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Almulla AF, Vasupanrajit A, Tunvirachaisakul C, Al-Hakeim HK, Solmi M, Verkerk R, Maes M. The tryptophan catabolite or kynurenine pathway in schizophrenia: meta-analysis reveals dissociations between central, serum, and plasma compartments. Mol Psychiatry 2022; 27:3679-3691. [PMID: 35422466 DOI: 10.1038/s41380-022-01552-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/19/2022] [Accepted: 03/25/2022] [Indexed: 02/08/2023]
Abstract
The tryptophan catabolite (TRYCAT) pathway is implicated in the pathophysiology of schizophrenia (SCZ) since the rate-limiting enzyme indoleamine-dioxygenase (IDO) may be induced by inflammatory and oxidative stress mediators. This systematic review searched PubMed, Web of Science, and Google Scholar for papers published from inception until August 2021 and meta-analyzed the association between SCZ and TRYCATs in the central nervous system (CNS) and peripheral blood. We included 61 studies comprising 2813 patients and 2948 healthy controls. In the CNS we found a significant (p < 0.001) increase in the kynurenine/tryptophan (KYN/TRP) (standardized mean difference, SMD = 0.769, 95% confidence interval, CI: 0.456; 1.082) and kynurenic acid (KA)/KYN + TRP (SMD = 0.697, CI: 0.478-0.917) ratios, KA (SMD = 0.646, CI: 0.422; 0.909) and KYN (SMD = 1.238; CI: 0.590; 1.886), while the 3OH-kynurenine (3HK) + KYN-3-monooxygenase (KMO)/KYN ratio was significantly reduced (SMD = -1.089, CI: -1.682; -0.496). There were significant differences between KYN/TRP, (KYN + KA)/TRP, (3HK + KMO)/KYN, KA, and KYN levels among the CNS and peripheral blood, and among serum and plasma KYN. The only useful peripheral marker of CNS TRYCATs findings was the increased KYN/TRP ratio in serum (SMD = 0.211, CI: 0.056; 0.366, p = 0.007), but not in plasma. There was no significant increase in a neurotoxic composite score based on KYN, 3HK, and picolinic, xanthurenic, and quinolinic acid. SCZ is accompanied by increased IDO activity in the CNS and serum, and reduced KMO activity and a shift towards KA production in the CNS. This CNS TRYCATs profile indicates neuroprotective, negative immunoregulatory and anti-inflammatory effects. Peripheral blood levels of TRYCATs are dissociated from CNS findings except for a modest increase in serum IDO activity.
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Affiliation(s)
- Abbas F Almulla
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Medical Laboratory Technology Department, College of Medical Technology, The Islamic University, Najaf, Iraq
| | - Asara Vasupanrajit
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | | | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.,Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada.,Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada
| | - Robert Verkerk
- Laboratory of Medical Biochemistry, University of Antwerp, Antwerp, Belgium
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. .,Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria. .,Department of Psychiatry, IMPACT Strategic Research Centre, Deakin University, Geelong, VIC, Australia.
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2
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Kaddah MMY, Ali HM, Hammad SF, El-Malla SF. New quantification method for monitoring eighteen L-amino acids levels in schizophrenic patients by high-performance liquid chromatography coupled to tandem quadrupole mass spectrometer. Biomed Chromatogr 2022; 36:e5472. [PMID: 35906747 DOI: 10.1002/bmc.5472] [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: 04/25/2022] [Revised: 07/07/2022] [Accepted: 07/26/2022] [Indexed: 11/07/2022]
Abstract
A fast, uncomplicated, sensitive, and fully validated high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method has been developed for estimating L-amino acids in the plasma of schizophrenic patients. The gradient-elution chromatographic method was implemented with the Luna® PFP column (50 × 2.0 mm, 5-μm), and a mobile phase of 0.1% formic acid in water and methanol was used. The intraday and interday variability of the L-amino acids were less than 13.11%, and their accuracy ranged from 85.14 - 116.75% at the quality control levels and the lower limit of quantification (LLOQ) ranged from 2.5 - 15 nM. The extraction efficiency (apparent recovery) of amino acids from healthy plasma was employed by spiking the plasma with standard amino acids at the quality control levels. Their percentage recoveries ranged from 80.4% to 119.94%. Our method has a short run time and fast sample preparation compared with existing methods, which are suffered from long preparative steps and/or time-consuming analysis, restricted reagents, and suboptimal performance characteristics presently available technologies. Therefore, the proposed HPLC-MS/MS method was effectively applied for monitoring the L-amino acids in the plasma of schizophrenic patients and healthy volunteers.
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Affiliation(s)
- Mohamed M Y Kaddah
- Pharmaceutical and Fermentation Industries Development Center, City of Scientific Research and Technological Applications, Alexandria, Egypt
| | - Heba M Ali
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Sherin F Hammad
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Samah F El-Malla
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, Tanta University, Tanta, Egypt
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3
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Karahalil B, Elkama A, Ak M, Nemutlu E. Metabolomics mapping changed after olanzapine therapy in drug-naive schizophrenia patients—the significant impact of gene polymorphisms. Toxicol Res (Camb) 2022; 11:547-556. [DOI: 10.1093/toxres/tfac034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/26/2022] [Accepted: 03/26/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Oxidative stress may contribute to the development of schizophrenia and antipsychotics used in schizophrenia treatment may also cause oxidative stress. Gene polymorphisms on antioxidant and repair enzymes are responsible for individual variations and may change the efficacy of olanzapine treatment among schizophrenia patients. In our study, we assessed oxidative stress-related metabolite changes due to genetic polymorphisms on first diagnosed-schizophrenia patients treated with olanzapine. Blood samples (n = 30 patients) were taken before treatment (T1), after 10 ± 1 days (T2), and after 3 ± 1 months (T3). T1 served as control for T2 and T3, since it is advantageous to perform on same patient to evaluate the impact of olanzapine only. GSTs (GSTM1, GSTT1, and GSTP1) and OGG1 gene polymorphisms were analyzed by polymerase chain reaction. Changes in metabolites were detected with metabolomics profiling by gas chromatography–mass spectrometry according to each genotype before and after treatment. Multivariate analysis showed that metabolomics profiles differed after olanzapine treatment regardless gene polymorphisms. Tryptophan could be a biomarker in response to olanzapine treatment since its levels were increased after treatment. GSTM1 gene polymorphism caused significant changes in some metabolites after treatment. Urea, palmitic acid, and caprylic acid levels increased and alanine levels decreased in patients with GSTM1 null genotypes after olanzapine. In future, targeted metabolomics with these prominent metabolites and assessing gene expressions of GSTs will be beneficial to understand the mechanism of action.
