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Cadenhead KS, Mirzakhanian H, Achim C, Reyes-Madrigal F, de la Fuente-Sandoval C. Peripheral and central biomarkers associated with inflammation in antipsychotic naïve first episode psychosis: Pilot studies. Schizophr Res 2024; 264:39-48. [PMID: 38091871 DOI: 10.1016/j.schres.2023.11.012] [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: 06/29/2023] [Revised: 09/26/2023] [Accepted: 11/28/2023] [Indexed: 03/01/2024]
Abstract
BACKGROUND Elevated serum pro-inflammatory molecules have been reported in early psychosis. What is not known is whether peripheral inflammatory biomarkers are associated with CNS biomarkers. In the brain, release of pro-inflammatory molecules by microglial hyperactivity may lead to neuronal apoptosis seen in neurodegenerative disorders and account for loss of brain tissue observed in psychotic disorders. Neurochemical changes, including elevated glutamate levels, are also associated with neuroinflammation, present in early psychosis and change with antipsychotic treatment. METHODS Antipsychotic naïve patients with first episode psychosis (FEP) were studied as part of a collaborative project of neuroinflammation. In Study 1 we explored associations between plasma inflammatory molecules and neurometabolites in the dorsal caudate using magnetic resonance spectroscopy (1H-MRS) in N = 13 FEP participants. Study 2 examined the relationship between inflammatory molecules in the Plasma and CSF in N = 20 FEP participants. RESULTS In Study 1, the proinflammatory chemokine MDC/CCL22 and IL10 were significantly positively correlated with Glutamate and Glx (glutamate + glutamine) levels in the dorsal caudate. In Study 2, plasma inflammatory molecules (MIP1β/CCL4, MCP1/CCL2, Eotaxin-1/CCL11 and TNFα) were significantly correlated with CSF MIP1β/CCL4, IL10, MCP1/CCL2 and Fractalkine/CX3CL1 and symptoms ratings. DISCUSSION Plasma inflammatory biomarkers are elevated in early psychosis, associated with neurochemical markers as well as CSF inflammatory molecules found in neurodegenerative disorders. Future studies are needed that combine both peripheral and central biomarkers in both FEP and HC to better understand a potential neuroinflammatory subtype of psychosis likely to respond to targeted interventions.
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Affiliation(s)
- Kristin S Cadenhead
- University of California San Diego (UCSD), 9500 Gilman Dr, La Jolla, CA 92093-0810, United States of America.
| | - Heline Mirzakhanian
- University of California San Diego (UCSD), 9500 Gilman Dr, La Jolla, CA 92093-0810, United States of America.
| | - Cristian Achim
- University of California San Diego (UCSD), 9500 Gilman Dr, La Jolla, CA 92093-0810, United States of America.
| | - Francisco Reyes-Madrigal
- Instituto Nacional de Neurología y Neurocirugía (INNN), Insurgentes Sur 3877, Tlalpan, 14269 Mexico City, Mexico.
| | - Camilo de la Fuente-Sandoval
- Instituto Nacional de Neurología y Neurocirugía (INNN), Insurgentes Sur 3877, Tlalpan, 14269 Mexico City, Mexico.
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2
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Çiftci H, Aşut G, Kaya H, Çakmak IB, Aydıner Yılmaz M, Çöpür A, Çalcı E, Fırat Oğuz E, Turhan T, Göka E. Neutrophil gelatinase-associated lipocalin (NGAL) and inflammatory markers in schizophrenia: A comparative analysis of drug-naive schizophrenia patients, remitted patients, and healthy controls. J Psychiatr Res 2024; 169:14-21. [PMID: 37995497 DOI: 10.1016/j.jpsychires.2023.11.006] [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: 07/04/2023] [Revised: 09/18/2023] [Accepted: 11/15/2023] [Indexed: 11/25/2023]
Abstract
This study aims to examine the plasma concentrations of NGAL and other inflammatory parameters, including TNF-α, IL-1β, and IFN-γ, in schizophrenia patients and healthy volunteers. It also investigates potential associations between these biomarkers and symptom severity in schizophrenia and the utility of NGAL as a potential diagnostic and monitoring biomarker for schizophrenia. The study included 49 drug-naive schizophrenia patients (DNS), 59 patients with schizophrenia in remission (REM) on antipsychotic treatment, and 58 healthy volunteers (HC). The Positive and Negative Symptoms Evaluation Scale (PANSS) was utilized to assess the severity of symptoms in schizophrenia patients. Plasma levels of TNF-α, IL-1β, IFN-γ, and NGAL were measured for all participants. NGAL levels were significantly lower in the DNS group than in HC. Significantly lower TNF-α levels were observed in both the DNS and REM groups compared to the HC group. Notably, a statistically significant positive correlation was detected between TNF-α and NGAL levels. The findings of this study are noteworthy, as they demonstrate that drug-naive individuals with schizophrenia exhibit significantly diminished levels of NGAL and TNF-α compared to healthy controls. These identified biomarkers hold promise for providing valuable insights into the complex and evolving pathophysiology of schizophrenia.
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Affiliation(s)
- Hatice Çiftci
- Department of Psychiatry, University of Health Sciences Ankara City Hospital, Ankara, Turkey.
| | - Gonca Aşut
- Department of Psychiatry, Baskent University Faculty of Medicine, Ankara, Turkey.
| | - Hasan Kaya
- Department of Psychiatry, University of Health Sciences Ankara City Hospital, Ankara, Turkey.
| | | | - Meltem Aydıner Yılmaz
- Department of Psychiatry, Samsun Mental Health and Dıseases Hospital, Samsun, Turkey
| | - Ahmet Çöpür
- Department of Psychiatry, University of Health Sciences Ankara Etlik City Hospital, Ankara, Turkey
| | - Esin Çalcı
- Department of Clinical Biochemistery, Uşak Public Health Laboratory, Uşak, Turkey
| | - Esra Fırat Oğuz
- Department of Clinical Biochemistery, University of Health Sciences Ankara City Hospital, Ankara, Turkey
| | - Turan Turhan
- Department of Clinical Biochemistery, University of Health Sciences Ankara City Hospital, Ankara, Turkey
| | - Erol Göka
- Department of Psychiatry, University of Health Sciences Ankara City Hospital, Ankara, Turkey.
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3
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Juckel G, Freund N. Microglia and microbiome in schizophrenia: can immunomodulation improve symptoms? J Neural Transm (Vienna) 2023; 130:1187-1193. [PMID: 36810627 PMCID: PMC10460707 DOI: 10.1007/s00702-023-02605-w] [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: 01/10/2023] [Accepted: 02/13/2023] [Indexed: 02/24/2023]
Abstract
In this overview, influences of microglia activation and disturbances of the microbiome in the devastating disorder schizophrenia are discussed. Despite previous assumptions of a primary neurodegenerative character of this disorder, current research underlines the important autoimmunological and inflammatory processes here. Early disturbances of microglial cells as well as cytokines could lead to weakness of the immunological system in the prodromal phase and then fully manifest in patients with schizophrenia. Measurements of microbiome features might allow identifying the prodromal phase. In conclusion, such thinking would imply several new therapeutic options regulating immune processes by old or new anti-inflammatory agents in patients.
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Affiliation(s)
- Georg Juckel
- Department of Psychiatry, Ruhr-University Bochum, LWL-University Hospital, Alexandrinenstr.1, 44791, Bochum, Germany.
| | - Nadja Freund
- Department of Psychiatry, Ruhr-University Bochum, LWL-University Hospital, Alexandrinenstr.1, 44791, Bochum, Germany
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4
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Wang M, Zhou Z, Tang W, Peng M, Chen L, Lou M, Fang X, Xu H. Regulatory T cells mediate insomnia-related psychotic symptoms and cognitive impairment in chronic schizophrenia patients. J Psychiatr Res 2023; 163:102-108. [PMID: 37207432 DOI: 10.1016/j.jpsychires.2023.05.011] [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: 01/15/2023] [Revised: 04/19/2023] [Accepted: 05/01/2023] [Indexed: 05/21/2023]
Abstract
Insomnia occurs frequently in schizophrenia patients and is often accompanied with severe psychotic symptoms and cognition impairment. Moreover, chronic insomnia is associated with immune alterations. This study explored the correlations between insomnia and clinical manifestations of schizophrenia and analyzed mediation effects of regulatory T cells (Tregs) on these correlations. In a total of 655 chronic schizophrenia patients, 70 persons (10.69%) had an ISI (Insomnia Severity Index) score >7 and were referred to as Insomnia group. Compared to non-Insomnia group, Insomnia group presented more severe psychotic symptoms (assessed by PANSS) and cognitive impairment (assessed by RBANS). The total effect of ISI on PANSS/RBANS total score was not significant due to the mediation effects by Tregs, in which Tregs strongly mediated the effect of ISI on PANSS total score in negative direction but mediated the effect of ISI on RBANS total score in positive direction. Pearson Correlation Coefficient revealed negative correlations between Tregs and PANSS total score or disorganization subscale of PANSS. Positive correlations existed between Tregs and RBANS total score, between Tregs and the subscales of attention, delayed memory, or language of RBANS. These mediation effects of Tregs on insomnia-related psychotic symptoms and cognitive impairment in chronic schizophrenia patients point to a potential therapeutic strategy of modulating Tregs for the patients.
