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Lv H, Guo M, Guo C, He K. The Interrelationships between Cytokines and Schizophrenia: A Systematic Review. Int J Mol Sci 2024; 25:8477. [PMID: 39126046 DOI: 10.3390/ijms25158477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/26/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024] Open
Abstract
Schizophrenia (SCZ) imposes a significant burden on patients and their families because of its high prevalence rate and disabling nature. Given the lack of definitive conclusions regarding its pathogenesis, physicians heavily rely on patients' subjective symptom descriptions for diagnosis because reliable diagnostic biomarkers are currently unavailable. The role of the inflammatory response in the pathogenesis of SCZ has been supported by some studies. The findings of these studies showed abnormal changes in the levels of inflammatory factors, such as cytokines (CKs), in both peripheral blood and cerebrospinal fluid (CSF) among individuals affected by SCZ. The findings imply that inflammatory factors could potentially function as risk indicators for the onset of SCZ. Consequently, researchers have directed their attention towards investigating the potential utility of CKs as viable biomarkers for diagnosing SCZ. Extracellular vesicles (EVs) containing disease-specific components exhibit remarkable stability and abundance, making them promising candidates for biomarker discovery across various diseases. CKs encapsulated within EVs secreted by immune cells offer valuable insights into disease progression. This review presents a comprehensive analysis summarizing the relationship between CKs and SCZ and emphasizes the vital role of CKs encapsulated within EVs in the pathogenesis and development of SCZ.
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Affiliation(s)
- Haibing Lv
- College of Life Sciences and Food Engineering, Inner Mongolia Minzu University, Tongliao 028000, China
| | - Meng Guo
- Finance Office, Inner Mongolia Minzu University, Tongliao 028000, China
| | - Chuang Guo
- College of Life Sciences and Food Engineering, Inner Mongolia Minzu University, Tongliao 028000, China
| | - Kuanjun He
- College of Life Sciences and Food Engineering, Inner Mongolia Minzu University, Tongliao 028000, China
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Yuan X, Yang Q, Yao Y, Song S, Zhou X, Liu H, Zhang K. Role of HOMA-IR and IL-6 as screening markers for the metabolic syndrome in patients with chronic schizophrenia: a psychiatric hospital-based cross-sectional study. Eur Arch Psychiatry Clin Neurosci 2024; 274:1063-1070. [PMID: 37166483 DOI: 10.1007/s00406-023-01618-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/26/2023] [Indexed: 05/12/2023]
Abstract
This study starts from the metabolic related indexes and cellular inflammatory factors in patients with chronic schizophrenia to find out that it can be used as an effective screening index of metabolic syndrome. 320 patients with chronic schizophrenia (course of disease > 5 years) and 165 healthy subjects were selected. The mental symptoms of the patients were measured by positive and negative syndrome scale. Blood samples from patients and healthy controls were collected to detect blood glucose, triglyceride, HDL and fasting insulin. The serum levels of IL-1β, IL-2, IL-6, IL-17, IFN-γ and TNF-α were determined repeatedly by sandwich enzyme-linked immunosorbent assay. The levels of HOMA-IR, plasma inflammatory factors IL-2, IL-6, IL-17 and TNF-α in patient group were higher than those in healthy group. It was found that there were differences in age and related metabolic indexes between patients with chronic schizophrenia with and without metabolic syndrome. In addition, HOMA-IR, plasma cytokines IL-2 and IL-6 still showed differences between groups. In the Spearmen correlation analysis of insulin resistance index, cytokines and metabolic indexes, it was found that there was a significant correlation between HOMA-IR, IL-6 and related metabolic indexes and metabolic syndrome. ROC curve analysis showed that HOMAIR and IL-6 could be used as screening indexes for MS in male and female patients with schizophrenia.Metabolic syndrome is an important risk factor for cardiovascular disease in patients with chronic schizophrenia. HOMA-IR and IL-6 can be used as effective biological indicators to screen MS in patients with chronic schizophrenia.
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Affiliation(s)
- Xiaoping Yuan
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Hefei, 238000, China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Qiongyao Yang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Hefei, 238000, China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yitan Yao
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Hefei, 238000, China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Suqi Song
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Hefei, 238000, China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Xiaoqin Zhou
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Hefei, 238000, China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Hefei, 238000, China.
- Anhui Psychiatric Center, Anhui Medical University, Hefei, China.
| | - Kai Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 North Chaohu Road, Hefei, 238000, China.
- Anhui Psychiatric Center, Anhui Medical University, Hefei, China.
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Shinohara RC, Oshima T, Otsubo T, Ariga K, Ono T, Muneoka K, Umezu H, Mikami N. Successful utilization of clozapine for a patient with treatment-resistant schizophrenia after recurrent violent behavior. Neuropsychopharmacol Rep 2024. [PMID: 38961521 DOI: 10.1002/npr2.12462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/14/2024] [Accepted: 06/15/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND In patients with schizophrenia, violent behavior is a clinically important factor that prevents their discharge. Clozapine is an effective antipsychotic medication for treatment-resistant schizophrenia, and its usefulness for aggressive behavior has also been suggested. CASE PRESENTATION We present the case of a 38-year-old male patient diagnosed with schizophrenia who was successfully treated with clozapine after recurrent violent behavior. He was diagnosed with schizophrenia during his adolescence. He was hospitalized for treatment in his teens, but his hallucinations and delusions persisted even after discharge. In his 30s, he became noticeably emotionally unstable, and despite being treated for an adequate period with sufficient doses of several antipsychotics, his symptoms did not improve. This led to repeated hospitalizations triggered by violent behavior toward his parents and siblings within the home. During his fourth hospitalization, clozapine was initiated due to multiple incidents of violence toward nursing staff secondary to hallucinations and delusions. As the dose of clozapine was gradually increased with therapeutic drug monitoring, the patient's hostility, uncooperativeness, and suspiciousness markedly improved, and his aggressive behavior disappeared. He was discharged to a facility on day 194 after starting clozapine and has continued outpatient visits. CONCLUSION Clozapine was suggested to be effective for aggressive behavior in patients with treatment-resistant schizophrenia and should be actively considered. In such cases, regular measurement of blood concentration is useful for adjusting the dosage of clozapine.