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Affiliation(s)
- Bensu Karahalil
- Department of Toxicology , Faculty of Pharmacy, Gazi University, Ankara 06330 , Turkey
| | - Aylin Elkama
- Department of Toxicology , Faculty of Pharmacy, Gazi University, Ankara 06330 , Turkey
| | - Mehmet Ak
- Department of Psychiatry , Meram Faculty of Medicine, Necmettin Erbakan University, Konya 42080 , Turkey
| | - Emirhan Nemutlu
- Department of Analytical Chemistry , Faculty of Pharmacy, Hacettepe University, Ankara 06230 , Turkey
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4
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Marx W, McGuinness AJ, Rocks T, Ruusunen A, Cleminson J, Walker AJ, Gomes-da-Costa S, Lane M, Sanches M, Diaz AP, Tseng PT, Lin PY, Berk M, Clarke G, O'Neil A, Jacka F, Stubbs B, Carvalho AF, Quevedo J, Soares JC, Fernandes BS. The kynurenine pathway in major depressive disorder, bipolar disorder, and schizophrenia: a meta-analysis of 101 studies. Mol Psychiatry 2021; 26:4158-4178. [PMID: 33230205 DOI: 10.1038/s41380-020-00951-9] [Citation(s) in RCA: 125] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/29/2020] [Accepted: 11/02/2020] [Indexed: 12/29/2022]
Abstract
The importance of tryptophan as a precursor for neuroactive compounds has long been acknowledged. The metabolism of tryptophan along the kynurenine pathway and its involvement in mental disorders is an emerging area in psychiatry. We performed a meta-analysis to examine the differences in kynurenine metabolites in major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SZ). Electronic databases were searched for studies that assessed metabolites involved in the kynurenine pathway (tryptophan, kynurenine, kynurenic acid, quinolinic acid, 3-hydroxykynurenine, and their associate ratios) in people with MDD, SZ, or BD, compared to controls. We computed the difference in metabolite concentrations between people with MDD, BD, or SZ, and controls, presented as Hedges' g with 95% confidence intervals. A total of 101 studies with 10,912 participants were included. Tryptophan and kynurenine are decreased across MDD, BD, and SZ; kynurenic acid and the kynurenic acid to quinolinic acid ratio are decreased in mood disorders (i.e., MDD and BD), whereas kynurenic acid is not altered in SZ; kynurenic acid to 3-hydroxykynurenine ratio is decreased in MDD but not SZ. Kynurenic acid to kynurenine ratio is decreased in MDD and SZ, and the kynurenine to tryptophan ratio is increased in MDD and SZ. Our results suggest that there is a shift in the tryptophan metabolism from serotonin to the kynurenine pathway, across these psychiatric disorders. In addition, a differential pattern exists between mood disorders and SZ, with a preferential metabolism of kynurenine to the potentially neurotoxic quinolinic acid instead of the neuroprotective kynurenic acid in mood disorders but not in SZ.
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Affiliation(s)
- Wolfgang Marx
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia.
| | - Amelia J McGuinness
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Tetyana Rocks
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Anu Ruusunen
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Jasmine Cleminson
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Adam J Walker
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Susana Gomes-da-Costa
- Bipolar and Depression Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Melissa Lane
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Marsal Sanches
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Alexandre P Diaz
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Ping-Tao Tseng
- Institute of Biomedical Sciences and Prospect Clinic for Otorhinolaryngology & Neurology, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Gerard Clarke
- Department of Psychiatry and Neurobehavioural Science and APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Adrienne O'Neil
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Felice Jacka
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - André F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - João Quevedo
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Jair C Soares
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Brisa S Fernandes
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA. .,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
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5
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Cao B, Chen Y, Ren Z, Pan Z, McIntyre RS, Wang D. Dysregulation of kynurenine pathway and potential dynamic changes of kynurenine in schizophrenia: A systematic review and meta-analysis. Neurosci Biobehav Rev 2021; 123:203-214. [PMID: 33513412 DOI: 10.1016/j.neubiorev.2021.01.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 12/26/2022]
Abstract
The kynurenine (KYN) pathway is postulated to play various roles in immune system dysregulation of schizophrenia (SCZ). We conducted a meta-analysis to explore the association between six key metabolites of KYN pathway (i.e., tryptophan (TRP), KYN, quinolinic acid (QUIN), and kynurenic acid (KYNA)) and SCZ. Priori Bonferroni adjustments were conducted for multiple comparisons. In total, 42 studies that examined the relationship between the metabolites in KYN pathway mentioned above and SCZ in 4217 participants and nine studies that examined alterations of these metabolites after antipsychotic treatments were included. The results demonstrate that (1) subjects with prescribed medication had significantly higher KYN levels when compared to controls; (2) higher KYN levels in cerebrospinal fluid (CSF), lower plasma KYN levels and higher CSF KYNA levels were associated with SCZ; (3) the KYN levels were higher in subjects with SCZ after antipsychotic treatments when compared with baseline. The evidence provides valuable insight of the potential underlying involvement of the KYN pathway in the pathogenesis of SCZ.
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Affiliation(s)
- Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University (SWU), Chongqing, 400715, PR China; National Demonstration Center for Experimental Psychology Education (Southwest University), Chongqing, PR China.
| | - Yan Chen
- Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON, Canada
| | - Zhongyu Ren
- College of Physical Education, Southwest University, Chongqing, PR China
| | - Zihang Pan
- Duke-NUS Medical School, Singapore, Singapore; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada; Department of Pharmacology, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Dongfang Wang
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China; Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China.
