# Schizophrenia as a Disorder of Biological Barriers: A Narrative Review and Potential Interventions

**Authors:** Adonis Sfera, Nyla Jafri, Jacob Anton, Dragos Turturica, Edelina Turturica, Bernardo Bozza, Ioana Ciuperca

PMC · DOI: 10.3390/ijms27041811 · 2026-02-13

## TL;DR

This paper explores how biological barriers may be involved in schizophrenia and suggests potential interventions to maintain these barriers.

## Contribution

The paper introduces a novel perspective on schizophrenia as a disorder of biological barriers and proposes new intervention strategies.

## Key findings

- Schizophrenia may involve premature aging of neurons and glial cells, leading to cognitive symptoms.
- Aryl hydrocarbon receptor may regulate gut and blood-brain barriers, influencing microorganism translocation.
- Interventions targeting barrier function could prevent central nervous system pathology in schizophrenia.

## Abstract

Severe mental illnesses, including schizophrenia and schizophrenia-like disorders, have been associated with premature neuronal and glial senescence, microglial activation, and gray matter volume reduction. These changes may drive clinical symptoms of schizophrenia, including cognitive impairment. Aryl hydrocarbon receptor, abundantly expressed in the intestinal and blood–brain barrier, is the master regulator of both tight junctions and cellular senescence. Under pathological circumstances, this receptor may promote premature gut aging, enabling the translocation of bacteria or their components from the gastrointestinal tract into systemic circulation and from there into the central nervous system. In this review article, we discuss a potential mechanism of schizophrenia–microorganismal migration, microglial activation, and gray matter volume reduction. We also focus on potential interventions for maintaining barrier function. These approaches include natural and synthetic modulators of the aryl hydrocarbon receptor as well as biophysical strategies to preserve barrier integrity and prevent central nervous system pathology.

## Linked entities

- **Diseases:** schizophrenia (MONDO:0005090)