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Affiliation(s)
| | - Tomomi Oshima
- Department of Psychiatry, Kushiro City General Hospital, Kushiro, Japan
| | - Takafumi Otsubo
- Department of Psychiatry, Kushiro City General Hospital, Kushiro, Japan
| | - Keita Ariga
- Department of Psychiatry, Kushiro City General Hospital, Kushiro, Japan
| | - Tesshu Ono
- Department of Psychiatry, Kushiro City General Hospital, Kushiro, Japan
| | - Koya Muneoka
- Department of Psychiatry, Kushiro City General Hospital, Kushiro, Japan
| | - Hiroki Umezu
- Department of Psychiatry, Kushiro City General Hospital, Kushiro, Japan
| | - Nobuhiro Mikami
- Department of Psychiatry, Kushiro City General Hospital, Kushiro, Japan
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Leung JG, Allen ND, Markota M. A case series of clozapine titrations affected by inflammatory processes. Schizophr Res 2024; 268:94-97. [PMID: 37633777 DOI: 10.1016/j.schres.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 08/10/2023] [Accepted: 08/12/2023] [Indexed: 08/28/2023]
Affiliation(s)
- Jonathan G Leung
- Department of Pharmacy, Mayo Clinic Rochester, MN, United States of America.
| | - Nicholas D Allen
- Department of Psychiatry and Psychology, Mayo Clinic Rochester, MN, United States of America
| | - Matej Markota
- Department of Psychiatry and Psychology, Mayo Clinic Rochester, MN, United States of America
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Chen Z, Ge R, Wang C, Elazab A, Fu X, Min W, Qin F, Jia G, Fan X. Identification of important gene signatures in schizophrenia through feature fusion and genetic algorithm. Mamm Genome 2024; 35:241-255. [PMID: 38512459 DOI: 10.1007/s00335-024-10034-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/07/2024] [Indexed: 03/23/2024]
Abstract
Schizophrenia is a debilitating psychiatric disorder that can significantly affect a patient's quality of life and lead to permanent brain damage. Although medical research has identified certain genetic risk factors, the specific pathogenesis of the disorder remains unclear. Despite the prevalence of research employing magnetic resonance imaging, few studies have focused on the gene level and gene expression profile involving a large number of screened genes. However, the high dimensionality of genetic data presents a great challenge to accurately modeling the data. To tackle the current challenges, this study presents a novel feature selection strategy that utilizes heuristic feature fusion and a multi-objective optimization genetic algorithm. The goal is to improve classification performance and identify the key gene subset for schizophrenia diagnostics. Traditional gene screening techniques are inadequate for accurately determining the precise number of key genes associated with schizophrenia. Our innovative approach integrates a filter-based feature selection method to reduce data dimensionality and a multi-objective optimization genetic algorithm for improved classification tasks. By combining the filtering and wrapper methods, our strategy leverages their respective strengths in a deliberate manner, leading to superior classification accuracy and a more efficient selection of relevant genes. This approach has demonstrated significant improvements in classification results across 11 out of 14 relevant datasets. The performance on the remaining three datasets is comparable to the existing methods. Furthermore, visual and enrichment analyses have confirmed the practicality of our proposed method as a promising tool for the early detection of schizophrenia.
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Affiliation(s)
| | - Ruiquan Ge
- Hangzhou Dianzi University, Hangzhou, China.
- Hangzhou Institute of Advanced Technology, Hangzhou, China.
- Key Laboratory of Discrete Industrial Internet of Things of Zhejiang Province, Hangzhou, China.
| | - Changmiao Wang
- Shenzhen Research Institute of Big Data, Shenzhen, China
| | - Ahmed Elazab
- Computer Science Department, Misr Higher Institute for Commerce and Computers, Mansoura, Egypt
| | - Xianjun Fu
- School of Artificial Intelligence, Zhejiang College of Security Technology, Wenzhou, China
| | - Wenwen Min
- School of Information Science and Engineering, Yunnan University, Kunming, China
| | - Feiwei Qin
- Hangzhou Dianzi University, Hangzhou, China
| | | | - Xiaopeng Fan
- Hangzhou Institute of Advanced Technology, Hangzhou, China
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Li M, Wang X, Kong S, Qiu Y, Jiang C, Sun W, Yang S, Ji L, Zhang Y, Li J. Sex-specific associations of plasma neutrophil gelatinase-associated lipocalin (NGAL) with cognition in patients with drug-naïve schizophrenia. J Psychiatr Res 2024; 174:19-25. [PMID: 38604111 DOI: 10.1016/j.jpsychires.2024.03.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/14/2024] [Accepted: 03/29/2024] [Indexed: 04/13/2024]
Abstract
This present study aimed to investigate the sex-specific association of plasma neutrophil gelatinase-associated lipocalin (NGAL) with cognition in drug-naïve schizophrenia patients for the first time. A total of 204 participants in this study, including 137 drug-naïve schizophrenia (DNS) patients and 67 healthy controls (HCs). All participants completed the Measurements and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB), and were collected fasting venous blood for NGAL measurement. DNS patients also complete the Positive and Negative Syndrome Scale (PANSS). Partial correlation analysis and multiple linear regression were used to explore sex-specific associations between NGAL and cognition. All dimensions of MCCB scores were significantly lower in both male and female DNS patients than HCs. Sex differences were significant in cognitive performance in both DNS patients and HCs. Female DNS patients experienced poorer working memory and reason& problem solving than male patients. Female HCs performed a better attention/vigilance and visual learning, a poorer reason& problem solving than male HCs. In patients with DNS, NGAL levels were negatively associated with positive subscale of PANSS and positively associated with working memory and visual learning only in female. However, there was no significant correlation between NGAL levels and all cognitive tests in both male and female HCs. Regression model showed that higher level of NGAL was an independent protective factor for cognitive performance in female patients with DNS, whereas there was no such role in male patients. Our findings suggest sex specificity between NGAL levels and cognitive performance in DNS patients.
