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The incidence of smoking is very high in non-schizophrenic subjects presenting various psychiatric disorders (35 to 54%). However, the incidence of smoking is extremely high in schizophrenic patients: 80% to 90%, versus 25% to 30% of the general population. Various studies have demonstrated that the use of tobacco transiently restores the schizophrenic patient's cognitive and sensory deficits. Smoking cessation also appears to exacerbate the symptoms of the disease. Post-mortem binding studies have revealed a disturbance of nicotinic receptor expression, affecting the alpha(7) and alpha(4)beta(2) subunits, in various cerebral areas. Genetic linkage studies have also shown that the alpha(7) subunit is involved in schizophrenia. This review assesses the involvement of the nicotinic system in schizophrenia and suggests ways in which this system may participate in the pathophysiology of this disease.

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Nicotinic receptors (NRs) belong to the group of polymeric receptors of the cell membrane and are key elements of cholinergic transmission. Numerous subtypes of NRs exist with the alpha 4 beta 2 and alpha 7 types being encountered most frequently. Deficiencies in NRs seem to play a role in Alzheimer's disease, which is characterised by accumulation of senile plaques, mainly composed of beta-amyloid peptide (beta A). Although the aetiology of this disease is unknown, different pathogenesis hypotheses implicating alpha 7 NRs have been proposed, with the receptors exerting a direct or indirect action on the mechanism of beta A toxicity. Allosteric modulators of NRs, such as the cholinesterase inhibitor galantamine, that facilitate the action of acetylcholine on these receptors may provide therapeutic benefits in the areas of cognition, attention and antineurodegenerative activity.

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