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Affiliation(s)
- Mengpu Wang
- School of Mental Health, Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zihan Zhou
- School of Mental Health, Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Wei Tang
- School of Mental Health, Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Meiliu Peng
- School of Mental Health, Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Lijing Chen
- School of Mental Health, Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Mengbei Lou
- School of Mental Health, Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xinyu Fang
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.
| | - Haiyun Xu
- School of Mental Health, Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, China.
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5
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Chen W, Gou M, Wang L, Li N, Li W, Tong J, Zhou Y, Xie T, Yu T, Feng W, Li Y, Chen S, Tian B, Tan S, Wang Z, Pan S, Luo X, Zhang P, Huang J, Tian L, Li CSR, Tan Y. Inflammatory disequilibrium and lateral ventricular enlargement in treatment-resistant schizophrenia. Eur Neuropsychopharmacol 2023; 72:18-29. [PMID: 37058967 DOI: 10.1016/j.euroneuro.2023.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/28/2023] [Accepted: 03/30/2023] [Indexed: 04/16/2023]
Abstract
Treatment-resistant schizophrenia (TRS) patient respond poorly to antipsychotics. Inflammatory imbalance involving pro- and anti-inflammatory cytokines may play an important role in the mechanism of antipsychotic-medication response. This study aimed to investigate immune imbalance and how the latter relates to clinical manifestations in patients with TRS. The level of net inflammation was estimated by evaluating the immune-inflammatory response system and compensatory immune-regulatory reflex system (IRS/CIRS) in 52 patients with TRS, 47 with non-TRS, and 56 sex and age matched healthy controls. The immune biomarkers mainly included macrophagic M1, T helper, Th-1, Th-2, Th-17, and T regulatory cytokines and receptors. Plasma cytokine levels were measured using enzyme-linked immunosorbent assay. Psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS). Subcortical volumes were quantified using a 3-T Prisma Magnetic Resonance Imaging scanner. The results showed that (1) patients with TRS were characterized by activated pro-inflammatory cytokines and relatively insufficient anti-inflammatory cytokines, with an elevated IRS/CIRS ratio indicating a new homeostatic immune setpoint; (2) IRS/CIRS ratio was positively correlated with larger lateral ventricle volume and higher PANSS score in patients with TRS. Our findings highlighted the inflammatory disequilibrium as a potential pathophysiological process of TRS.
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Affiliation(s)
- Wenjin Chen
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Mengzhuang Gou
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Leilei Wang
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Na Li
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Wei Li
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Jinghui Tong
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Yanfang Zhou
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Ting Xie
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Ting Yu
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Wei Feng
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Yanli Li
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Song Chen
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Baopeng Tian
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Shuping Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Zhiren Wang
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Shujuan Pan
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Xingguang Luo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Ping Zhang
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Junchao Huang
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Li Tian
- Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Yunlong Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China.
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6
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Nisar A, Jagtap S, Vyavahare S, Deshpande M, Harsulkar A, Ranjekar P, Prakash O. Phytochemicals in the treatment of inflammation-associated diseases: the journey from preclinical trials to clinical practice. Front Pharmacol 2023; 14:1177050. [PMID: 37229273 PMCID: PMC10203425 DOI: 10.3389/fphar.2023.1177050] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/27/2023] [Indexed: 05/27/2023] Open
Abstract
Advances in biomedical research have demonstrated that inflammation and its related diseases are the greatest threat to public health. Inflammatory action is the pathological response of the body towards the external stimuli such as infections, environmental factors, and autoimmune conditions to reduce tissue damage and improve patient comfort. However, when detrimental signal-transduction pathways are activated and inflammatory mediators are released over an extended period of time, the inflammatory process continues and a mild but persistent pro-inflammatory state may develop. Numerous degenerative disorders and chronic health issues including arthritis, diabetes, obesity, cancer, and cardiovascular diseases, among others, are associated with the emergence of a low-grade inflammatory state. Though, anti-inflammatory steroidal, as well as non-steroidal drugs, are extensively used against different inflammatory conditions, they show undesirable side effects upon long-term exposure, at times, leading to life-threatening consequences. Thus, drugs targeting chronic inflammation need to be developed to achieve better therapeutic management without or with a fewer side effects. Plants have been well known for their medicinal use for thousands of years due to their pharmacologically active phytochemicals belonging to diverse chemical classes with a number of these demonstrating potent anti-inflammatory activity. Some typical examples include colchicine (alkaloid), escin (triterpenoid saponin), capsaicin (methoxy phenol), bicyclol (lignan), borneol (monoterpene), and quercetin (flavonoid). These phytochemicals often act via regulating molecular mechanisms that synergize the anti-inflammatory pathways such as increased production of anti-inflammatory cytokines or interfere with the inflammatory pathways such as to reduce the production of pro-inflammatory cytokines and other modulators to improve the underlying pathological condition. This review describes the anti-inflammatory properties of a number of biologically active compounds derived from medicinal plants, and their mechanisms of pharmacological intervention to alleviate inflammation-associated diseases. The emphasis is given to information on anti-inflammatory phytochemicals that have been evaluated at the preclinical and clinical levels. Recent trends and gaps in the development of phytochemical-based anti-inflammatory drugs have also been included.
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Affiliation(s)
- Akib Nisar
- Biochemical Sciences Division, Rajiv Gandhi Institute of IT and Biotechnology, Bharati Vidyapeeth Deemed to be University, Pune, Maharashtra, India
| | - Suresh Jagtap
- Herbal Medicine, Interactive Research School for Health Affairs, Bharati Vidyapeeth Deemed to be University, Pune, Maharashtra, India
| | - Suresh Vyavahare
- Shatayu Ayurved and Research Centre, Solapur, Maharashtra, India
| | - Manasi Deshpande
- Department of Dravyagun Vigyan, College of Ayurved, Bharati Vidyapeeth Deemed to be University, Pune, Maharashtra, India
| | - Abhay Harsulkar
- Herbal Medicine, Interactive Research School for Health Affairs, Bharati Vidyapeeth Deemed to be University, Pune, Maharashtra, India
- Pharmaceutical Biotechnology, Poona College of Pharmacy, Bharati Vidyapeeth Deemed to be University, Pune, Maharashtra, India
| | | | - Om Prakash
- Department of Microbiology, Immunology and Parasitology, University Health Sciences Center, New Orleans, LA, United States
- Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA, United States
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Hoprekstad GE, Kjelby E, Gjestad R, Fathian F, Larsen TK, Reitan SK, Rettenbacher M, Torsvik A, Skrede S, Johnsen E, Kroken RA. Depression trajectories and cytokines in schizophrenia spectrum disorders - A longitudinal observational study. Schizophr Res 2023; 252:77-87. [PMID: 36634451 DOI: 10.1016/j.schres.2022.12.049] [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: 06/23/2022] [Revised: 12/01/2022] [Accepted: 12/30/2022] [Indexed: 01/11/2023]
Abstract
Depression occurs frequently in all phases of schizophrenia spectrum disorders. Altered activity in the immune system is seen in both depression and schizophrenia. We aimed to uncover depressive trajectories in a sample of 144 adult individuals with schizophrenia spectrum disorders followed for one year, in order to identify possible cytokine profile differences. Patients were assessed longitudinally with the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS), where a score above 6 predicts depression. The serum cytokine concentrations for tumor necrosis factor (TNF)-alpha, interferon (IFN)-gamma, interleukin (IL)-1beta, IL-2, IL-4, IL-6, IL-10, IL-12p70 and IL-17A were measured using immunoassays. Latent growth curve models, multilevel models and latent class growth analysis (LCGA) were applied. The LCGA model supported three latent classes (trajectories) with differing CDSS profiles during the one-year follow-up: a high CDSS group (40.8 % of participants), a moderate CDSS group (43.9 %) and a low CDSS group (15.3 %). Five single PANSS items predicted affiliation to depressive trajectory: hallucinations, difficulty in abstract thinking, anxiety, guilt feelings and tension. In the high CDSS group, despite diminishing psychotic symptoms, depressive symptoms persisted throughout one year. The pro-inflammatory cytokines IFN-γ, IL-1β and TNF-α were differentially distributed between the depressive trajectories, although levels remained remarkably stable throughout 12 months. Significant changes were found for the anti-inflammatory cytokine IL-10 at baseline with an accompanying difference in change over time. More research is required to optimize future treatment stratification and investigate the contribution of inflammation in depressed patients with schizophrenia spectrum disorders.