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Affiliation(s)
- Meijuan Li
- Tianjin Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Xiaoli Wang
- Tianjin Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Siying Kong
- Tianjin Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Yuying Qiu
- Tianjin Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Changyong Jiang
- Tianjin Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Wei Sun
- Tianjin Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Shu Yang
- Tianjin Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Lijie Ji
- Tianjin Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Yonghui Zhang
- Tianjin Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China.
| | - Jie Li
- Tianjin Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China.
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Krzyściak W, Szwajca M, Śmierciak N, Chrzan R, Turek A, Karcz P, Bryll A, Pilecki M, Morava E, Ligęzka A, Kozicz T, Mazur P, Batko B, Skalniak A, Popiela T. From periphery immunity to central domain through clinical interview as a new insight on schizophrenia. Sci Rep 2024; 14:5755. [PMID: 38459093 PMCID: PMC10923880 DOI: 10.1038/s41598-024-56344-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/05/2024] [Indexed: 03/10/2024] Open
Abstract
Identifying disease predictors through advanced statistical models enables the discovery of treatment targets for schizophrenia. In this study, a multifaceted clinical and laboratory analysis was conducted, incorporating magnetic resonance spectroscopy with immunology markers, psychiatric scores, and biochemical data, on a cohort of 45 patients diagnosed with schizophrenia and 51 healthy controls. The aim was to delineate predictive markers for diagnosing schizophrenia. A logistic regression model was used, as utilized to analyze the impact of multivariate variables on the prevalence of schizophrenia. Utilization of a stepwise algorithm yielded a final model, optimized using Akaike's information criterion and a logit link function, which incorporated eight predictors (White Blood Cells, Reactive Lymphocytes, Red Blood Cells, Glucose, Insulin, Beck Depression score, Brain Taurine, Creatine and Phosphocreatine concentration). No single factor can reliably differentiate between healthy patients and those with schizophrenia. Therefore, it is valuable to simultaneously consider the values of multiple factors and classify patients using a multivariate model.
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Affiliation(s)
- Wirginia Krzyściak
- Department of Medical Diagnostic, Faculty of Pharmacy, Jagiellonian University Medical College, 30-688, Krakow, Poland.
| | - Marta Szwajca
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, 31-501, Krakow, Poland
| | - Natalia Śmierciak
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, 31-501, Krakow, Poland
| | - Robert Chrzan
- Department of Radiology, Faculty of Medicine, Jagiellonian University Medical College, 31-503, Krakow, Poland
| | - Aleksander Turek
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, 31-501, Krakow, Poland
| | - Paulina Karcz
- Department of Electroradiology, Faculty of Health Sciences, Jagiellonian University Medical College, 31-126, Krakow, Poland
| | - Amira Bryll
- Department of Radiology, Faculty of Medicine, Jagiellonian University Medical College, 31-503, Krakow, Poland
| | - Maciej Pilecki
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, 31-501, Krakow, Poland
| | - Eva Morava
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA
| | - Anna Ligęzka
- Department of Research Immunology, Mayo Clinic, Arizona, USA
| | - Tamas Kozicz
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA
| | - Paulina Mazur
- Department of Medical Diagnostic, Faculty of Pharmacy, Jagiellonian University Medical College, 30-688, Krakow, Poland
| | - Bogna Batko
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, 31-501, Krakow, Poland
| | - Anna Skalniak
- Division of Molecular Biology and Clinical Genetics, Department of Medicine, Jagiellonian University Medical College, Skawińska 8, 31-066, Krakow, Poland
| | - Tadeusz Popiela
- Department of Radiology, Faculty of Medicine, Jagiellonian University Medical College, 31-503, Krakow, Poland
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Leung JG, Zhang L, Markota M, Ellingrod VL, Gerberi DJ, Bishop JR. A systematic review of clozapine-associated inflammation and related monitoring. Pharmacotherapy 2023; 43:1364-1396. [PMID: 37842767 DOI: 10.1002/phar.2887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 10/17/2023]
Abstract
Clozapine is an effective antipsychotic medication used for treatment-resistant schizophrenia. However, it is underutilized due to rigorous hematologic monitoring requirements and many adverse drug reactions. Publications have highlighted the occurrence of inflammatory reactions, some life-threatening, particularly during the early stages of clozapine treatment. Although guidelines have suggested monitoring for inflammatory processes during clozapine initiation, screening in clinical practice is not universal. This systematic review aimed to investigate the relationship between clozapine and inflammation and assess the importance of monitoring for inflammatory reactions. A comprehensive literature search yielded 6915 unique publication records after removal of duplicates. After a rigorous screening process, 75 publications were included in the review, which focused on three main aspects: (i) the impact of clozapine on inflammatory markers, (ii) monitoring cardiac and other organ function during clozapine-associated inflammatory processes, and (iii) monitoring non-specific signs and symptoms of inflammation. Elevated levels of C-reactive protein (CRP) and several proinflammatory cytokines have been observed in association with clozapine treatment. However, the practicality of measuring specific markers in clinical practice remains uncertain. Current evidence supports monitoring CRP levels during the first 4-8 weeks of treatment, especially to facilitate myocarditis screening. Further research is needed to establish clinically relevant CRP thresholds for intervention. The implementation of monitoring protocols during the early phase of clozapine treatment may mitigate adverse reactions and allow for continued use of clozapine. Future studies should also explore the association between clozapine-associated inflammation and pneumonia, as well as investigate the impact of inflammation on clozapine metabolism to predict the need for dose adjustment. These endeavors may facilitate the development and implementation of evidence-based guidelines for the monitoring of clozapine-associated inflammation.