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6
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Postolache TT, Wadhawan A, Rujescu D, Hoisington AJ, Dagdag A, Baca-Garcia E, Lowry CA, Okusaga OO, Brenner LA. Toxoplasma gondii, Suicidal Behavior, and Intermediate Phenotypes for Suicidal Behavior. Front Psychiatry 2021; 12:665682. [PMID: 34177652 PMCID: PMC8226025 DOI: 10.3389/fpsyt.2021.665682] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/30/2021] [Indexed: 12/27/2022] Open
Abstract
Within the general literature on infections and suicidal behavior, studies on Toxoplasma gondii (T. gondii) occupy a central position. This is related to the parasite's neurotropism, high prevalence of chronic infection, as well as specific and non-specific behavioral alterations in rodents that lead to increased risk taking, which are recapitulated in humans by T. gondii's associations with suicidal behavior, as well as trait impulsivity and aggression, mental illness and traffic accidents. This paper is a detailed review of the associations between T. gondii serology and suicidal behavior, a field of study that started 15 years ago with our publication of associations between T. gondii IgG serology and suicidal behavior in persons with mood disorders. This "legacy" article presents, chronologically, our primary studies in individuals with mood disorders and schizophrenia in Germany, recent attempters in Sweden, and in a large cohort of mothers in Denmark. Then, it reviews findings from all three meta-analyses published to date, confirming our reported associations and overall consistent in effect size [ranging between 39 and 57% elevation of odds of suicide attempt in T. gondii immunoglobulin (IgG) positives]. Finally, the article introduces certain links between T. gondii and biomarkers previously associated with suicidal behavior (kynurenines, phenylalanine/tyrosine), intermediate phenotypes of suicidal behavior (impulsivity, aggression) and state-dependent suicide risk factors (hopelessness/dysphoria, sleep impairment). In sum, an abundance of evidence supports a positive link between suicide attempts (but not suicidal ideation) and T. gondii IgG (but not IgM) seropositivity and serointensity. Trait impulsivity and aggression, endophenotypes of suicidal behavior have also been positively associated with T. gondii seropositivity in both the psychiatrically healthy as well as in patients with Intermittent Explosive Disorder. Yet, causality has not been demonstrated. Thus, randomized interventional studies are necessary to advance causal inferences and, if causality is confirmed, to provide hope that an etiological treatment for a distinct subgroup of individuals at an increased risk for suicide could emerge.
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Affiliation(s)
- Teodor T Postolache
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States.,Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, United States.,Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD, United States
| | - Abhishek Wadhawan
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Psychiatry, Saint Elizabeth's Hospital, Washington, DC, United States
| | - Dan Rujescu
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Halle, Halle, Germany
| | - Andrew J Hoisington
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, United States.,Department of Systems Engineering and Management, Air Force Institute of Technology, Dayton, OH, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Aline Dagdag
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Enrique Baca-Garcia
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain.,Department of Psychiatry, Madrid Autonomous University, Madrid, Spain.,Department of Psychiatry, Rey Juan Carlos University Hospital, Móstoles, Spain.,Department of Psychiatry, General Hospital of Villalba, Madrid, Spain.,Department of Psychiatry, Infanta Elena University Hospital, Valdemoro, Spain.,Universidad Catolica del Maule, Talca, Chile.,Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | - Christopher A Lowry
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States.,Department of Integrative Physiology, Center for Neuroscience, Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, United States
| | - Olaoluwa O Okusaga
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States.,Michael E DeBakey VA Medical Center, Houston, TX, United States
| | - Lisa A Brenner
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States.,Department of Psychiatry & Neurology, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
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7
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Parksepp M, Leppik L, Koch K, Uppin K, Kangro R, Haring L, Vasar E, Zilmer M. Metabolomics approach revealed robust changes in amino acid and biogenic amine signatures in patients with schizophrenia in the early course of the disease. Sci Rep 2020; 10:13983. [PMID: 32814830 PMCID: PMC7438522 DOI: 10.1038/s41598-020-71014-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 08/04/2020] [Indexed: 02/06/2023] Open
Abstract
The primary objective of this study was to evaluate how schizophrenia (SCH) spectrum disorders and applied antipsychotic (AP) treatment affect serum level of amino acids (AAs) and biogenic amines (BAs) in the early course of the disorder. We measured 21 different AAs and 10 BAs in a sample of antipsychotic (AP)-naïve first-episode psychosis (FEP) patients (n = 52) at baseline, after 0.6-year as well as after 5.1-year treatment compared to control subjects (CSs, n = 37). Serum levels of metabolites were determined with AbsoluteIDQ p180 kit using flow injection analysis tandem mass spectrometry and liquid chromatography technique. Elevated level of taurine and reduced level of proline and alpha-aminoadipic acid (alpha-AAA) were established as metabolites with significant change in AP-naïve FEP patients compared to CSs. The following 0.6-year treatment restored these alterations. However, further continuous 5.1-year AP treatment changed the metabolic profile substantially. Significantly elevated levels of asparagine, glutamine, methionine, ornithine and taurine, alongside with decreased levels of aspartate, glutamate and alpha-AAA were observed in the patient group compared to CSs. These biomolecule profile alterations provide further insights into the pathophysiology of SCH spectrum disorders and broaden our understanding of the impact of AP treatment in the early stages of the disease.
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Affiliation(s)
- Madis Parksepp
- Department of Psychiatry, Institute of Clinical Medicine, University of Tartu, 31 Raja Street, 50417, Tartu, Estonia
- Psychiatry Clinic of Viljandi Hospital, 6 Pargi tee Street, 71024, Viljandi County, Estonia
| | - Liisa Leppik
- Psychiatry Clinic of Viljandi Hospital, 6 Pargi tee Street, 71024, Viljandi County, Estonia
| | - Kadri Koch
- Psychiatry Clinic of Tartu University Hospital, 31 Raja Street, 50417, Tartu, Estonia
| | - Kärt Uppin
- Psychiatry Clinic of Tartu University Hospital, 31 Raja Street, 50417, Tartu, Estonia
| | - Raul Kangro
- Institute of Mathematics and Statistics, University of Tartu, 18 Narva mnt, 51009, Tartu, Estonia
| | - Liina Haring
- Department of Psychiatry, Institute of Clinical Medicine, University of Tartu, 31 Raja Street, 50417, Tartu, Estonia.
