The oro- and nasopharyngeal microbiota as a revolutionary perspective on mental disorders and related psychopathology: a systematic review and meta-analysis

Abstract Background A growing body of evidence highlights the significant role of disruptions in the brain-gut-microbiota axis in the pathogenesis of various mental disorders. However, the potential impact of the “oro- and nasopharyngeal (ONP) microbiota” on mental well-being has been largely overlo...

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Main Authors: Zeinab Hesami, Mohammad Atashrooz, Reyhaneh Sardarzehi, Mehdi Azizmohammad Looha, Babak Khorsand, Hamidreza Houri
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of Translational Medicine
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Online Access:https://doi.org/10.1186/s12967-025-06759-x
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author Zeinab Hesami
Mohammad Atashrooz
Reyhaneh Sardarzehi
Mehdi Azizmohammad Looha
Babak Khorsand
Hamidreza Houri
author_facet Zeinab Hesami
Mohammad Atashrooz
Reyhaneh Sardarzehi
Mehdi Azizmohammad Looha
Babak Khorsand
Hamidreza Houri
author_sort Zeinab Hesami
collection DOAJ
description Abstract Background A growing body of evidence highlights the significant role of disruptions in the brain-gut-microbiota axis in the pathogenesis of various mental disorders. However, the potential impact of the “oro- and nasopharyngeal (ONP) microbiota” on mental well-being has been largely overlooked. This is particularly significant, as the ONP microbiota constitutes one of the most complex microbial ecosystems in the human body. Dysbiosis in this region has been associated with systemic diseases, which may, in turn, contribute to disruptions in the gut microbiota. Methods In this study, we synthesized the current literature investigating differences in ONP microbial composition in people with various mental disorders, compared to healthy controls. We also conducted a meta-analysis on studies developing predictive models based on microbial profiles for the diagnosis of mental disorders. Out of 26 studies that met the inclusion criteria, 9 had constructed diagnostic models. Results Our findings suggest that, despite inconsistencies in reported microbial alterations, ONP microbial signatures could represent a preliminary avenue for exploring associations with mental disorders. Interestingly, the unique dysbiosis patterns reported in the studies demonstrated diagnostic accuracy for conditions including autism spectrum disorder (ASD) and obstructive sleep apnea (OSA). This systematic review and meta-analysis revealed that the microbial communities in the ONP region of individuals with mental disorders differ significantly from those of healthy individuals. Moreover, the alterations in the ONP microbiota appear to be specific to different mental health conditions, suggesting their potential utility in the detection of mental disorders and even the prediction of comorbidities in the future. Conclusions Further prospective and experimental studies are needed, with careful control for confounders and consideration of heterogeneity, to advance our understanding of the role of the ONP microbiota in mental health. Additionally, future research should explore the relationship between ONP and gut microbial dysbiosis to provide a more comprehensive understanding of their interplay in mental health disorders.
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spelling doaj-art-b7d0466749a8474aa32f8dd1bb6ce2c72025-08-20T03:45:34ZengBMCJournal of Translational Medicine1479-58762025-07-0123112110.1186/s12967-025-06759-xThe oro- and nasopharyngeal microbiota as a revolutionary perspective on mental disorders and related psychopathology: a systematic review and meta-analysisZeinab Hesami0Mohammad Atashrooz1Reyhaneh Sardarzehi2Mehdi Azizmohammad Looha3Babak Khorsand4Hamidreza Houri5Student Research Committee, Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical SciencesDepartment of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical SciencesDepartment of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical SciencesBasic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical SciencesDepartment of Neurology, University of CaliforniaCeliac Disease and Gluten Related Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical SciencesAbstract Background A growing body of evidence highlights the significant role of disruptions in the brain-gut-microbiota axis in the pathogenesis of various mental disorders. However, the potential impact of the “oro- and nasopharyngeal (ONP) microbiota” on mental well-being has been largely overlooked. This is particularly significant, as the ONP microbiota constitutes one of the most complex microbial ecosystems in the human body. Dysbiosis in this region has been associated with systemic diseases, which may, in turn, contribute to disruptions in the gut microbiota. Methods In this study, we synthesized the current literature investigating differences in ONP microbial composition in people with various mental disorders, compared to healthy controls. We also conducted a meta-analysis on studies developing predictive models based on microbial profiles for the diagnosis of mental disorders. Out of 26 studies that met the inclusion criteria, 9 had constructed diagnostic models. Results Our findings suggest that, despite inconsistencies in reported microbial alterations, ONP microbial signatures could represent a preliminary avenue for exploring associations with mental disorders. Interestingly, the unique dysbiosis patterns reported in the studies demonstrated diagnostic accuracy for conditions including autism spectrum disorder (ASD) and obstructive sleep apnea (OSA). This systematic review and meta-analysis revealed that the microbial communities in the ONP region of individuals with mental disorders differ significantly from those of healthy individuals. Moreover, the alterations in the ONP microbiota appear to be specific to different mental health conditions, suggesting their potential utility in the detection of mental disorders and even the prediction of comorbidities in the future. Conclusions Further prospective and experimental studies are needed, with careful control for confounders and consideration of heterogeneity, to advance our understanding of the role of the ONP microbiota in mental health. Additionally, future research should explore the relationship between ONP and gut microbial dysbiosis to provide a more comprehensive understanding of their interplay in mental health disorders.https://doi.org/10.1186/s12967-025-06759-xMental disordersOro- and nasopharyngeal microbiotaAutism spectrum disorderObstructive sleep apneaSchizophrenia
spellingShingle Zeinab Hesami
Mohammad Atashrooz
Reyhaneh Sardarzehi
Mehdi Azizmohammad Looha
Babak Khorsand
Hamidreza Houri
The oro- and nasopharyngeal microbiota as a revolutionary perspective on mental disorders and related psychopathology: a systematic review and meta-analysis
Journal of Translational Medicine
Mental disorders
Oro- and nasopharyngeal microbiota
Autism spectrum disorder
Obstructive sleep apnea
Schizophrenia
title The oro- and nasopharyngeal microbiota as a revolutionary perspective on mental disorders and related psychopathology: a systematic review and meta-analysis
title_full The oro- and nasopharyngeal microbiota as a revolutionary perspective on mental disorders and related psychopathology: a systematic review and meta-analysis
title_fullStr The oro- and nasopharyngeal microbiota as a revolutionary perspective on mental disorders and related psychopathology: a systematic review and meta-analysis
title_full_unstemmed The oro- and nasopharyngeal microbiota as a revolutionary perspective on mental disorders and related psychopathology: a systematic review and meta-analysis
title_short The oro- and nasopharyngeal microbiota as a revolutionary perspective on mental disorders and related psychopathology: a systematic review and meta-analysis
title_sort oro and nasopharyngeal microbiota as a revolutionary perspective on mental disorders and related psychopathology a systematic review and meta analysis
topic Mental disorders
Oro- and nasopharyngeal microbiota
Autism spectrum disorder
Obstructive sleep apnea
Schizophrenia
url https://doi.org/10.1186/s12967-025-06759-x
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