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Affiliation(s)
| | - Lusi Zhang
- Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, Minnesota, USA
| | - Matej Markota
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Vicki L Ellingrod
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan, USA
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | | | - Jeffrey R Bishop
- Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, Minnesota, USA
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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Zhang Y, Yin J, Yan H, Yan L, Li Y, Zhang C, Li Y, Liu B, Lin J, Zhang L, Hu X, Song C. Correlations between omega-3 fatty acids and inflammatory/glial abnormalities: the involvement of the membrane and neurotransmitter dysfunction in schizophrenia. Front Cell Neurosci 2023; 17:1163764. [PMID: 37937262 PMCID: PMC10626455 DOI: 10.3389/fncel.2023.1163764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 09/21/2023] [Indexed: 11/09/2023] Open
Abstract
Introduction Macrophages or T-lymphocytes triggered inflammation and, consequently, activated glial cells may contribute to neuroinflammation and neurotransmitter dysfunction in schizophrenia (SZ), while omega(n)-3 polyunsaturated fatty acids (PUFAs) can attenuate some SZ symptoms through anti-inflammatory effects. However, the correlations between macrophage/T-lymphocyte-produced cytokines and glia phenotypes, between inflammatory status and PUFAs composition, between cytokines and neurotransmitter function, and between n-3 PUFAs and neurotransmitter abnormality in SZ are unclear. Methods Changes in T-helper (h) patterns, peripheral macrophage/glial markers, PUFAs profile, membrane fluidity, and neurotransmitter functions were evaluated in SZ patients (n = 50) and healthy controls (n = 30) using ELISA, gas chromatography, fluorescence anisotropy techniques, and HPLC, respectively. Results Compared to the control, blood lymphocyte proliferation, the concentration of macrophage/microglia phenotype M1 markers, including cytokines IL-1β, TNF-α (Th1) and IL-6 (Th2), and astrocyte phenotype A1 marker S100β was significantly increased, while IL-17 and n-3 PUFAs contents, n-3/n-6 ratio, and membrane fluidity (FLU) were significantly decreased in SZ. Moreover, increased DA and HVA, decreased 5-HT and NE, and their metabolites appeared in SZ. Moreover, negative correlations between IL-6 and A2 marker Brain-Derived Neurotrophic Factor (BDNF) or n-3 PUFAs EPA and between IL-1β and FLU or 5HIAA, while positive correlations between EPA and 5-HIAA and between FLU and DHA were found in SZ. Discussion These findings showed (1) no clear Th pattern, but pro-inflammatory-dominant immunity occurred; (2) the pro-inflammatory pattern may result in the activated microglia M1 and astrocyte A1 phenotype; and (3) increased pro-inflammatory cytokines were related to decreased n-3 PUFA and decreased membrane fluidity and dysfunctional neurotransmitter systems in SZ.
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Affiliation(s)
- Yongping Zhang
- Research Institute for Marine Drugs and Nutrition, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang, China
- Marine Medicine Research and Development Center of Shenzhen Institutes of Guangdong Ocean University, Shenzhen, China
- Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang, China
| | - Jingwen Yin
- Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Haifeng Yan
- Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Ling Yan
- Research Institute for Marine Drugs and Nutrition, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang, China
| | - Yuyu Li
- Research Institute for Marine Drugs and Nutrition, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang, China
| | - Cai Zhang
- Research Institute for Marine Drugs and Nutrition, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang, China
| | - Yajuan Li
- Research Institute for Marine Drugs and Nutrition, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang, China
| | - Baiping Liu
- Research Institute for Marine Drugs and Nutrition, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang, China
| | - Juda Lin
- Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | | | - Xueqiong Hu
- Research Institute for Marine Drugs and Nutrition, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang, China
| | - Cai Song
- Research Institute for Marine Drugs and Nutrition, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang, China
- Marine Medicine Research and Development Center of Shenzhen Institutes of Guangdong Ocean University, Shenzhen, China
- Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang, China