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Affiliation(s)
- Gunnhild E Hoprekstad
- Division of Psychiatry, Haukeland University Hospital, Box 1400, 5021 Bergen, Norway; Department of Clinical Medicine, University of Bergen, P.O. Box 7804, 5020 Bergen, Norway; Norwegian Centre for Mental Disorders Research (NORMENT), Haukeland University Hospital, Box 1400, 5021 Bergen, Norway.
| | - Eirik Kjelby
- Division of Psychiatry, Haukeland University Hospital, Box 1400, 5021 Bergen, Norway; Norwegian Centre for Mental Disorders Research (NORMENT), Haukeland University Hospital, Box 1400, 5021 Bergen, Norway
| | - Rolf Gjestad
- Division of Psychiatry, Haukeland University Hospital, Box 1400, 5021 Bergen, Norway; Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Farivar Fathian
- Division of Psychiatry, Haukeland University Hospital, Box 1400, 5021 Bergen, Norway; Norwegian Centre for Mental Disorders Research (NORMENT), Haukeland University Hospital, Box 1400, 5021 Bergen, Norway
| | - Tor K Larsen
- Department of Clinical Medicine, University of Bergen, P.O. Box 7804, 5020 Bergen, Norway; The TIPS-center, Stavanger University Hospital, Stavanger, Norway
| | - Solveig K Reitan
- St. Olav's University Hospital, Department of Mental Health, Trondheim, Norway; Norwegian University of Science and Technology, Department of Mental Health, Trondheim, Norway
| | | | - Anja Torsvik
- Norwegian Centre for Mental Disorders Research (NORMENT), Haukeland University Hospital, Box 1400, 5021 Bergen, Norway; Department of Clinical Science, University of Bergen, P.O. Box 7804, 5020 Bergen, Norway; Dr. Einar Martens Research Group for Biological Psychiatry, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
| | - Silje Skrede
- Department of Clinical Science, University of Bergen, P.O. Box 7804, 5020 Bergen, Norway; Section of Clinical Pharmacology, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Box 1400, 5021 Bergen, Norway
| | - Erik Johnsen
- Division of Psychiatry, Haukeland University Hospital, Box 1400, 5021 Bergen, Norway; Department of Clinical Medicine, University of Bergen, P.O. Box 7804, 5020 Bergen, Norway; Norwegian Centre for Mental Disorders Research (NORMENT), Haukeland University Hospital, Box 1400, 5021 Bergen, Norway
| | - Rune A Kroken
- Division of Psychiatry, Haukeland University Hospital, Box 1400, 5021 Bergen, Norway; Department of Clinical Medicine, University of Bergen, P.O. Box 7804, 5020 Bergen, Norway; Norwegian Centre for Mental Disorders Research (NORMENT), Haukeland University Hospital, Box 1400, 5021 Bergen, Norway
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8
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Bhatt S, Dhar AK, Samanta MK, Suttee A. Effects of Current Psychotropic Drugs on Inflammation and Immune System. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1411:407-434. [PMID: 36949320 DOI: 10.1007/978-981-19-7376-5_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
The immune system and inflammation are involved in the pathological progression of various psychiatric disorders such as depression or major depressive disorder (MDD), generalized anxiety disorder (GAD) or anxiety, schizophrenia, Alzheimer's disease (AD), and Huntington's disease. It is observed that levels of inflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and other markers are highly increased in the abovementioned disorders. The inflammation and immune component also lead to enhance the oxidative stress. The oxidative stress and increased production of reactive oxygen species (ROS) are considered as important factors that are involved in pathological progression of psychiatric disorders. Increase production of ROS is associated with excessive inflammation followed by cell necrosis and death. The psychotropic drugs are mainly work through modulations of neurotransmitter system. However, it is evident that inflammation and immune modulation are also having important role in the progression of psychiatric disorders. Rationale of the use of current psychotropic drugs is modulation of immune system by them. However, the effects of psychotropic drugs on the immune system and how these might contribute to their efficacy remain largely unclear. The drugs may act through modification of inflammation and related markers. The main purpose of this book chapter is to address the role of current psychotropic drugs on inflammation and immune system. Moreover, it will also address the role of inflammation in the progression of psychiatric disorders.
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Affiliation(s)
- Shvetank Bhatt
- School of Pharmacy, Dr. Vishwanath Karad MIT World Peace University, Pune, Maharashtra, India
- Amity Institute of Pharmacy, Amity University Madhya Pradesh, Gwalior, India
| | | | | | - Ashish Suttee
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
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Saleem A, Qurat-ul-Ain, Akhtar MF. Alternative Therapy of Psychosis: Potential Phytochemicals and Drug Targets in the Management of Schizophrenia. Front Pharmacol 2022; 13:895668. [PMID: 35656298 PMCID: PMC9152363 DOI: 10.3389/fphar.2022.895668] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/18/2022] [Indexed: 11/25/2022] Open
Abstract
Schizophrenia is a chronic mental and behavioral disorder characterized by clusters of symptoms including hallucinations, delusions, disorganized thoughts and social withdrawal. It is mainly contributed by defects in dopamine, glutamate, cholinergic and serotonergic pathways, genetic and environmental factors, prenatal infections, oxidative stress, immune system activation and inflammation. Management of schizophrenia is usually carried out with typical and atypical antipsychotics, but it yields modest benefits with a diversity of side effects. Therefore, the current study was designed to determine the phytochemicals as new drug candidates for treatment and management of schizophrenia. These phytochemicals alter and affect neurotransmission, cell signaling pathways, endocannabinoid receptors, neuro-inflammation, activation of immune system and status of oxidative stress. Phytochemicals exhibiting anti-schizophrenic activity are mostly flavonoids, polyphenols, alkaloids, terpenoids, terpenes, polypropanoids, lactones and glycosides. However, well-designed clinical trials are consequently required to investigate potential protective effect and therapeutic benefits of these phytochemicals against schizophrenia.