## Full-text entities

- **Genes:** GPX4 (glutathione peroxidase 4) [NCBI Gene 2879] {aka GPx-4, GSHPx-4, MCSP, PHGPx, SMDS, snGPx}, GSK3B (glycogen synthase kinase 3 beta) [NCBI Gene 2932], Ahr (aryl-hydrocarbon receptor) [NCBI Gene 11622] {aka Ah, Ahh, Ahre, In, bHLHe76}, POMC (proopiomelanocortin) [NCBI Gene 5443] {aka ACTH, CLIP, LPH, MSH, NPP, OBAIRH}, ARNT (aryl hydrocarbon receptor nuclear translocator) [NCBI Gene 405] {aka ARNT1, HIF-1-beta, HIF-1beta, HIF1-beta, HIF1B, HIF1BETA}, DRD2 (dopamine receptor D2) [NCBI Gene 1813] {aka D2DR, D2R}, NLRP3 (NLR family pyrin domain containing 3) [NCBI Gene 114548] {aka AGTAVPRL, AII, AVP, C1orf7, CIAS1, CLR1.1}, DISC1 (DISC1 scaffold protein) [NCBI Gene 27185] {aka C1orf136, SCZD9}, PYCARD (PYD and CARD domain containing) [NCBI Gene 29108] {aka ASC, CARD5, TMS, TMS-1, TMS1}, CLDN1 (claudin 1) [NCBI Gene 9076] {aka CLD1, ILVASC, SEMP1}, S100a9 (S100 calcium binding protein A9 (calgranulin B)) [NCBI Gene 20202] {aka 60B8Ag, BEE22, Cagb, GAGB, L1Ag, MRP14}, CD14 (CD14 molecule) [NCBI Gene 929], CASP1 (caspase 1) [NCBI Gene 834] {aka ICE, IL1BC, P45}, S100A9 (S100 calcium binding protein A9) [NCBI Gene 6280] {aka 60B8AG, CAGB, CFAG, CGLB, L1AG, LIAG}, LBP (lipopolysaccharide binding protein) [NCBI Gene 3929] {aka BPIFD2}, IL18 (interleukin 18) [NCBI Gene 3606] {aka IGIF, IL-18, IL-1g, IL1F4}, CLDN4 (claudin 4) [NCBI Gene 1364] {aka CPE-R, CPER, CPETR, CPETR1, WBSCR8, hCPE-R}, IL10 (interleukin 10) [NCBI Gene 3586] {aka CSIF, GVHDS, IL-10, IL10A, TGIF}, OCLN (occludin) [NCBI Gene 100506658] {aka BLCPMG, PPP1R115, PTORCH1}, TLR4 (toll like receptor 4) [NCBI Gene 7099] {aka ARMD10, CD284, TLR-4, TOLL}, IL22 (interleukin 22) [NCBI Gene 50616] {aka IL-21, IL-22, IL-D110, IL-TIF, ILTIF, TIFIL-23}, IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, AHR (aryl hydrocarbon receptor) [NCBI Gene 196] {aka FVH3, RP85, bHLHe76}
- **Diseases:** cortical volume reduction (MESH:D054220), tuberculosis (MESH:D014376), dementia (MESH:D003704), neuronal death (MESH:D009410), IBD (MESH:D015212), psychotic decompensation (MESH:D006333), cognitive decline (MESH:D003072), infectious diseases (MESH:D003141), SMI (MESH:D045169), MS (MESH:D009103), immune dysregulation (OMIM:614878), HIV infection (MESH:D015658), atherosclerotic plaques (MESH:D058226), neurodevelopmental disorder (MESH:D002658), intestinal (MESH:D007410), migraine headaches (MESH:D008881), delusions (MESH:D063726), translocation (MESH:D014178), hallucinations (MESH:D006212), leprosy (MESH:D007918), seizure disorder (MESH:D004827), symptoms (MESH:D012816), urinary tract infections (MESH:D014552), reduction of (MESH:D015431), cytotoxicity (MESH:D064420), infection (MESH:D007239), neurocognitive impairment (MESH:D019965), psychosis (MESH:D011618), neuropsychiatric illness (MESH:C000631768), neurodevelopmental disabilities (MESH:D007859), tumorigenesis (MESH:D063646), pneumonia (MESH:D011014), matter (MESH:D056784), autoimmune disorders (MESH:D001327), axonal loss (MESH:D012183), gray matter damage (MESH:D002549), MDD (MESH:D003865), ischemia (MESH:D007511), inflammation (MESH:D007249), injury to (MESH:D014947), ASD (MESH:D001321), disruptive behavior (MESH:D019958), Barrier Dysfunction (MESH:C536830), atrophy (MESH:D001284), anxiety (MESH:D001007), neuroinflammation (MESH:D000090862), SCZ (MESH:D012559), psychotic episode (MESH:C580065), CNS disease (MESH:D002493), neurotoxic (MESH:D020258), insomnia (MESH:D007319), mental illness (MESH:D001523), AD (MESH:D000544), tumor (MESH:D009369)
- **Chemicals:** Cysteine (MESH:D003545), lipid (MESH:D008055), LPS (MESH:D008070), Polyphenols (MESH:D059808), quinoline-3-carboxamides (MESH:C541322), Glutamine (MESH:D005973), GSH (MESH:D005978), indole (MESH:C030374), flavonoid (MESH:D005419), 5HT (MESH:D012701), calcium (MESH:D002118), SCFA (MESH:D005232), Luteolin (MESH:D047311), DA (MESH:D004298), tryptophan (MESH:D014364), Paquinimod (MESH:C573440), phthalate (MESH:C032279), indole-3-lactic acid (MESH:C024139), Cobenfy (-), dioxin (MESH:D004147), melatonin (MESH:D008550), Curcumin (MESH:D003474), laquinimod (MESH:C476223), Alstonine (MESH:C009244), PS (MESH:D010718), aspartate (MESH:D001224), Butyrate (MESH:D002087), Amino Acids (MESH:D000596), Rituximab (MESH:D000069283), bisphenol A (MESH:C006780), phenothiazines (MESH:D010640), PAH (MESH:D011084), indole-3-carbinol (MESH:C016517), Phenazines (MESH:D010619), GABA (MESH:D005680), L-glutamate (MESH:D018698), indole alkaloid (MESH:D026121), kynurenine (MESH:D007737), TMAO (MESH:C005855), clozapine (MESH:D003024), vitamin D (MESH:D014807), lactate (MESH:D019344), carbidopa (MESH:D002230), Quercetin (MESH:D011794)
- **Species:** Strobilanthes formosana (species) [taxon 262989], Human immunodeficiency virus (species) [taxon 12721], Streptococcus (genus) [taxon 1301], Streptomyces sp. (species) [taxon 1931], Homo sapiens (human, species) [taxon 9606], Human immunodeficiency virus 1 (no rank) [taxon 11676], Escherichia coli (E. coli, species) [taxon 562], Catharanthus roseus (chatas, species) [taxon 4058], Pseudomonas aeruginosa (species) [taxon 287], Mus musculus (house mouse, species) [taxon 10090]
- **Mutations:** Glutamate/Aspartate, glutamine/glutamate

## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12940251/full.md

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Source: https://tomesphere.com/paper/PMC12940251