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He J, Wei Y, Li J, Tang Y, Liu J, He Z, Zhou R, He X, Ren H, Liao Y, Gu L, Yuan N, Chen X, Tang J. Sex differences in the association of treatment-resistant schizophrenia and serum interleukin-6 levels. BMC Psychiatry 2023; 23:470. [PMID: 37370004 DOI: 10.1186/s12888-023-04952-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Low-grade inflammation and altered inflammatory markers have been observed in treatment-resistant schizophrenia (TRS). Interleukin-6 (IL-6) is one of the pro-inflammatory cytokines linked with TRS and receives increasing attention. Previous studies showed that patients with TRS might have higher IL-6 levels compared with healthy individuals and treatment-responsive patients. Besides, emerging evidence has suggested that there are sex differences in the associations between IL-6 levels and various illnesses, including chronic hepatitis C, metabolic syndrome, etc.; however, there is limited study on TRS. In this present study, we aimed to compare the serum IL-6 levels of TRS and partially responsive schizophrenia (PRS) and explore potential sex differences in the association of TRS and IL-6 levels. METHODS The study population consisted of a total of 90 patients with schizophrenia: 64 TRS patients (45.3% males and 54.7% females) and 26 PRS patients (46.2% males and 53.8% females). We measured serum IL-6 levels using enzyme-linked immunosorbent assay (ELISA) and analyzed them separately by gender, controlling for confounders (age, education, medication, body mass index, and PANSS scores) rigorously. RESULT The results showed that patients with TRS had higher serum IL-6 levels than patients with PRS (p = 0.002). In females, IL-6 levels increased significantly in the TRS group compared with the PRS group (p = 0.005). And a positive correlation tendency was observed between IL-6 levels and PANSS general sub-scores (r = 0.31, p = 0.039), although this correlation was not significant after correcting for multiple comparisons. Whereas, there were no differences in IL-6 levels between the TRS and PRS (p = 0.124) in males. CONCLUSION Our findings provided evidence supporting the hypothesis that the inflammatory response system (IRS) may play a role in the pathogenesis of TRS in a sex-dependent manner. In addition, sex differences in the immune dysfunction of individuals with schizophrenia cannot be neglected, and inflammation in male and female TRS should be discussed separately.
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Affiliation(s)
- Jingqi He
- Department of Psychiatry, Sir Run-Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yisen Wei
- Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Psychiatry, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Jinguang Li
- Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
- Affiliated Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying Tang
- Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Junyu Liu
- Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
- Xiangya Nursing School of Central South University, Changsha, China
| | - Zhangyin He
- Department of Psychiatry, Sir Run-Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | | | - Xingtao He
- The Ninth Hospital of Changsha, Changsha, China
| | - Honghong Ren
- Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Psychiatry, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Yanhui Liao
- Department of Psychiatry, Sir Run-Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lin Gu
- RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
- Research Center for Advanced Science and Technology (RCAST), University of Tokyo, Tokyo, Japan
| | - Ning Yuan
- Hunan Provincial Brain Hospital (The Second People's Hospital of Hunan Province), Changsha, China.
| | - Xiaogang Chen
- Department of Psychiatry, National Center for Mental Disorders, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.
| | - Jinsong Tang
- Department of Psychiatry, Sir Run-Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
- Zigong Mental Health Center, Zigong, China.
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11
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Ermakov EA, Melamud MM, Boiko AS, Kamaeva DA, Ivanova SA, Nevinsky GA, Buneva VN. Association of Peripheral Inflammatory Biomarkers and Growth Factors Levels with Sex, Therapy and Other Clinical Factors in Schizophrenia and Patient Stratification Based on These Data. Brain Sci 2023; 13:brainsci13050836. [PMID: 37239308 DOI: 10.3390/brainsci13050836] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/18/2023] [Accepted: 05/20/2023] [Indexed: 05/28/2023] Open
Abstract
Multiple lines of evidence are known to confirm the pro-inflammatory state of some patients with schizophrenia and the involvement of inflammatory mechanisms in the pathogenesis of psychosis. The concentration of peripheral biomarkers is associated with the severity of inflammation and can be used for patient stratification. Here, we analyzed changes in serum concentrations of cytokines (IL-1β, IL-2, IL-4, IL-6, IL-10, IL-21, APRIL, BAFF, PBEF/Visfatin, IFN-α, and TNF-α) and growth/neurotrophic factors (GM-CSF, NRG1-β1, NGF-β, and GDNF) in patients with schizophrenia in an exacerbation phase. IL-1β, IL-2, IL-4, IL-6, BAFF, IFN-α, GM-CSF, NRG1-β1, and GDNF increased but TNF-α and NGF-β decreased in schizophrenia compared to healthy individuals. Subgroup analysis revealed the effect of sex, prevalent symptoms, and type of antipsychotic therapy on biomarker levels. Females, patients with predominantly negative symptoms, and those taking atypical antipsychotics had a more pro-inflammatory phenotype. Using cluster analysis, we classified participants into "high" and "low inflammation" subgroups. However, no differences were found in the clinical data of patients in these subgroups. Nevertheless, more patients (17% to 25.5%) than healthy donors (8.6% to 14.3%) had evidence of a pro-inflammatory condition depending on the clustering approach used. Such patients may benefit from personalized anti-inflammatory therapy.