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Affiliation(s)
- Ammara Saleem
- Department of Pharmacology, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad, Pakistan
| | - Qurat-ul-Ain
- Department of Pharmacology, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad, Pakistan
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Pakistan
| | - Muhammad Furqan Akhtar
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore, Pakistan
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Sahbaz C, Zibandey N, Kurtulmus A, Duran Y, Gokalp M, Kırpınar I, Sahin F, Guloksuz S, Akkoc T. Reduced regulatory T cells with increased proinflammatory response in patients with schizophrenia. Psychopharmacology (Berl) 2020; 237:1861-1871. [PMID: 32221694 DOI: 10.1007/s00213-020-05504-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 03/05/2020] [Indexed: 02/07/2023]
Abstract
AIM To investigate whether circulating T cells including regulatory T cells (Treg) and derived cytokines contribute to the immune imbalance observed in schizophrenia. METHODS Forty patients with schizophrenia and 40 age, sex, body mass index, education, and smoking status-matched healthy controls (HC) are included in the study. We stained cells with anti-CD14, anti-CD3, anti-CD4, anti-CD8, anti-CD19, anti-CD20, and anti-CD16/56. Peripheral blood mononuclear cells (PBMCs) were isolated and stained with the human FoxP3 kit containing anti-CD4/anti-CD25 and intracellular anti-Foxp3. PBMCs were cultured for 72 h and stimulated with anti-CD3/anti-CD28. Cytokines (IL-2, IL-4, IL-6, IL-10, IFN-γ, TNF-α, and IL-17A) were measured from the culture supernatant and plasma using the Th1/Th2/Th17 cytokine bead array kit. RESULTS In comparison with HC, Treg percentages in schizophrenia were higher (1.17 ± 0.63 vs 0.81 ± 0.53, P = 0.005) in unstimulated but lower in the stimulated condition (0.73 ± 0.69 vs 0.97 ± 0.55, P = 0.011). Activated T cell percentages were higher in schizophrenia than HC in unstimulated (2.22 ± 0.78 vs 1.64 ± 0.89, P = 0.001) and stimulated (2.25 ± 1.01 vs 1.72 ± 1.00, P = 0.010) conditions. The culture supernatant levels of IL-6 (7505.17 ± 5170.07 vs 1787.81 ± 1363.32, P < 0.001), IL-17A (191.73 ± 212.49 vs 46.43 ± 23.99, P < 0.001), TNF-α (1557 ± 1059.69 vs 426.57 ± 174.62, P = 0.023), and IFN-γ (3204.13 ± 1397.06 vs 447.79 ± 270.13, P < 0.001); and plasma levels of IL-6 (3.83 ± 3.41vs 1.89 ± 1.14, P = 0.003) and IL-17A (1.20 ± 0.84 vs 0.83 ± 0.53, P = 0.033) were higher in patients with schizophrenia than HC. CONCLUSION Our explorative study shows reduced level of Foxp3 expressing Treg in a stimulated condition with induced levels of proinflammatory cytokines in patients with schizophrenia.
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Affiliation(s)
- Cigdem Sahbaz
- Department of Psychiatry, Bezmialem Vakif University, Istanbul, Turkey.
| | | | - Ayse Kurtulmus
- Department of Psychiatry, Bezmialem Vakif University, Istanbul, Turkey
| | - Yazgul Duran
- Department of Immunology, Marmara University, Istanbul, Turkey
| | - Muazzez Gokalp
- Department of Immunology, Marmara University, Istanbul, Turkey
| | - Ismet Kırpınar
- Department of Psychiatry, Bezmialem Vakif University, Istanbul, Turkey
| | - Fikrettin Sahin
- Department of Bioengineering and Genetics, Yeditepe University, Istanbul, Turkey
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Tunc Akkoc
- Department of Immunology, Marmara University, Istanbul, Turkey
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11
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MacDowell KS, Marsá MD, Buenache E, Villatoro JML, Moreno B, Leza JC, Carrasco JL. Inflammatory and antioxidant pathway dysfunction in borderline personality disorder. Psychiatry Res 2020; 284:112782. [PMID: 31955054 DOI: 10.1016/j.psychres.2020.112782] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 01/07/2020] [Accepted: 01/10/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION This study investigates the alteration of the inflammatory/oxidative pathway in patients with borderline personality disorder (BPD) and its relationship with clinical features of the disorder. METHODS 49 BPD patients and 33 healthy control subjects were studied. Plasma levels of TBARS, nitrites, and the antioxidant enzymes CAT, GPx and SOD were measured. In addition, peripheral blood mononuclear cells were obtained to investigate levels of intracellular components of the inflammatory/oxidative pathway including the IκBα, NFκB, iNOS, COX2, Keap1, NQO1, and HO1. Western Blot and ELISA were used to measure protein expression. Patients were assessed for different clinical dimensions of BPD with scales for depression, anxiety, impulsivity and functioning. RESULTS A significant decrease of IκBα levels and a significant increase of inflammatory factors, including NFκB, COX2 and iNOS levels were found in patients. On the other hand, a significant decrease was observed for all antioxidant enzymes in patients with BPD, except for HO1. The inflammatory factor NFκB showed a significant positive correlation with impulsivity scores. CONCLUSIONS Patients with BPD presented an increased activation of several components of the inflammatory pathways, as well as an inhibition of the antioxidant path. These alterations appear partially correlated with the impulsivity scores in these patients.
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Affiliation(s)
- Karina S MacDowell
- Department of Pharmacology and Toxicology, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Spain; Institute of Health Research Hospital 12 de Octubre (imas12), Spain; University Institute of Research in Neurochemistry UCM, Spain; Biomedical Research Networking Consortium for Mental Health (CIBERSAM), Hospital Gregorio Marañón, Pabellón de Gobierno 1ª Planta C/Dr. Esquerdo 46, 28007 Madrid, Spain
| | - Marina Díaz Marsá
- Biomedical Research Networking Consortium for Mental Health (CIBERSAM), Hospital Gregorio Marañón, Pabellón de Gobierno 1ª Planta C/Dr. Esquerdo 46, 28007 Madrid, Spain; Department of Psychiatry and Medical Psychology, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Ciudad Universitaria s/n, 28040 Madrid, Spain
| | - Eva Buenache
- Department of Pharmacology and Toxicology, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Spain; Institute of Health Research Hospital 12 de Octubre (imas12), Spain; University Institute of Research in Neurochemistry UCM, Spain
| | - Jose M López Villatoro
- Sanitary Research Institute, Hospital Clínico San Carlos (IdISSC), Avenida del Profesor Martín Lagos s/n, 28040 Madrid, Spain.
| | - Beatriz Moreno
- Department of Pharmacology and Toxicology, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Spain; Institute of Health Research Hospital 12 de Octubre (imas12), Spain; University Institute of Research in Neurochemistry UCM, Spain; Biomedical Research Networking Consortium for Mental Health (CIBERSAM), Hospital Gregorio Marañón, Pabellón de Gobierno 1ª Planta C/Dr. Esquerdo 46, 28007 Madrid, Spain
| | - Juan C Leza
- Department of Pharmacology and Toxicology, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Spain; Institute of Health Research Hospital 12 de Octubre (imas12), Spain; University Institute of Research in Neurochemistry UCM, Spain; Biomedical Research Networking Consortium for Mental Health (CIBERSAM), Hospital Gregorio Marañón, Pabellón de Gobierno 1ª Planta C/Dr. Esquerdo 46, 28007 Madrid, Spain
| | - José L Carrasco
- Biomedical Research Networking Consortium for Mental Health (CIBERSAM), Hospital Gregorio Marañón, Pabellón de Gobierno 1ª Planta C/Dr. Esquerdo 46, 28007 Madrid, Spain; Department of Psychiatry and Medical Psychology, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Ciudad Universitaria s/n, 28040 Madrid, Spain
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12
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Snijders GJLJ, van Mierlo HC, Boks MP, Begemann MJH, Sutterland AL, Litjens M, Ophoff RA, Kahn RS, de Witte LD. The association between antibodies to neurotropic pathogens and bipolar disorder : A study in the Dutch Bipolar (DB) Cohort and meta-analysis. Transl Psychiatry 2019; 9:311. [PMID: 31748521 PMCID: PMC6868237 DOI: 10.1038/s41398-019-0636-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 05/08/2019] [Accepted: 08/01/2019] [Indexed: 12/22/2022] Open
Abstract
Exposure to neurotropic pathogens has been hypothesized to be a risk factor for the development of bipolar disorder (BD). However, evidence so far is inconsistent. We, therefore, analyzed the seroprevalence and titer levels of IgG antibodies against several herpesviruses and Toxoplasma gondii (T. gondii) in plasma of 760 patients with a bipolar disorder, 144 first-degree matched relatives and 132 controls of the Dutch Bipolar (DB) Cohort using ELISA. In addition, we performed a literature-based meta-analysis on the seroprevalence of IgG antibodies against these pathogens (n = 14). Our results in the DB Cohort and subsequent meta-analysis (n = 2364 BD patients, n = 5101 controls) show no association between exposure to herpesviruses and bipolar disorder (HSV-1 [adjusted OR 0.842, 95% CI 0.567-1.230], HSV-2 [adjusted OR 0.877, 95% CI 0.437-1.761], CMV [adjusted OR 0.884 95% CI 0.603-1.295], EBV [adjusted OR 0.968 95% CI 0.658-1.423]). In the DB Cohort, we did not find an association between bipolar disorder and T. gondii titer or seroprevalence either [adjusted OR 1.018, 95% CI 0.672-1.542]. The overall OR was not significant for T. gondii [OR: 1.4, 95% CI 0.95-1.90, p = 0.09), but subgroup analyses in age groups below 40 years showed a significantly increased seroprevalence of T. gondii IgGs in BD [OR: 1.8 (95% CI 1.10-2.89, p = 0.021]. Our meta-analysis indicates that T. gondii exposure may be a risk factor for BD in certain subpopulations.
