use the single drug of risperidone in the treatment and follow up the patients on day 1, the third week, the third month, the sixth month and the first year. In addition, the other two groups of patients with schizophrenia will be included, one with olanzapine and the other with aripiprazole. There are three objectives: Compare healthy population with schizophrenia patients in the difference of gut metagenome and inflammatory factors in the blood, stool samples aimed at detecting the difference of composition of intestinal microorganism; Observe the change of intestinal microorganism, inflammatory factors, γ-aminobutyric acid of schizophrenic patients who received risperidone treatment according to the blood, stool samples, cerebrospinal fluid during the follow-up period. Study the difference of intestinal flora composition between schizophrenia patients with metabolic disorder and schizophrenia patients without metabolic disorder after olanzapine or aripiprazole treatment and discuss the relationship between intestinal flora composition and metabolic disorder.

Official Title
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The Gut Metagenome Research of Schizophrenia

Conditions
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Schizophrenia

Intervention / Treatment
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* Genetic: sequencing faecal metagenome


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The first episode or recurrent acute-exacerbation schizophrenia patients who correspond to the Diagnostic and Statistical Manual of Mental Disorders-Ⅵ (DSM-Ⅵ) diagnostic criteria. Between 18 and 45 years old (including 18 and 45 years old, male or female). Patients never accepted full range of psychotropic drugs before admission(taking psychotropic drug less than 5 days before admission) the duration of recurrent patients is less than 5 years the period of taking psychiatric drug before admission is no more than 2 weeks. didn't use of antibiotics within consecutive 3 days in recent 3 months. meet the indications of a single antipsychotic risperidone treatment. All the patients must have a good family support and comply with the requirements and signed informed consent The PANSS score is greater than 60 or equal to 60. BMI is greater than or equal 17.5 and less than or equal to 30. Exclusion Criteria: Patients have severe unstable cardiovascular disease, liver disease, kidney disease, blood disease and endocrine disease or history. Patients have the history of systematic disease or history of malignant tumor or relevant complications. Patients have the activity of gastrointestinal diseases. Patients have organic brain disease or complications and mental retardation. According to the DSM-Ⅵ diagnostic criteria , patients have drug abuse or drug dependence and incomplete remission. glutamic-oxalacetic transaminase (AST) or glutamic-pyruvic transaminase (ALT) is 2 times higher than the normal limit. Renal dysfunction, creatinine is higher than the upper limit of normal value. The women in pregnancy or lactation now, and may be in pregnant during the study period. Patients are allergic to risperidone.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| schizophrenia group<br>schizophrenia patients in the group | Genetic: sequencing faecal metagenome<br>* sequencing faecal metagenome is not the intervention measure.It is the observational method for investigators to detect the component of faecal microorganism.<br>|
| control group<br>healthy population | Genetic: sequencing faecal metagenome<br>* sequencing faecal metagenome is not the intervention measure.It is the observational method for investigators to detect the component of faecal microorganism.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| species-level molecular operational taxonomic units | The composition of the gut microbe was evaluated by sequencing faecal metagenome. The specific measures representing the above characteristics of gut microbe contain species-level molecular operational taxonomic units. | at the beginning | 
| species-level molecular operational taxonomic units | The composition of the gut microbe was evaluated by sequencing faecal metagenome. The specific measures representing the above characteristics of gut microbe contain species-level molecular operational taxonomic units. | the third month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| concentration of inflammatory factors | concentration of inflammatory factors including interleukin-1(IL-1),interleukin-10(IL-10),interleukin-2 (IL-2),interleukin-6 (IL-6),tumor necrosis factor (TNF), the measure unit is U/mL | at the beginning | 
| concentration of inflammatory factors | concentration of inflammatory factors including IL-1,IL-10,IL-2,IL-6,TNF, the measure unit is U/mL | the third week | 
| concentration of inflammatory factors | concentration of inflammatory factors including IL-1,IL-10,IL-2,IL-6,TNF, the measure unit is U/mL | the third month | 
| concentration of inflammatory factors | concentration of inflammatory factors including IL-1,IL-10,IL-2,IL-6,TNF, the measure unit is U/mL | the sixth month | 
| concentration of inflammatory factors | concentration of inflammatory factors including IL-1,IL-10,IL-2,IL-6,TNF, the measure unit is U/mL | one year | 
| concentration of γ-aminobutyric acid | γ-aminobutyric acid was measured by high efficiency liquid chromatography in cerebrospinal fluid, the measure unit is mg/kg | at the beginning | 
| concentration of γ-aminobutyric acid | γ-aminobutyric acid was measured by high efficiency liquid chromatography in cerebrospinal fluid, the measure unit is mg/kg | the sixth month | 
| gene profiles | The composition of the gut microbe was evaluated by sequencing faecal metagenome. The specific measures representing the above characteristics of gut microbe contain gene profiles. | at the beginning | 
| gene profiles | The composition of the gut microbe was evaluated by sequencing faecal metagenome. The specific measures representing the above characteristics of gut microbe contain gene profiles. | the third month | 
| metagenomic linkage groups | The composition of the gut microbe was evaluated by sequencing faecal metagenome. The specific measures representing the above characteristics of gut microbe contain metagenomic linkage groups. | at the beginning | 
| metagenomic linkage groups | The composition of the gut microbe was evaluated by sequencing faecal metagenome. The specific measures representing the above characteristics of gut microbe contain metagenomic linkage groups. | the third month | 
| Encyclopedia of Genes and Genomes (KEGG) ortholog | The composition of the gut microbe was evaluated by sequencing faecal metagenome. The specific measures representing the above characteristics of gut microbe contain Encyclopedia of Genes and Genomes (KEGG) ortholog. | at the beginning | 
| Encyclopedia of Genes and Genomes (KEGG) ortholog | The composition of the gut microbe was evaluated by sequencing faecal metagenome. The specific measures representing the above characteristics of gut microbe contain Encyclopedia of Genes and Genomes (KEGG) ortholog. | the third month | 
| module and pathway profiles of faecal microbiota | The composition of the gut microbe was evaluated by sequencing faecal metagenome. The specific measures representing the above characteristics of gut microbe contain module and pathway profiles of faecal microbiota. | at the beginning | 
| module and pathway profiles of faecal microbiota | The composition of the gut microbe was evaluated by sequencing faecal metagenome. The specific measures representing the above characteristics of gut microbe contain module and pathway profiles of faecal microbiota. | the third month |