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Affiliation(s)
- Evgeny A Ermakov
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, 630090 Novosibirsk, Russia
- Department of Natural Sciences, Novosibirsk State University, 630090 Novosibirsk, Russia
| | - Mark M Melamud
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, 630090 Novosibirsk, Russia
| | - Anastasiia S Boiko
- Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, 634014 Tomsk, Russia
| | - Daria A Kamaeva
- Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, 634014 Tomsk, Russia
| | - Svetlana A Ivanova
- Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, 634014 Tomsk, Russia
| | - Georgy A Nevinsky
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, 630090 Novosibirsk, Russia
- Department of Natural Sciences, Novosibirsk State University, 630090 Novosibirsk, Russia
| | - Valentina N Buneva
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, 630090 Novosibirsk, Russia
- Department of Natural Sciences, Novosibirsk State University, 630090 Novosibirsk, Russia
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12
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Skalniak A, Krzyściak W, Śmierciak N, Szwajca M, Donicz P, Kozicz T, Pilecki M. Immunological routine laboratory parameters at admission influence the improvement of positive symptoms in schizophrenia patients after pharmacological treatment. Front Psychiatry 2023; 14:1082135. [PMID: 37032951 PMCID: PMC10073498 DOI: 10.3389/fpsyt.2023.1082135] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/20/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction The standard care of schizophrenia patients is based on the assessment of their psychotic behavior, using interview-based, subjective scales that measure symptoms severity. We aimed at defining easily accessible and inexpensive blood-derived clinical diagnostic parameters that might serve as objective markers in the prediction of the effects of pharmacological treatment of schizophrenia patients. Methods A total of 40 patients with schizophrenia diagnosis according to ICD 10 during psychotic decompensation were included in the study. Blood-based biochemical parameters, BMI and interview-based medical scales of symptom severity were determined - all at admission and after 12 weeks of standard pharmacological treatment. Results The drops in scale values were correlated with clinical parameters. All scale changes after treatment were dependent on the value of the given scale at admission, with higher initial values leading to larger drops of the values after treatment. Models based on those correlations were significantly improved when immune and metabolism parameters were included. C4 complement and C-reactive protein (CRP) level at admission were predictive of changes in Positive and Negative Syndrome Scale (PANSS) subscales related to significant disruption of thought processes, reality testing and disorganization. The pharmacological treatment-driven changes in scales representing negative symptoms were correlated with markers of the patients' thyroid status and metabolism. Discussion We show that objective markers can be obtained by testing immune and metabolic parameters from the patients' blood and may be added at a low cost to the standard care of schizophrenia patients in order to predict the outcome of pharmacological treatment.
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Affiliation(s)
- Anna Skalniak
- Department of Endocrinology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Wirginia Krzyściak
- Department of Medical Diagnostics, Faculty of Pharmacy, Jagiellonian University Medical College, Kraków, Poland
- *Correspondence: Wirginia Krzyściak,
| | - Natalia Śmierciak
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Marta Szwajca
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Paulina Donicz
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Tamas Kozicz
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN, United States
| | - Maciej Pilecki
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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13
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Catalase and interleukin-6 serum elevation in a prediction of treatment-resistance in male schizophrenia patients. Asian J Psychiatr 2023; 79:103400. [PMID: 36521406 DOI: 10.1016/j.ajp.2022.103400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 12/04/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Oxidative stress (OS) and neuroinflammatory pathways play an important role in the pathophysiology of schizophrenia. The present study investigated the relationship between OS, inflammatory cytokines, and clinical features in male patients with treatment-resistant schizophrenia (TRS). METHOD We measured plasma OS parameters, including manganese-superoxide dismutase (Mn-SOD), copper/zinc-containing SOD (CuZn-SOD), total-SOD (T-SOD), malondialdehyde (MDA), catalase (CAT), and glutathione peroxidase (GSH-Px); and serum inflammatory cytokines, including interleukin (IL)- 1α, IL-6, tumor necrosis factor-alpha (TNF-α), and interferon (IFN)-γ, from 80 male patients with chronic schizophrenia (31 had TRS and 49 had chronic stable schizophrenia (CSS)), and 42 healthy controls. The severity of psychotic symptoms was evaluated using the Positive and Negative Syndrome Scale (PANSS). RESULTS Compared with healthy controls, plasma Mn-SOD, CuZn-SOD, T-SOD, GSH-Px, and MDA levels were significantly lower, while CAT and serum IL-6 levels were higher in both TRS and CSS male patients (all P < 0.05). Significant differences in the activities of CAT (F = 6.068, P = 0.016) and IL-6 levels (F = 6.876, P = 0.011) were observed between TRS and CSS male patients after analysis of covariance. Moreover, a significant positive correlation was found between IL-6 levels and PANSS general psychopathology subscores (r = 0.485, P = 0.006) and between CAT activity and PANSS total scores (r = 0.409, P = 0.022) in TRS male patients. CAT and IL-6 levels were predictors for TRS. Additionally, in chronic schizophrenia patients, a significant positive correlation was observed between IL-6 and GSH-Px (r = 0.292, P = 0.012), and the interaction effect of IL-6 and GSH-Px was positively associated with PANSS general psychopathology scores (r = 0.287, P = 0.014). CONCLUSION This preliminary study indicated that variations in OS and inflammatory cytokines may be involved in psychopathology for patients with chronic schizophrenia, especially in male patients with TRS.
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14
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The Modernization of Clozapine: A Recapitulation of the Past in the United States and the View Forward. J Clin Psychopharmacol 2022; 42:565-580. [PMID: 36170148 DOI: 10.1097/jcp.0000000000001606] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Although clozapine was Food and Drug Administration (FDA) approved more than 3 decades ago, major barriers and gaps in knowledge continue to prevent its effective and safe use. We review modern-day problems encountered with clozapine in the United States (US). METHODS Information surrounding current administrative, clinical, research, and technological gaps or barriers related to clozapine use in the US was reviewed. FINDINGS The history of how clozapine became FDA approved likely contributes to gaps in knowledge. The frequency of safety warnings added to the FDA prescribing information may add to fears about clozapine, as evidence by numerous published survey studies. The clozapine Risk Evaluation and Mitigation Strategy (REMS) program has been modified several times in the last decade, causing access and safety issues for patients, which are discussed. Evidence may suggest that the FDA REMS requirements for hematologic monitoring are too cumbersome, and there may be ability to safely loosen requirements. The COVID-19 pandemic brought forth the ability for extended interval monitoring but also greater awareness of the clozapine-inflammation interaction. Newer guidelines published describe considerations in personalizing clozapine titration based on principles of ethnopsychopharmacology. Emerging technologies to support the use of clozapine are not widely available. IMPLICATIONS Clozapine is a unique life-saving drug but it is underused in the US, despite its established efficacy. The 2021 REMS changes led to significant difficulties for providers and patients. We highlight the importance of the clozapine-inflammation interaction, therapeutic drug monitoring, and the ability for individual care based on patient-specific factors. There is an urgent need for advancing technology used for clozapine monitoring, evaluating barriers created by REMS, and establishing consistent practices throughout the US.