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Affiliation(s)
- Gijsje J L J Snijders
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Hans C van Mierlo
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marco P Boks
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marieke J H Begemann
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Arjen L Sutterland
- Department of Psychiatry, Academic Medical Centre (AMC), Amsterdam, The Netherlands
| | - Manja Litjens
- Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Roel A Ophoff
- Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, CA, USA
| | - René S Kahn
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lot D de Witte
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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13
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Beydoun MA, Weiss J, Obhi H, Beydoun HA, Dore GA, Liang H, Evans MK, Zonderman AB. Cytokines are associated with longitudinal changes in cognitive performance among urban adults. Brain Behav Immun 2019; 80:474-487. [PMID: 30981715 PMCID: PMC6698146 DOI: 10.1016/j.bbi.2019.04.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 03/20/2019] [Accepted: 04/10/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Chronic systemic inflammation has been positively associated with structural and functional brain changes representing early markers of Alzheimer's Disease (AD) and cognitive decline. The current study examined associations between systemic inflammation and cognitive performance among African-Americans and Whites urban adults. METHODS Participants were selected from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (2004-2013, baseline age: 30-64 y, mean ± SD follow-up time of 4.64 ± 0.93 y, N = 189-222, k = 1.5-1.7 observations/participant). Cytokines known to be positively linked to AD incidence among others were tested against cross-sectional and longitudinal cognitive function, stratifying by age group (≤50 y vs. >50 y), sex and race. A series of mixed-effects regression models were conducted, adjusting for key confounders. RESULTS Among key findings, IL1β was positively associated with a faster rate of decline on a test of executive functioning, among older adults (age >50 y, γ11 = +2.49 ± 0.89, p = 0.005), while in the total population, IL-6 was linked to a faster decline on a test of verbal memory (γ11 = -0.011 ± 0.004, p = 0.009). Among younger participants, IL-18 was linked to a poorer performance on a test of attention at baseline (age ≤50 y, γ01 = -0.007 ± 0.0025, p = 0.004) though a slower rate of decline with higher IL-18 was detected for a test of psychomotor speed in older adults (age >50 y, γ11 = +0.0010 ± 0.0004, p = 0.008). Finally, among Whites, unlike among African-Americans, IL-6 was associated with a better baseline performance on two tests of verbal and working memory. CONCLUSIONS Cytokines were shown to be associated with age-related cognitive decline among middle-aged and older urban adults in an age group and race-specific manner. Further longitudinal studies are needed to replicate our findings and mediation through relevant biological and psychosocial factors need to be studied as well.
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Affiliation(s)
- May A. Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD.,Corresponding author: May A. Beydoun, PhD, NIH Biomedical Research Center, National Institute on Aging, IRP, 251 Bayview Blvd., Suite 100, Room#: 04B118, Baltimore, MD 21224, , Fax:410-558-8236
| | - Jordan Weiss
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Hardeep Obhi
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Hind A. Beydoun
- Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD
| | - Gregory A. Dore
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Hailun Liang
- Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, MD
| | - Michele K. Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
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14
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Corsi-Zuelli F, Fachim HA, Loureiro CM, Shuhama R, Bertozi G, Joca SRL, Menezes PR, Louzada-Junior P, Del-Ben CM. Prolonged Periods of Social Isolation From Weaning Reduce the Anti-inflammatory Cytokine IL-10 in Blood and Brain. Front Neurosci 2019; 12:1011. [PMID: 30686977 PMCID: PMC6337063 DOI: 10.3389/fnins.2018.01011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 12/17/2018] [Indexed: 01/31/2023] Open
Abstract
Life stressors during critical periods are reported to trigger an immune dysfunction characterised by abnormal production of inflammatory cytokines. Despite the relationship between early stressors and schizophrenia is described, the evidence on inflammatory biomarkers remains limited. We aimed to investigate whether an imbalance between pro- and anti-inflammatory cytokines in the brain is reflected in the peripheral blood of rats submitted to post-weaning social isolation (pwSI), a model with validity to study schizophrenia. We evaluated pro- and anti-inflammatory cytokines (IL-6, TNF-α, and IL-10) simultaneously at blood, prefrontal cortex and hippocampal tissues (Milliplex MAP), including the respective cytokines gene expression (mRNA) (qRT-PCR TaqMan mastermix). We also performed a correlation matrix to explore significant correlations among cytokines (protein and mRNA) in blood and brain, as well as cytokines and total number of square crossings in the open field for isolated-reared animals. Male Wistar rats (n = 10/group) were kept isolated (n = 1/cage) or grouped (n = 3–4/cage) since weaning for 10 weeks. After this period, rats were assessed for locomotion and sacrificed for blood and brain cytokines measurements. Prolonged pwSI decreased IL-10 protein and mRNA in the blood, and IL-10 protein in the hippocampus, along with decreased IL-6 and its mRNA expression in the prefrontal cortex. Our results also showed that cytokines tend to correlate to one-another among the compartments investigated, although blood and brain correlations are far from perfect. IL-10 hippocampal levels were negatively correlated with hyperlocomotion in the open field. Despite the unexpected decrease in IL-6 and unchanged TNF-α levels contrast to the expected pro-inflammatory phenotype, this may suggest that reduced anti-inflammatory signalling may be critical for eliciting abnormal behaviour in adulthood. Altogether, these results suggest that prolonged early-life adverse events reduce the ability to build proper anti-inflammatory cytokine that is translated from blood-to-brain.
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Affiliation(s)
- Fabiana Corsi-Zuelli
- Division of Psychiatry, Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Helene Aparecida Fachim
- Division of Psychiatry, Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.,Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield, United Kingdom
| | - Camila Marcelino Loureiro
- Division of Clinical Immunology, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Rosana Shuhama
- Division of Psychiatry, Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Giuliana Bertozi
- Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Sâmia Regiane Lourenço Joca
- Department of Physics and Chemistry, School of Pharmaceutical Sciences, University of São Paulo, Ribeirão Preto, Brazil.,Department of Clinical Medicine, Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo Louzada-Junior
- Division of Clinical Immunology, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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15
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Juncal-Ruiz M, Riesco-Dávila L, Ortiz-García de la Foz V, Martínez-Garcia O, Ramírez-Bonilla M, Ocejo-Viñals JG, Leza JC, López-Hoyos M, Crespo-Facorro B. Comparison of the anti-inflammatory effect of aripiprazole and risperidone in 75 drug-naïve first episode psychosis individuals: A 3 months randomized study. Schizophr Res 2018; 202:226-233. [PMID: 29941296 DOI: 10.1016/j.schres.2018.06.039] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 06/03/2018] [Accepted: 06/13/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Evidence about the anti-inflammatory properties of antipsychotics has grown. However, no previous studies have compared the immunomodulatory effect of risperidone and aripiprazole. OBJECTIVES The main aim of the present work is to compare the anti-inflammatory effect of risperidone and aripiprazole on a large array of serum cytokines at 3 months following the onset of treatment. METHODS This is a prospective, randomized, open-label study. Patients were randomly assigned to risperidone or aripiprazole. From this randomization, 75 patients and 75 healthy volunteers that matched with the selected patients were picked for entry in this study. Serum concentrations of 21 cytokines/chemokines were measured at baseline and 3 months following the initiation of antipsychotic medication. RESULTS Those patients who were randomly assigned to risperidone had higher levels of IL-8 (p = 0.000) and MIP-1β (p = 0.007) than healthy volunteers at baseline, whereas no differences were found between patients initially assigned to aripiprazole and healthy volunteers. Three months following the onset of medication several cytokines decreased significantly: IL-8, MIP-1β, Fractalkine, TNF-α, IL-7, IL-13, IL-17α, IL-23, IL-21 (all ps < 0.01). No differences were found in the percentages of change between both treatments. The effect size of the two antipsychotics was similar, except for TNF-α, IL-13, IL-17α and Fractalkine, in which aripiprazole seems to have a greater effect size than risperidone, whereas risperidone seems to have a greater effect size than aripiprazole on MIP-1β. CONCLUSIONS This is the first study that has compared the immunomodulatory effect of risperidone and aripiprazole, finding that the anti-inflammatory effect of both treatments was similar.