- Psychiatry Clinic of Tartu University Hospital, 31 Raja Street, 50417, Tartu, Estonia.
- Institute of Biomedicine and Translational Medicine, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, 19 Ravila Street, 50411, Tartu, Estonia.
| | - Eero Vasar
- Institute of Biomedicine and Translational Medicine, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, 19 Ravila Street, 50411, Tartu, Estonia
| | - Mihkel Zilmer
- Institute of Biomedicine and Translational Medicine, Centre of Excellence for Genomics and Translational Medicine, University of Tartu, 19 Ravila Street, 50411, Tartu, Estonia
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8
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Peng X, Brenner LA, Mathai AJ, Cook TB, Fuchs D, Postolache N, Groer MW, Pandey JP, Mohyuddin F, Giegling I, Wadhawan A, Hartmann AM, Konte B, Brundin L, Friedl M, Stiller JW, Lowry CA, Rujescu D, Postolache TT. Moderation of the relationship between Toxoplasma gondii seropositivity and trait impulsivity in younger men by the phenylalanine-tyrosine ratio. Psychiatry Res 2018; 270:992-1000. [PMID: 30057257 PMCID: PMC6371810 DOI: 10.1016/j.psychres.2018.03.045] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 12/23/2017] [Accepted: 03/20/2018] [Indexed: 11/27/2022]
Abstract
Previously, we reported that Toxoplasma gondii (T. gondii)-seropositivity is associated with higher impulsive sensation seeking in younger men. As dopaminergic and serotonergic signaling regulate impulsivity, and as T. gondii directly and indirectly affects dopaminergic signaling and induces activation of the kynurenine pathway leading to the diversion of tryptophan from serotonin production, we investigated if dopamine and serotonin precursors or the tryptophan metabolite kynurenine interact with the T. gondii-impulsivity association. In 950 psychiatrically healthy participants, trait impulsivity scores were related to T. gondii IgG seropositivity. Interactions were also identified between categorized levels of phenylalanine (Phe), tyrosine (Tyr), Phe:Tyr ratio, kynurenine (Kyn), tryptophan (Trp) and Kyn:Trp ratio, and age and gender. Only younger T. gondii-positive men with a high Phe:Tyr ratio, were found to have significantly higher impulsivity scores. There were no significant associations in other demographic groups, including women and older men. No significant effects or interactions were identified for Phe, Tyr, Kyn, Trp, or Kyn:Trp ratio. Phe:Tyr ratio, therefore, may play a moderating role in the association between T. gondii seropositivity and impulsivity in younger men. These results could potentially lead to individualized approaches to reduce impulsivity, based on combined demographic, biochemical and serological factors.
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Affiliation(s)
- Xiaoqing Peng
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA,Saint Elizabeths Hospital, Psychiatry Residency Training Program, Washington, DC, USA
| | - Lisa A. Brenner
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Denver, CO, USA,University of Colorado Anschutz Medical Campus, Departments of Psychiatry, Physical Medicine and Rehabilitation, and Neurology, Denver, CO, USA,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE). Denver, CO, USA
| | - Ashwin J. Mathai
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA,Saint Elizabeths Hospital, Psychiatry Residency Training Program, Washington, DC, USA
| | - Thomas B. Cook
- Department of Public Health & Mercyhurst Institute for Public Health, Mercyhurst University, Erie, PA, USA
| | - Dietmar Fuchs
- Division of Biological Chemistry, Biocenter, Innsbruck Medical University, Innsbruck, Austria
| | - Nadine Postolache
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Janardan P. Pandey
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA
| | - Farooq Mohyuddin
- Saint Elizabeths Hospital, Psychiatry Residency Training Program, Washington, DC, USA
| | - Ina Giegling
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - Abhishek Wadhawan
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA,Saint Elizabeths Hospital, Psychiatry Residency Training Program, Washington, DC, USA
| | - Annette M. Hartmann
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - Bettina Konte
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - Lena Brundin
- Division of Psychiatry and Behavioral Medicine, College of Human Medicine, Michigan State University and the Van Andel Research Institute, Grand Rapids, MI, USA
| | - Marion Friedl
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - John W. Stiller
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA,Saint Elizabeths Hospital, Psychiatry Residency Training Program, Washington, DC, USA
| | - Christopher A. Lowry
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Denver, CO, USA,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE). Denver, CO, USA,Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA,Department of Physical Medicine and Rehabilitation and Center for Neuroscience, University of Colorado Anschutz Medical Campus, Denver, CO, USA
| | - Dan Rujescu
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - Teodor T. Postolache
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA,Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Denver, CO, USA,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE). Denver, CO, USA,VA Capitol Health Care Network, Mental Illness Research, Education and Clinical Center (VISN 5 MIRECC), Baltimore, MD, USA,Correspondent author. (T.T. Postolache)
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9
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Leppik L, Kriisa K, Koido K, Koch K, Kajalaid K, Haring L, Vasar E, Zilmer M. Profiling of Amino Acids and Their Derivatives Biogenic Amines Before and After Antipsychotic Treatment in First-Episode Psychosis. Front Psychiatry 2018; 9:155. [PMID: 29740359 PMCID: PMC5928450 DOI: 10.3389/fpsyt.2018.00155] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 04/06/2018] [Indexed: 12/13/2022] Open
Abstract
Schizophrenia (SCH) is a heterogeneous disorder, deriving from a potential multitude of etiopathogenetic factors. During the past few years there has been an increasing interest in the role of circulating amino acids (AAs) and biogenic amines (BAs) in the pathophysiology of SCH. In the present study, we aimed to provide an insight into the potential role of alterations in levels of AAs and BAs as well as examine their more specific metabolic shifts in relation to early stage of SCH. We measured 21 AAs and 17 BAs in serum samples of patients with first-episode psychosis (FEP) before and after 7-month antipsychotic treatment in comparison to control subjects (CSs). According to multivariate analysis, antipsychotic-naïve FEP patients had significantly higher levels of taurine and spermine, whereas values of proline (Pro), alpha-aminoadipic acid (alpha-AAA), kynurenine (Kyn), valine (Val), tyrosine (Tyr), citrulline (Citr), tryptophan (Trp), and histidine (His) were diminished compared to CSs. Increased levels of taurine and spermine, as well as reduced levels of alpha-AAA and Kyn probably reflect the compromised function of N-methyl-D-aspartate (NMDA) receptors in patients. The decreased levels of Pro (AA modulating the function of glutamate decarboxylase) likely reflect the imbalanced function of gamma-aminobutyric acid (GABA) system in the brain of FEP patients. The alterations in ratio between Tyr and phenylalanine (Phe) can be taken as a sign of compromised function of dopaminergic system. These metabolic shifts were reinstated by 7-month antipsychotic treatment. Serum metabolic profiles can be regarded as important indicators to investigate clinical course of SCH and treatment response.