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15
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Kawakita Y, Takeshima M, Komatsu T, Imanishi A, Fujiwara D, Itoh Y, Mishima K. Relationship between clozapine exposure and the onset of appendicitis in schizophrenia patients: a retrospective cohort study. BMC Psychiatry 2022; 22:653. [PMID: 36271340 PMCID: PMC9587653 DOI: 10.1186/s12888-022-04312-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 10/12/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Clozapine may cause serious side effects despite benefits in patients with schizophrenia. Thus, an accurate understanding of the side-effect profile of clozapine is extremely important in the management of its administration to patients with schizophrenia. Our aim was to validate the relationship between clozapine exposure and appendicitis onset in patients with schizophrenia. METHODS In this study, we retrospectively compared the incidence and cumulative incidence of appendicitis in patients with schizophrenia with and without a history of clozapine exposure. Among the patients with schizophrenia who visited our hospital between June 2009 and August 2021, we extracted those with a history of clozapine treatment. Patients with a history of taking clozapine were defined as the clozapine exposure group, while the others were defined as the clozapine non-exposure group. Patients with a history of appendectomy before their initial visit to our hospital or with a history of clozapine use at other hospitals were excluded. RESULTS There were 65 patients in the clozapine exposure group and 400 patients in the clozapine non-exposure group who met the inclusion criteria. The exposure group exhibited a remarkably higher incidence of appendicitis during the observation period than the non-exposure group (863 cases vs. 124 cases per 100,000 person-years). In particular, if limited to the period of clozapine exposure, the incidence of appendicitis is extremely high, at 2,086 cases per 100,000 person-years. Moreover, multivariable analysis showed that clozapine exposure was an independent factor contributing to the onset of appendicitis. CONCLUSIONS Clozapine exposure is associated with appendicitis onset in patients with schizophrenia.
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Affiliation(s)
- Yuta Kawakita
- Department of Neuropsychiatry, Akita City Hospital, 4-30 Kawamoto Matsuokamachi, Akita City, 010-0933, Japan. .,Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan.
| | - Masahiro Takeshima
- grid.251924.90000 0001 0725 8504Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Tomonari Komatsu
- Department of Neuropsychiatry, Noshiro Kousei Medical Center, Akita, Japan
| | - Aya Imanishi
- grid.251924.90000 0001 0725 8504Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Dai Fujiwara
- grid.251924.90000 0001 0725 8504Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Yu Itoh
- grid.251924.90000 0001 0725 8504Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Kazuo Mishima
- grid.251924.90000 0001 0725 8504Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
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16
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The Interrelation between Interleukin-2 and Schizophrenia. Brain Sci 2022; 12:brainsci12091154. [PMID: 36138890 PMCID: PMC9496814 DOI: 10.3390/brainsci12091154] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/23/2022] [Accepted: 08/27/2022] [Indexed: 11/16/2022] Open
Abstract
Interleukin-2 (IL-2) is a growth factor that regulates T-cell autocrine secretion and has long been considered to be closely related to immune response. With the advance in neuroinflammation theory and immunology research on schizophrenia, it is interesting and meaningful to discuss the possible role of IL-2 in schizophrenia. Here, we reviewed a series of studies published from the 1990s and found that IL-2 was closely associated with schizophrenia. For example, IL-2 is responsible for mediating toxic reactions, which are the causes of schizophrenia symptoms in patients, and such symptoms resolve after discontinuation of the drug. In addition, we focused on the changes of IL-2 in the onset, progression and treatment of schizophrenia and the possible mechanisms by which IL-2 affects schizophrenia. Our review suggests that IL-2 is associated with schizophrenia and plays a role in its pathogenesis, and progression IL-2 and sIL-2R could serve as potential biomarkers of schizophrenia.
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17
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Zhao J, Diao J, Li X, Yang Y, Yao Y, Shi S, Yuan X, Liu H, Zhang K. Gender Differences in Psychiatric Symptoms and the Social Functioning of 610 Patients with Schizophrenia in Urban China: A 10-Year Follow-Up Study. Neuropsychiatr Dis Treat 2022; 18:1545-1551. [PMID: 35923298 PMCID: PMC9342654 DOI: 10.2147/ndt.s373923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/21/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To explore the different outcomes between male and female patients with schizophrenia after long-term follow-up. PATIENTS AND METHODS Schizophrenia patients were participants in our study. First, two senior psychiatrists collected data on the demographic characteristics and clinical symptoms of patients from the Hospital Information System between February 2009 and January 2010. Second, two other senior psychiatrists called the patients and their guardians between February 2019 and January 2020 to get general information on the patients and assess their psychiatric symptoms and social functioning using the Positive and Negative Syndrome Scale (PANSS) and the Personal and Social Performance (PSP) scale. RESULTS Of the 610 participants, the 306 female participants were younger (48.32 ± 12.99 vs 49.84 ± 12.60) and had received more education (8.08 ± 3.76 vs 7.94 ±3 0.73). After 10 years, women were found to have more outpatient visits than men (20.86 ± 22.21 vs 16.11 ± 16.87, P < 0.05). However, there was no significant gender difference in number of hospitalizations (3.12 ± 5.34 vs 2.77 ± 5.84, P > 0.05). The PANSS scores were lower for both groups at the 10-year follow-up. Women had significantly lower scores than men after the 10-year period (P < 0.05). With regard to social functioning, there was a significant difference in social functioning between baseline scores and 10-year follow-up scores indicating an improvement in social functioning. PSP scores had significantly increased in women (P < 0.01) but not in men (P > 0.05). CONCLUSION Female patients had significantly lower levels of psychiatric symptoms and higher levels of social functioning at 10-year follow-up than male patients. They also reported more outpatient visits, which may have contributed to the gender differences in outcomes. Family members and doctors of patients should urge patients to make regular outpatient visits for better outcomes after hospitalization.