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Affiliation(s)
- María Juncal-Ruiz
- Department of Psychiatry, Sierrallana Hospital, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain.
| | - Laura Riesco-Dávila
- Department of Immunology, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Víctor Ortiz-García de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Obdulia Martínez-Garcia
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Mariluz Ramírez-Bonilla
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Javier Gonzalo Ocejo-Viñals
- Department of Immunology, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Juan Carlos Leza
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Complutense University, Madrid, Spain; Department of Pharmacology, Faculty of Medicine, Complutense University, Madrid, Spain; Instituto de Investigación Sanitaria (IIS), Hospital 12 de Octubre (i+12), Madrid, Spain
| | - Marcos López-Hoyos
- Department of Immunology, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain; Centro de investigación Biomédica en Red de Salud Mental (CIBERSAM), Santander, Spain.
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16
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Alterations of eicosanoids and related mediators in patients with schizophrenia. J Psychiatr Res 2018; 102:168-178. [PMID: 29674269 DOI: 10.1016/j.jpsychires.2018.04.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 03/22/2018] [Accepted: 04/04/2018] [Indexed: 02/08/2023]
Abstract
Schizophrenia (SCZ) is a multifactorial psychiatric disorder. Currently, its molecular pathogenesis remains largely unknown, and no reliable test for diagnosis and therapy monitoring is available. Polyunsaturated fatty acids (PUFAs) and their derived eicosanoid signaling abnormalities are relevant to the pathophysiology of schizophrenia. However, comprehensive analysis of eicosanoids and related mediators for schizophrenia is very rare. In this study, we applied a targeted liquid chromatography-mass spectrometry based method to monitor 158 PUFAs, eicosanoids and related mediators from enzyme-dependent or independent pathways, in the serum samples of 109 healthy controls, and 115 schizophrenia patients at baseline and after an 8-week period of antipsychotic therapy. Twenty-three metabolites were identified to be significantly altered in SCZ patients at baseline compared to healthy controls, especially arachidonic acid (AA) derived eicosanoids. These disturbances may be related to altered immunological reactions and neurotransmitter signaling. After 8-week antipsychotic treatment, there were 22 metabolites, especially AA and linoleic acid derived eicosanoids, significantly altered in posttreatment patients. Some metabolites, such as several AA derived prostaglandins, thromboxanes, and di-hydroxy-eicosatrienoic acids were reversed toward normal levels after treatment. Based on univariate analysis and orthogonal partial least-squares discriminant analysis, anandamide, oleoylethanolamine, and AA were selected as a panel of potential biomarkers for differentiating baseline SCZ patients from controls, which showed a high sensitivity (0.907), good specificity (0.843) and excellent area under the receiver operating characteristic curve (0.940). This study provided a new perspective to understand the pathophysiological mechanism and identify potential biomarkers of SCZ.
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17
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Borovcanin MM, Jovanovic I, Radosavljevic G, Pantic J, Minic Janicijevic S, Arsenijevic N, Lukic ML. Interleukin-6 in Schizophrenia-Is There a Therapeutic Relevance? Front Psychiatry 2017; 8:221. [PMID: 29163240 PMCID: PMC5681495 DOI: 10.3389/fpsyt.2017.00221] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 10/20/2017] [Indexed: 12/13/2022] Open
Abstract
Renewing interest in immune aspects of schizophrenia and new findings about the brain-fat axis encourage us to discuss the possible role of interleukin-6 (IL-6) in schizophrenia. Previously, it was suggested that a primary alteration of the innate immune system may be relevant in schizophrenia. Functional dichotomy of IL-6 suggests that this chemical messenger may be responsible for regulating the balance between pro- and anti-inflammatory responses, with tissue-specific properties at the periphery and in the central nervous system. Specific phase of this chronic and deteriorating disorder must be considered, which can involve IL-6 in acute or possible chronic inflammation and/or autoimmunity. We give an overview of IL-6 role in the onset and progression of this disorder, also considering cognitive impairment and metabolic changes in patients with schizophrenia. Data suggest that decreased serum level of IL-6 following antipsychotic therapy could be predisposing factor for the development of obesity and obesity-related metabolic disorders in schizophrenia. As we reviewed, the IL-6 plays significant role in disease genesis and progression, so the use of specific inhibitors may not only be beneficial for exacerbation and alleviation of positive symptoms, but may attenuate cognitive impairment in patients with schizophrenia.
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Affiliation(s)
| | - Ivan Jovanovic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Gordana Radosavljevic
- 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
| | | | - Nebojsa Arsenijevic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Miodrag L. Lukic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
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18
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Petrikis P, Voulgari PV, Tzallas AT, Boumba VA, Archimandriti DT, Zambetas D, Papadopoulos I, Tsoulos I, Skapinakis P, Mavreas V. Changes in the cytokine profile in first-episode, drug-naïve patients with psychosis after short-term antipsychotic treatment. Psychiatry Res 2017; 256:378-383. [PMID: 28688350 DOI: 10.1016/j.psychres.2017.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 05/17/2017] [Accepted: 07/01/2017] [Indexed: 10/19/2022]
Abstract
An increasing body of evidence suggests that antipsychotic medication can cause immunological changes that could be attributed to the amelioration of psychotic symptoms or the metabolic side effects of the drugs. So far, the results of the studies remain controversial. Our aim was to compare the levels of interleukin (IL) IL-2, IL-6 and transforming growth factor-β2 (TGF-β2) in drug-naïve, first-episode patients with psychosis before and after six weeks of antipsychotic medication. Thirty-nine first-episode patients with psychosis were enrolled in the study. Serum levels of IL-2, IL-6 and TGF-β2 were measured by enzyme linked immunosorbent assay (ELISA) before and six weeks after the initiation of antipsychotics. In addition, clinical psychopathology was assessed using Positive and Negative Syndrome Scale (PANSS) before and after treatment. Serum levels of IL-2 were significantly increased six weeks after the initiation of antipsychotic treatment (p <0.001) while TGF-β2 levels were decreased (p <0.001). IL-6 levels were overall increased (p <0.004), but this occurred in a non-linear way. These findings, although preliminary, provide further evidence that antipsychotic treatment in patients with psychosis may be correlated with immunological changes but further research is needed.
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Affiliation(s)
- Petros Petrikis
- Psychiatric Clinic, Faculty of Medicine, School of Health Sciences, University of Ioannina (UOI), P.O. Box 1186, 45110 Ioannina, Greece.