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Affiliation(s)
- Liisa Leppik
- Department of Physiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
- Psychiatry Clinic of Tartu University Hospital, Tartu, Estonia
| | - Kärt Kriisa
- Department of Biochemistry, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Kati Koido
- Department of Physiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Kadri Koch
- Department of Physiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
- Psychiatry Clinic of Tartu University Hospital, Tartu, Estonia
| | - Kärolin Kajalaid
- Department of Physiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
- Psychiatry Clinic of Tartu University Hospital, Tartu, Estonia
| | - Liina Haring
- Department of Physiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
- Psychiatry Clinic of Tartu University Hospital, Tartu, Estonia
| | - Eero Vasar
- Department of Physiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Mihkel Zilmer
- Department of Biochemistry, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
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10
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Teraishi T, Kajiwara M, Hori H, Sasayama D, Hidese S, Matsuo J, Ishida I, Kajiwara Y, Ozeki Y, Ota M, Hattori K, Higuchi T, Kunugi H. 13C-phenylalanine breath test and serum biopterin in schizophrenia, bipolar disorder and major depressive disorder. J Psychiatr Res 2018; 99:142-150. [PMID: 29454221 DOI: 10.1016/j.jpsychires.2018.01.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 12/23/2017] [Accepted: 01/26/2018] [Indexed: 10/18/2022]
Abstract
Phenylalanine is required for the synthesis of the neurotransmitters dopamine, noradrenaline, and adrenaline. The rate-limiting step for phenylalanine metabolism is catalyzed by phenylalanine hydroxylase (PAH) and its cofactor tetrahydrobiopterin. We aimed to detect altered phenylalanine metabolism in major psychiatric disorders using the l-[1-13C]phenylalanine breath test (13C-PBT) and serum biopterin levels. We also investigated association of PAH mutations with schizophrenia and phenylalanine metabolism. 13C-phenylalanine (100 mg) was orally administered, and the breath 13CO2/12CO2 ratio was monitored for 120 min in four groups: 103 patients with schizophrenia (DSM-IV), 39 with bipolar disorder, 116 with major depressive disorder (MDD), and 241 healthy controls. Serum biopterin levels were measured by high performance liquid chromatography. Mutation screening of PAH exons was performed by direct sequencing in 46 schizophrenia patients. Association analysis was performed using six tag single nucleotide polymorphisms and the PAH Arg53His mutation by TaqMan assays in 616 schizophrenia patients and 1194 healthy controls. Analyses of covariance controlling for age, sex, and body weight showed that the index for the amount of exhaled 13CO2 was significantly lower in the schizophrenia group than in the other three groups (all p < 0.05). Biopterin levels in schizophrenia and MDD were significantly lower than those in controls. Biopterin levels correlated with 13C-PBT indices in controls. PAH polymorphisms were not associated with schizophrenia or 13C-PBT indices. 13C-PBT revealed reduced phenylalanine metabolism in schizophrenia, though we obtained no evidence of involvement of PAH polymorphism. Serum biopterin levels were lower in schizophrenia and MDD, warranting further investigation.
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Affiliation(s)
- Toshiya Teraishi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8502, Japan
| | - Masahiro Kajiwara
- Yokohama University of Pharmacy, 601 Matano-cho, Totsuka-ku, Yokohama, Kanagawa, 245-0066, Japan; Tri-X Biomedical, Inc., 4-12-5-406, Minamiyawata, Ichikawa, Chiba, 272-0023, Japan
| | - Hiroaki Hori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8502, Japan
| | - Daimei Sasayama
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8502, Japan
| | - Shinsuke Hidese
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8502, Japan
| | - Junko Matsuo
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8502, Japan
| | - Ikki Ishida
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8502, Japan
| | - Yasuhiro Kajiwara
- Yokohama University of Pharmacy, 601 Matano-cho, Totsuka-ku, Yokohama, Kanagawa, 245-0066, Japan
| | - Yuji Ozeki
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8502, Japan; Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, 321-0293, Japan
| | - Miho Ota
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8502, Japan
| | - Kotaro Hattori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8502, Japan
| | - Teruhiko Higuchi
- National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8551, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8502, Japan.