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Affiliation(s)
- Jintao Zhao
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, People's Republic of China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, People's Republic of China
| | - Jian Diao
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, People's Republic of China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, People's Republic of China
| | - Xiaoyue Li
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, People's Republic of China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, People's Republic of China
| | - Yating Yang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, People's Republic of China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, People's Republic of China
| | - Yitan Yao
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, People's Republic of China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, People's Republic of China
| | - Shengya Shi
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, People's Republic of China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, People's Republic of China
| | - Xiaoping Yuan
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, People's Republic of China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, People's Republic of China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, People's Republic of China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, People's Republic of China
| | - Kai Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, People's Republic of China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, People's Republic of China
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18
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Koricanac A, Tomic Lucic A, Veselinovic M, Bazic Sretenovic D, Bucic G, Azanjac A, Radmanovic O, Matovic M, Stanojevic M, Jurisic Skevin A, Simovic Markovic B, Pantic J, Arsenijevic N, Radosavljevic GD, Nikolic M, Zornic N, Nesic J, Muric N, Radmanovic B. Influence of antipsychotics on metabolic syndrome risk in patients with schizophrenia. Front Psychiatry 2022; 13:925757. [PMID: 35958655 PMCID: PMC9357900 DOI: 10.3389/fpsyt.2022.925757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/30/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Many studies so far have shown that antipsychotic therapy may have an effect on the development of metabolic syndrome in patients diagnosed with schizophrenia. Our goal was to determine whether our respondents are at risk for developing metabolic syndrome and who is more predisposed to it. METHODS In a stable phase, 60 patients diagnosed with schizophrenia were equally divided into three groups according to the drug (risperidone, clozapine, and aripiprazole monotherapy). Control group had 20 healthy examinees. Patients were evaluated first using The Positive and Negative Syndrome Scale (PANSS). Prolactin, lipid status, glycemia, insulin, cytokine values (IL-33, TGF-β, and TNF-α) and C-reactive protein (CRP) were measured. Also, Body mass index (BMI), Homeostatic Model Assesment for Insulin Resistance (HOMA index), waist and hip circumference (WHR) and blood pressure (TA) measurement were performed in the study. RESULTS Patients treated with risperidone compared to healthy control subjects and aripiprazol group of patients had statistically significant difference in prolactin levels. In clozapine group compared to healthy control group values of HDL cholesterol and glucose level were statistically significant different. In aripiprazole group compared to healthy control group value of BMI was statistically significant different. Statistically significant correlations were found in TNF-α with glucose and HOMA index in risperidone treated patients and with BMI in clozapine group of patients; IL-33 with glucose in risperidone and with BMI in clozapine group of patients and TGF-β with glucose in risperidone group, with insulin and HOMA index in clozapine group and statistically significant negative correlation with LDL cholesterol in aripiprazole group of patients. CONCLUSION Patients on risperidone and clozapine therapy may be at greater risk of developing metabolic syndrome than patients treated with aripiprazole. Statistically significant difference in concentration of TNF-α and TGF-β was in the group of patients treated with risperidone compared to healthy control group.
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Affiliation(s)
- Aleksandra Koricanac
- Department of Internal Medicine, General Hospital Kraljevo, Kraljevo, Serbia.,Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Aleksandra Tomic Lucic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.,Clinic for Rheumatology and Allergology, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Mirjana Veselinovic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.,Clinic for Rheumatology and Allergology, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Danijela Bazic Sretenovic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.,Clinic for Rheumatology and Allergology, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Gorica Bucic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.,Clinic for Rheumatology and Allergology, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Anja Azanjac
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.,Clinic for Rheumatology and Allergology, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Olivera Radmanovic
- Clinic for Rheumatology and Allergology, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Mirjana Matovic
- Department of Internal Medicine, General Hospital Kraljevo, Kraljevo, Serbia.,Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Marijana Stanojevic
- Department of Biochemistry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.,Department of Laboratory Diagnostics, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Aleksandra Jurisic Skevin
- Department of Physical Medicine and Rehabilitation, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Bojana Simovic Markovic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Jelena Pantic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Nebojša Arsenijevic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Gordana D Radosavljevic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Maja Nikolic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Nenad Zornic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.,Department for Anesthesiology and Reanimation, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Jelena Nesic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.,Clinic for Endocrinology, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Nemanja Muric
- Department of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.,Psychiatry Clinic, University Clinical Center Kragujevac, Kragujevac, Serbia
| | - Branimir Radmanovic
- Department of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.,Psychiatry Clinic, University Clinical Center Kragujevac, Kragujevac, Serbia
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