| | - Paraskevi V Voulgari
- Rheumatology Clinic, Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina (UOI), P.O. Box 1186, 45110 Ioannina, Greece
| | - Alexandros T Tzallas
- Department of Computer Engineering, School of Applied Technology, Technological Educational Institute of Epirus (TEIEP), 47100 Arta, Greece
| | - Vassiliki A Boumba
- Laboratory of Forensic Medicine & Toxicology, Faculty of Medicine, School of Health Sciences, University of Ioannina (UOI), P.O. Box 1186, 45110 Ioannina, Greece
| | - Dimitra T Archimandriti
- Rheumatology Clinic, Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina (UOI), P.O. Box 1186, 45110 Ioannina, Greece
| | - Dimitrios Zambetas
- Psychiatric Clinic, Faculty of Medicine, School of Health Sciences, University of Ioannina (UOI), P.O. Box 1186, 45110 Ioannina, Greece
| | - Ioannis Papadopoulos
- Psychiatric Clinic, Faculty of Medicine, School of Health Sciences, University of Ioannina (UOI), P.O. Box 1186, 45110 Ioannina, Greece
| | - Ioannis Tsoulos
- Department of Computer Engineering, School of Applied Technology, Technological Educational Institute of Epirus (TEIEP), 47100 Arta, Greece
| | - Petros Skapinakis
- Psychiatric Clinic, Faculty of Medicine, School of Health Sciences, University of Ioannina (UOI), P.O. Box 1186, 45110 Ioannina, Greece
| | - Venetsanos Mavreas
- Psychiatric Clinic, Faculty of Medicine, School of Health Sciences, University of Ioannina (UOI), P.O. Box 1186, 45110 Ioannina, Greece
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19
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Aricioglu F, Ozkartal CS, Unal G, Dursun S, Cetin M, Müller N. Neuroinflammation in Schizophrenia: A Critical Review and The Future. ACTA ACUST UNITED AC 2017. [DOI: 10.5455/bcp.20161123044657] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Feyza Aricioglu
- Marmara University, Faculty of Pharmacy, Department of Pharmacology and Psychopharmacology Research Unit, Istanbul - Turkey
| | - Ceren Sahin Ozkartal
- Marmara University, Faculty of Pharmacy, Department of Pharmacology and Psychopharmacology Research Unit, Istanbul - Turkey
| | - Gokhan Unal
- Marmara University, Faculty of Pharmacy, Department of Pharmacology and Psychopharmacology Research Unit, Istanbul - Turkey
| | - Serdar Dursun
- University of Alberta, Department of Psychiatry, Edmonton, Alberta-Canada
| | - Mesut Cetin
- Bulletin of Clinical Psychopharmacology, Honorary President of Turkish Association for Psychopharmacology & General Secretary of Turkish Association for Psychopharmacology, Istanbul - Turkey
| | - Norbert Müller
- Ludwig-Maximilians-University Munich, Department of Psychiatry and Psychotherapy, Nussbaumstrasse 7, D - 80336 Munich-Germany
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20
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A systematic review of the effect of cannabidiol on cognitive function: Relevance to schizophrenia. Neurosci Biobehav Rev 2017; 72:310-324. [DOI: 10.1016/j.neubiorev.2016.11.012] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 10/25/2016] [Accepted: 11/17/2016] [Indexed: 11/18/2022]
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21
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Antonson AM, Radlowski EC, Lawson MA, Rytych JL, Johnson RW. Maternal viral infection during pregnancy elicits anti-social behavior in neonatal piglet offspring independent of postnatal microglial cell activation. Brain Behav Immun 2017; 59:300-312. [PMID: 27650113 DOI: 10.1016/j.bbi.2016.09.019] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/31/2016] [Accepted: 09/16/2016] [Indexed: 02/03/2023] Open
Abstract
Maternal infection during pregnancy increases risk for neurodevelopmental disorders and reduced stress resilience in offspring, but the mechanisms are not fully understood. We hypothesized that piglets born from gilts infected with a respiratory virus during late gestation would exhibit aberrant microglia activity, cognitive deficits and reduced sociability. Pregnant gilts were inoculated with porcine reproductive and respiratory syndrome virus (PRRSV; 5×105 TCID50 of live PRRSV) or saline at gestational day 76. Gilts infected with PRRSV exhibited fever (p<0.01) and reduced appetite (p<0.001) for 2weekspost-inoculation and were PRRSV-positive at parturition. Piglets born from infected and control gilts were weaned at postnatal day (PD) 1 and assigned to two groups. Group 1 was challenged with lipopolysaccharide (LPS, 5μg/kg body weight i.p.) or saline on PD 14 and tissues were collected. Group 2 was tested in a T-maze task to assess spatial learning and in a 3-chamber arena with unfamiliar conspecifics to assess social behavior from PD 14-27. Microglia (CD11b+ CD45low) isolated from Group 2 piglets at PD 28 were challenged ex vivo with LPS; a subset of cells was analyzed for MHCII expression. Maternal infection did not affect offspring circulating TNFα, IL-10, or cortisol levels basally or 4h post-LPS challenge. While performance in the T-maze task was not affected by maternal infection, both sociability and preference for social novelty were decreased in piglets from infected gilts. There was no effect of maternal infection on microglial MHCII expression or LPS-induced cytokine production. Taken together, these results suggest the reduced social behavior elicited by maternal infection is not due to aberrant microglia activity postnatally.
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Affiliation(s)
- Adrienne M Antonson
- Department of Animal Sciences, University of Illinois Urbana-Champaign, Urbana, IL, USA; Integrative Immunology and Behavior Program, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Emily C Radlowski
- Department of Animal Sciences, University of Illinois Urbana-Champaign, Urbana, IL, USA; Integrative Immunology and Behavior Program, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Marcus A Lawson
- Department of Animal Sciences, University of Illinois Urbana-Champaign, Urbana, IL, USA; Integrative Immunology and Behavior Program, University of Illinois Urbana-Champaign, Urbana, IL, USA; Neuroscience Program, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Jennifer L Rytych
- Department of Animal Sciences, University of Illinois Urbana-Champaign, Urbana, IL, USA; Integrative Immunology and Behavior Program, University of Illinois Urbana-Champaign, Urbana, IL, USA
| | - Rodney W Johnson
- Department of Animal Sciences, University of Illinois Urbana-Champaign, Urbana, IL, USA; Integrative Immunology and Behavior Program, University of Illinois Urbana-Champaign, Urbana, IL, USA; Neuroscience Program, University of Illinois Urbana-Champaign, Urbana, IL, USA; Division of Nutritional Sciences, University of Illinois Urbana-Champaign, Urbana, IL, USA.
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22
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Petrikis P, Tigas S, Tzallas AT, Archimandriti DT, Skapinakis P, Mavreas V. Prolactin levels in drug-naïve patients with schizophrenia and other psychotic disorders. Int J Psychiatry Clin Pract 2016; 20:165-9. [PMID: 27334805 DOI: 10.1080/13651501.2016.1197274] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Hyperprolactinaemia as a side effect of dopamine receptor blockers is common in patients with schizophrenia and other psychotic disorders and may lead to amenorrhoea, galactorrhoea, hypogonadism, subfertility and osteoporosis. The aim of our study was to determine whether hyperprolactinaemia occurs also in patients with schizophrenia and other psychotic disorders prior to any antipsychotic treatment. METHODS Serum prolactin, thyroid-stimulating hormone (TSH), triiodothyronine (T3), free tetraiodothyronine (FT4) and cortisol levels were measured in 40 newly diagnosed, drug naïve, patients with schizophrenia and other psychotic disorders and in 40 age and gender matched healthy subjects. RESULTS The median prolactin value was 12.5 ng/ml (range: 2-38 ng/ml) for patients and 8.6 ng/ml (range: 4-17.6 ng/ml) for healthy subjects (p = 0.011). Patients had lower levels of T3 compared to healthy controls (mean: 1.08 ng/ml, SD: 0.16 vs. 1.18 ng/ml, 0.18, respectively; p = 0.008). Serum TSH, FT4 and cortisol levels were similar between the two groups. Multiple regression analysis revealed that the difference in serum prolactin values was independent of thyroid function (TSH, FT4, T3) and serum cortisol levels. CONCLUSIONS A higher serum prolactin level was found in drug naïve, newly diagnosed patients with schizophrenia and other psychotic disorders compared to healthy controls, prior to starting any antipsychotic treatment.
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Affiliation(s)
- Petros Petrikis
- a Psychiatric Clinic, Medical School, University of Ioannina (UOI) , Ioannina , Greece
| | - Stelios Tigas
- b Department of Endocrinology , Medical School, University of Ioannina (UOI) , Ioannina , Greece
| | - Alexandros T Tzallas
- c Department of Computer Engineering, School of Applied Technology , Technological Educational Institute of Epirus (TEIEP) , Arta , Greece
| | - Dimitra T Archimandriti
- d Rheumatology Clinic, Department of Internal Medicine , Medical School, University of Ioannina (UOI) , Ioannina , Greece
| | - Petros Skapinakis
- a Psychiatric Clinic, Medical School, University of Ioannina (UOI) , Ioannina , Greece
| | - Venetsanos Mavreas
- a Psychiatric Clinic, Medical School, University of Ioannina (UOI) , Ioannina , Greece
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23
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Xia M, Abazyan S, Jouroukhin Y, Pletnikov M. Behavioral sequelae of astrocyte dysfunction: focus on animal models of schizophrenia. Schizophr Res 2016; 176:72-82. [PMID: 25468180 PMCID: PMC4439390 DOI: 10.1016/j.schres.2014.10.044] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 10/29/2014] [Accepted: 10/31/2014] [Indexed: 12/12/2022]
Abstract
Astrocytes regulate multiple processes in the brain ranging from trophic support of developing neurons to modulation of synaptic neurotransmission and neuroinflammation in adulthood. It is, therefore, understandable that pathogenesis and pathophysiology of major psychiatric disorders involve astrocyte dysfunctions. Until recently, there has been the paucity of experimental approaches to studying the roles of astrocytes in behavioral disease. A new generation of in vivo models allows us to advance our understanding of the roles of astrocytes in psychiatric disorders. This review will evaluate the recent studies that focus on the contribution of astrocyte dysfunction to behavioral alterations pertinent to schizophrenia and will propose the possible solutions of the limitations of the existing approaches.