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11
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Mathai AJ, Lowry CA, Cook TB, Brenner LA, Brundin L, Groer MW, Peng X, Giegling I, Hartmann AM, Konte B, Friedl M, Fuchs D, Rujescu D, Postolache TT. Reciprocal moderation by Toxoplasma gondii seropositivity and blood phenylalanine - tyrosine ratio of their associations with trait aggression. Pteridines 2016; 27:77-85. [PMID: 28943719 DOI: 10.1515/pterid-2016-0006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
We previously reported that trait aggression, proposed as an endophenotype for suicidal behavior, is positively associated with Toxoplasma gondii (T. gondii) seropositivity in females, but not in males. Additionally, older males seropositive for T. gondii had lower scores on measures of trait aggression, including self-aggression. Trait aggression may be influenced by dopaminergic signaling, which is known to be moderated by gender and age, and potentially enhanced in T. gondii positives through the intrinsic production of dopamine by the microorganism. Therefore, we investigated associations between trait aggression and interactions between T. gondii enzyme-linked immunoabsorbant assay (ELISA) IgG titer-determined seropositivity and high-performance liquid chromatography- (HPLC-) measured blood levels of dopamine precursors phenylalanine (Phe), tyrosine (Tyr), and their ratio in a sample of 1000 psychiatrically healthy participants. Aggressive traits were assessed using the questionnaire for measuring factors of aggression (FAF), the German version of the Buss-Durkee hostility questionnaire. We found that 1) the decrease in trait aggression scores in T. gondii-positive older males was only present in individuals with a low Phe:Tyr ratio, and 2) that there was a positive correlation between Phe:Tyr ratio and total aggression and selected subscales of aggression in T. gondii-positive males, but not in T. gondii-negative males. These findings point toward a gender-specific reciprocal moderation by Phe:Tyr ratio and T. gondii seropositivity of their associations with aggression scores, and lead to experimental interventions geared to manipulating levels of dopamine precursors in selected T. gondii positive individuals with increased propensity for aggression.
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Affiliation(s)
- Ashwin Jacob Mathai
- Mood and Anxiety Program, University of Maryland School of Medicine, 685 West Baltimore Street, MSTF Building, Baltimore, MD 21201, USA; and Saint Elizabeths Hospital-DBH Psychiatry Residency Training Program, Washington DC, USA
| | - Christopher A Lowry
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA; Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Denver, CO, USA; Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO, USA; and University of Colorado, Anschutz Medical Campus, Department of Physical Medicine and Rehabilitation, and Center for Neuroscience, Aurora, CO, USA
| | - Thomas B Cook
- Department of Public Health and Mercyhurst Institute for Public Health, Mercyhurst University, Erie, PA, USA
| | - Lisa A Brenner
- Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO, USA; Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Denver, CO, USA; and University of Colorado, Anschutz Medical Campus, Departments of Psychiatry, Physical Medicine and Rehabilitation, and Neurology, Aurora, CO, USA
| | - Lena Brundin
- Van Andel Research Institute, Grand Rapids, MI, USA
| | | | - Xiaoqing Peng
- Mood and Anxiety Program, University of Maryland School of Medicine, 685 West Baltimore Street, MSTF Building, Baltimore, MD 21201, USA; and Saint Elizabeths Hospital-DBH Psychiatry Residency Training Program, Washington DC, USA
| | - Ina Giegling
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - Annette M Hartmann
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - Bettina Konte
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - Marion Friedl
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - Dietmar Fuchs
- Division of Biological Chemistry, Biocenter, Innsbruck Medical University, Innsbruck, Austria
| | - Dan Rujescu
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - Teodor T Postolache
- Mood and Anxiety Program, University of Maryland School of Medicine, 685 West Baltimore Street, MSTF Building, Baltimore, MD 21201, USA; Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO, USA; Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Denver, CO, USA; and VISN 5 Capitol Health Care Network Mental Illness Research Education and Clinical Center (MIRECC), Baltimore, MD, USA
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12
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Mathai AJ, Kanwar J, Okusaga O, Fuchs D, Lowry CA, Peng X, Giegling I, Hartmann AM, Konte B, Friedl M, Gragnoli C, Reeves GM, Groer MW, Rosenthal RN, Rujescu D, Postolache TT. Blood Levels of Monoamine Precursors and Smoking in Patients with Schizophrenia. Front Public Health 2016; 4:182. [PMID: 27626030 PMCID: PMC5003942 DOI: 10.3389/fpubh.2016.00182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 08/15/2016] [Indexed: 01/08/2023] Open
Abstract
Smoking is highly prevalent in patients with schizophrenia and exerts a negative impact on cardiovascular mortality in these patients. Smoking has complex interactions with monoamine metabolism through the ability of cigarette smoke to suppress Type 1 T helper cell (Th1) type immunity, the immunophenotype that is implicated in phenylalanine hydroxylase (PAH) dysfunction and tryptophan (Trp) breakdown to kynurenine (Kyn) via indoleamine 2,3-dioxygenase. Nicotine also induces tyrosine hydroxylase (TH) gene expression, leading to increased synthesis of catecholamines. Furthermore, there is evidence for PAH dysfunction in schizophrenia. This study aimed to compare the plasma levels of selected monoamine precursors and their metabolites in smokers vs. non-smokers in a large sample of patients with schizophrenia. We measured plasma phenylalanine (Phe), tyrosine (Tyr), Trp, and Kyn levels using high-performance liquid chromatography and calculated Phe:Tyr and Kyn:Trp ratios in 920 patients with schizophrenia. Analysis of variance and linear regression analyses were used to compare these endpoints between three groups of patients with schizophrenia: (1) current smokers, (2) past smokers, and (3) non-smokers. There were significant differences among the three groups with regards to Tyr levels [F(2,789) = 3.77, p = 0.02], with current smokers having lower Tyr levels when compared with non-smokers (p = 0.02). Kyn levels and Kyn:Trp ratio were different among the three groups [F(2,738) = 3.17, p = 0.04, F(2,738) = 3.61, p = 0.03] with current smokers having lower Kyn levels (p = 0.04) and higher Kyn:Trp ratio (p = 0.02) when compared with past smokers. These findings need to be replicated with protocols that include healthy controls to further elucidate the neurobiological underpinnings of altered Tyr and Kyn levels in smokers. Results do suggest potential molecular links between schizophrenia and smoking that may represent biomarkers and treatment targets for reducing an important modifiable cause of general morbidity and mortality in patients with schizophrenia.
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Affiliation(s)
- Ashwin Jacob Mathai
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA; Saint Elizabeths Hospital Psychiatry Residency Training Program, Washington, DC, USA
| | - Jyoti Kanwar
- Mood and Anxiety Program, University of Maryland School of Medicine , Baltimore, MD , USA
| | - Olaoluwa Okusaga
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dietmar Fuchs
- Division of Biological Chemistry, Biocenter Innsbruck Medical University , Innsbruck , Austria
| | - Christopher A Lowry
- Department of Integrative Physiology, Center for Neuroscience, University of Colorado Boulder , Boulder, CO , USA
| | - Xiaoqing Peng
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA; Saint Elizabeths Hospital Psychiatry Residency Training Program, Washington, DC, USA
| | - Ina Giegling
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg , Halle , Germany
| | - Annette M Hartmann
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg , Halle , Germany
| | - Bettina Konte
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg , Halle , Germany
| | - Marion Friedl
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg , Halle , Germany
| | - Claudia Gragnoli
- Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA; Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Gloria M Reeves
- Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA; University of Maryland Child and Adolescent Mental Health Innovations Center, Baltimore, MD, USA
| | | | - Richard N Rosenthal
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai , New York, NY , USA
| | - Dan Rujescu
- Department of Psychiatry, Martin-Luther-University of Halle-Wittenberg , Halle , Germany
| | - Teodor T Postolache
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA; VISN 5 Capitol Health Care Network Mental Illness Research Education and Clinical Center (MIRECC), Baltimore, MD, USA; Rocky Mountain MIRECC, Denver, CO, USA
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13
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Okusaga O, Muravitskaja O, Fuchs D, Ashraf A, Hinman S, Giegling I, Hartmann AM, Konte B, Friedl M, Schiffman J, Hong E, Reeves G, Groer M, Dantzer R, Rujescu D, Postolache TT. Elevated levels of plasma phenylalanine in schizophrenia: a guanosine triphosphate cyclohydrolase-1 metabolic pathway abnormality? PLoS One 2014; 9:e85945. [PMID: 24465804 PMCID: PMC3897774 DOI: 10.1371/journal.pone.0085945] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 12/04/2013] [Indexed: 02/07/2023] Open
Abstract
Background Phenylalanine and tyrosine are precursor amino acids required for the synthesis of dopamine, the main neurotransmitter implicated in the neurobiology of schizophrenia. Inflammation, increasingly implicated in schizophrenia, can impair the function of the enzyme Phenylalanine hydroxylase (PAH; which catalyzes the conversion of phenylalanine to tyrosine) and thus lead to elevated phenylalanine levels and reduced tyrosine levels. This study aimed to compare phenylalanine, tyrosine, and their ratio (a proxy for PAH function) in a relatively large sample of schizophrenia patients and healthy controls. Methods We measured non-fasting plasma phenylalanine and tyrosine in 950 schizophrenia patients and 1000 healthy controls. We carried out multivariate analyses to compare log transformed phenylalanine, tyrosine, and phenylalanine:tyrosine ratio between patients and controls. Results Compared to controls, schizophrenia patients had higher phenylalanine (p<0.0001) and phenylalanine: tyrosine ratio (p<0.0001) but tyrosine did not differ between the two groups (p = 0.596). Conclusions Elevated phenylalanine and phenylalanine:tyrosine ratio in the blood of schizophrenia patients have to be replicated in longitudinal studies. The results may relate to an abnormal PAH function in schizophrenia that could become a target for novel preventative and interventional approaches.
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Affiliation(s)
- Olaoluwa Okusaga
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Olesja Muravitskaja
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Dietmar Fuchs
- Division of Biological Chemistry, Biocenter Innsbruck Medical University, Innsbruck, Austria
| | - Ayesha Ashraf
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Sarah Hinman
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Ina Giegling
- Section of Molecular and Clinical Neurobiology, Ludwig Maximilians University, Munich, Germany
| | - Annette M. Hartmann
- Section of Molecular and Clinical Neurobiology, Ludwig Maximilians University, Munich, Germany
| | - Bettina Konte
- Section of Molecular and Clinical Neurobiology, Ludwig Maximilians University, Munich, Germany
| | - Marion Friedl
- Section of Molecular and Clinical Neurobiology, Ludwig Maximilians University, Munich, Germany
| | - Jason Schiffman
- Department of Psychology, University of Maryland, Baltimore, Maryland, United States of America
| | - Elliot Hong
- Maryland Psychiatric Research Center (MPRC), Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Gloria Reeves
- Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
- University of Maryland Child and Adolescent Mental Health Innovations Center, Baltimore, Maryland, United States of America
| | - Maureen Groer
- University of South Florida, Tampa, Florida, United States of America
| | - Robert Dantzer
- The University of Texas, MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Dan Rujescu
- Section of Molecular and Clinical Neurobiology, Ludwig Maximilians University, Munich, Germany
- Department of Psychiatry, University of Halle-Wittenberg, Halle, Germany
| | - Teodor T. Postolache
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
- University of Maryland Child and Adolescent Mental Health Innovations Center, Baltimore, Maryland, United States of America
- VISN 5 Capitol Health Care Network Mental Illness Research Education and Clinical Center (MIRECC), Baltimore, Maryland, United States of America
- VISN 19 MIRECC, Denver, Colorado, United States of America
- * E-mail:
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14
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Abstract
Phenylalanine is an essential amino acid required for the synthesis of catecholamines including dopamine. Altered levels of phenylalanine and its metabolites in blood and cerebrospinal fluid have been reported in schizophrenia patients. This study attempted to examine for the first time whether phenylalanine kinetics is altered in schizophrenia using L-[1-(13)C]phenylalanine breath test ((13)C-PBT). The subjects were 20 chronically medicated schizophrenia patients (DSM-IV) and the same number of age- and sex-matched controls. (13)C-phenylalanine (99 atom% (13)C; 100 mg) was administered orally and the breath (13)CO(2) /(12)CO(2) ratio was monitored for 120 min. The possible effect of antipsychotic medication (risperidone (RPD) or haloperidol (HPD) treatment for 21 days) on (13)C-PBT was examined in rats. Body weight (BW), age and diagnostic status were significant predictors of the area under the curve of the time course of Δ(13)CO(2) (‰) and the cumulative recovery rate (CRR) at 120 min. A repeated measures analysis of covariance controlled for age and BW revealed that the patterns of CRR change over time differed between the patients and controls and that Δ(13)CO(2) was lower in the patients than in the controls at all sampling time points during the 120 min test, with an overall significant difference between the two groups. Chronic administration of RPD or HPD had no significant effect on (13)C-PBT indices in rats. Our results suggest that (13)C-PBT is a novel laboratory test that can detect altered phenylalanine kinetics in chronic schizophrenia patients. Animal experiments suggest that the observed changes are unlikely to be attributable to antipsychotic medication.
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15
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De Luca V, Viggiano E, Messina G, Viggiano A, Borlido C, Viggiano A, Monda M. Peripheral amino Acid levels in schizophrenia and antipsychotic treatment. Psychiatry Investig 2008; 5:203-8. [PMID: 20046338 PMCID: PMC2796006 DOI: 10.4306/pi.2008.5.4.203] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Abnormal levels of amino acids have been reported in patients with schizophrenia and have also been investigated as a biomarker to monitor antipsychotic treatment, however results have been inconsistent. The purpose of the present review is to summarize the evidence in the literature of whether amino acid levels can be a biomarker and predict the treatment outcome in schizophrenia. The current review does not support amino acid concentration as a useful biomarker for monitoring antipsychotic response in patients with schizophrenia, although there is evidence that high levels of serum homocysteine and glutamate might be considered as a trait marker for schizophrenia. This review has also highlighted a considerable dearth of studies, specifically of studies evaluating antipsychotic side-effects.
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Affiliation(s)
- Vincenzo De Luca
- Department of Psychiatry, University of Toronto, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Section of Human Physiology 'Filippo Bottazzi', Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Emanuela Viggiano
- Section of Human Physiology 'Filippo Bottazzi', Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Giovanni Messina
- Section of Human Physiology 'Filippo Bottazzi', Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Alessandro Viggiano
- Section of Human Physiology 'Filippo Bottazzi', Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Carol Borlido
- Department of Psychiatry, University of Toronto, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Andrea Viggiano
- Department of Study of Institutions and Territorial Systems, University of Naples "Parthenope", Naples, Italy
| | - Marcellino Monda
- Section of Human Physiology 'Filippo Bottazzi', Department of Experimental Medicine, Second University of Naples, Naples, Italy
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Saude EJ, Lacy P, Musat-Marcu S, Mayes DC, Bagu J, Man SFP, Sykes BD, Moqbel R. NMR analysis of neutrophil activation in sputum samples from patients with cystic fibrosis. Magn Reson Med 2005; 52:807-14. [PMID: 15389932 DOI: 10.1002/mrm.20242] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Disorders of the respiratory system, such as cystic fibrosis (CF), involve the infiltration and activation of airway inflammatory cells, including neutrophils. This leads to the secretion of peroxidases, which react further with substrates in solution to produce oxidative metabolites, such as 3-chlorotyrosine. Elevated levels of modified tyrosine residues in the airways of patients with CF may be detectable by nuclear magnetic resonance (NMR) in correlation with inflammatory cell influx. In this study, high-resolution (500 MHz) 1H NMR was used to analyze the production of modified tyrosine residues resulting from in vitro stimulation of peripheral blood eosinophils and neutrophils, as well as in sputum samples from control subjects and patients with CF. Following in vitro stimulation, purified peripheral blood neutrophils generated 3-chlorotyrosine, while eosinophils produced predominantly 3-bromotyrosine and 3,5-dibromotyrosine. Chlorinated and brominated tyrosine residues were detected in sputum samples from patients with CF (N=7), but were not detected in the control group (N=9). Neutrophil counts in CF sputum correlated strongly with the presence of 3-chlorotyrosine (r2=0.869). Our findings indicate that neutrophil and eosinophil activation in CF is detectable by NMR. NMR may be a useful tool for the detection of biological markers of inflammatory processes in patient airways.
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Affiliation(s)
- Erik J Saude
- CIHR Group in Protein Structure and Function, Department of Biochemistry, University of Alberta, Alberta, Canada
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Wei J, Xu HM, Ramchand CN, Hemmings GP. Is the polymorphic microsatellite repeat of the dopamine beta-hydroxylase gene associated with biochemical variability of the catecholamine pathway in schizophrenia? Biol Psychiatry 1997; 41:762-7. [PMID: 9084894 DOI: 10.1016/s0006-3223(96)00218-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Six allelic fragments were typed by a polymerase chain reaction process with a pair of primers specific for a sequence containing the polymorphic (GT)n repeat, a microsatellite repeat, in the human dopamine beta-hydroxylase (DBH) gene. Their frequencies in unrelated patients with schizophrenia were 0.003 (A1), 0.114 (A2), 0.343 (A3), 0.526 (A4), 0.006 (A5), and 0.009 (A6), and in unrelated control subjects, 0.012 (A1), 0.086 (A2), 0.309 (A3), 0.574 (A4), 0.006 (A5), and 0.012 (A6). Kruskal-Wallis analysis revealed significant differences among the three groups, the drug-free and drug-treated patients, and the control subjects, in serum DBH activity of the subjects whose genotype was A2/A3 (H = 6.0, p < .05) or A3/A3 (H = 9.8, p < .01), in serum homovanillic acid concentration of those whose genotype was A3/A4 (H = 7.7, p < .025), and in serum tyrosine concentration of those whose genotype was A4/A4 (H = 8.3, p < .02). Mann-Whitney U test showed that in the subjects carrying the A3/A4 genotype, serum noradrenaline concentration of drug-treated patients was significantly higher than that of control subjects (N = 58, p < .02). These results suggest that genotypic polymorphism of the human DBH is likely to be associated with biochemical variability of the catecholamine pathway in schizophrenia.
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Affiliation(s)
- J Wei
- Institute of Biological Psychiatry, Schizophrenia Association of Great Britain, Bangor, Gwynedd, United Kingdom
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