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Affiliation(s)
- Meng Xia
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine,Preclinical College, Guangxi University of Chinese Medicine, Nanning, 530001, Guangxi Province, China,Chinese Medicine College, Hubei University for Nationalities, ENSHI, 445000, Hubei Province, China
| | - Sofya Abazyan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - Yan Jouroukhin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - Mikhail Pletnikov
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, United States; Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, United States; Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, United States; Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, United States.
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24
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Watkins CC, Andrews SR. Clinical studies of neuroinflammatory mechanisms in schizophrenia. Schizophr Res 2016; 176:14-22. [PMID: 26235751 DOI: 10.1016/j.schres.2015.07.018] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 06/08/2015] [Accepted: 07/08/2015] [Indexed: 12/27/2022]
Abstract
Schizophrenia is a pervasive neurodevelopmental disorder that appears to result from genetic and environmental factors. Although the dopamine hypothesis is the driving theory behind the majority of translation research in schizophrenia, emerging evidence suggests that aberrant immune mechanisms in the peripheral and central nervous system influence the etiology of schizophrenia and the pathophysiology of psychotic symptoms that define the illness. The initial interest in inflammatory processes comes from epidemiological data and historical observations, dating back several decades. A growing body of research on developmental exposure to infection, stress-induced inflammatory response, glial cell signaling, structural and functional brain changes and therapeutic trials demonstrates the impact that inflammation has on the onset and progression of schizophrenia. Research in animal models of psychosis has helped to advance clinical and basic science investigations of the immune mechanisms disrupted in schizophrenia. However, they are limited by the inability to recapitulate the human experience of hallucinations, delusions and thought disorder that define psychosis. To date, translational studies of inflammatory mechanisms in human subjects have not been reviewed in great detail. Here, we critically review clinical studies that focus on inflammatory mechanisms in schizophrenia. Understanding the neuroinflammatory mechanisms involved in schizophrenia may be essential in identifying potential therapeutic targets to minimize the morbidity and mortality of schizophrenia by interrupting disease development.
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Affiliation(s)
- Crystal C Watkins
- Memory Center in Neuropsychiatry, Sheppard Pratt Health Systems, Baltimore, MD, United States; Department of Psychiatry, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, United States.
| | - Sarah Ramsay Andrews
- Department of Psychiatry, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, United States
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25
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Kastrin A, Rindflesch TC, Hristovski D. Link Prediction on a Network of Co-occurring MeSH Terms: Towards Literature-based Discovery. Methods Inf Med 2016; 55:340-6. [PMID: 27435341 DOI: 10.3414/me15-01-0108] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 05/19/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Literature-based discovery (LBD) is a text mining methodology for automatically generating research hypotheses from existing knowledge. We mimic the process of LBD as a classification problem on a graph of MeSH terms. We employ unsupervised and supervised link prediction methods for predicting previously unknown connections between biomedical concepts. METHODS We evaluate the effectiveness of link prediction through a series of experiments using a MeSH network that contains the history of link formation between biomedical concepts. We performed link prediction using proximity measures, such as common neighbor (CN), Jaccard coefficient (JC), Adamic / Adar index (AA) and preferential attachment (PA). Our approach relies on the assumption that similar nodes are more likely to establish a link in the future. RESULTS Applying an unsupervised approach, the AA measure achieved the best performance in terms of area under the ROC curve (AUC = 0.76), followed by CN, JC, and PA. In a supervised approach, we evaluate whether proximity measures can be combined to define a model of link formation across all four predictors. We applied various classifiers, including decision trees, k-nearest neighbors, logistic regression, multilayer perceptron, naïve Bayes, and random forests. Random forest classifier accomplishes the best performance (AUC = 0.87). CONCLUSIONS The link prediction approach proved to be effective for LBD processing. Supervised statistical learning approaches clearly outperform an unsupervised approach to link prediction.
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Affiliation(s)
- Andrej Kastrin
- Andrej Kastrin, PhD, Faculty of Information Studies, Ljubljanska cesta 31A, SI-8000 Novo Mesto, Slovenia, E-mail:
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26
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Allswede DM, Buka SL, Yolken RH, Torrey EF, Cannon TD. Elevated maternal cytokine levels at birth and risk for psychosis in adult offspring. Schizophr Res 2016; 172:41-5. [PMID: 26897476 DOI: 10.1016/j.schres.2016.02.022] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/09/2016] [Accepted: 02/11/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Pregnancy and birth complications, particularly those associated with maternal inflammation and fetal hypoxia, are associated with increased risk for schizophrenia later in life. However, the molecular mechanisms underlying these associations are not fully delineated. This study sought to examine the effect of exposure to maternal inflammation on risk of developing psychosis in adulthood. Maternal serum levels of pro-inflammatory Th1 cytokines (IL-2, interferon gamma [IFN-γ], IL-12) and Th17 cytokines (IL-1b, IL-6, IL-8, tumor necrosis factor alpha [TNF-α], granulocyte macrophage colony stimulating factor [gm-csf]) and anti-inflammatory Th2 cytokines (IL-4, IL-5, and IL-13) and Treg cytokines (IL-10) were evaluated for association with later psychosis in the offspring. METHODS Subjects were 43 adults with psychoses and 43 matched controls followed from gestation as part of the Philadelphia cohort of the National Collaborative Perinatal Project. Adult symptoms of psychosis were assessed via medical records review and confirmed with a validation study. Archived maternal serum samples collected at the time of birth were analyzed for cytokine levels using a multiplex bead assay. RESULTS Individuals exposed to elevated maternal levels of anti-inflammatory Th2 cytokines (≥75th percentile) were significantly less likely to develop psychosis in adulthood. CONCLUSIONS These results may suggest that increased maternal levels of anti-inflammatory cytokines during the perinatal period could protect against the development of psychosis.
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Affiliation(s)
- Dana M Allswede
- Department of Psychology, Yale University, New Haven, CT, USA.
| | - Stephen L Buka
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA.
| | - Robert H Yolken
- The Stanley Medical Research Institute, Chevy Chase, MD, USA.
| | - E Fuller Torrey
- The Stanley Medical Research Institute, Chevy Chase, MD, USA.
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA; Department of Psychiatry, Yale University, New Haven, CT, USA.
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27
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28
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Fonseka TM, Müller DJ, Kennedy SH. Inflammatory Cytokines and Antipsychotic-Induced Weight Gain: Review and Clinical Implications. MOLECULAR NEUROPSYCHIATRY 2016; 2:1-14. [PMID: 27606316 DOI: 10.1159/000441521] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 10/06/2015] [Indexed: 01/07/2023]
Abstract
Antipsychotic medications (APs), particularly second-generation APs, are associated with significant weight gain in schizophrenia patients. Recent evidence suggests that the immune system may contribute to antipsychotic-induced weight gain (AIWG) via AP-mediated alterations of cytokine levels. Antipsychotics with a high propensity for weight gain, such as clozapine and olanzapine, influence the expression of immune genes, and induce changes in serum cytokine levels to ultimately down-regulate neuroinflammation. Since inflammatory cytokines are normally involved in anorexigenic responses, reduced inflammation has been independently shown to mediate changes in feeding behaviours and other metabolic parameters, resulting in obesity. Genetic variation in pro-inflammatory cytokines is also associated with both general obesity and weight change during AP treatment, and thus, may be implicated in the pharmacogenetics of AIWG. At this time, preliminary data support a cytokine-mediated model of AIWG which may have clinical utility in developing more effective metabolic monitoring guidelines and prevention measures. However, further research is still needed to clearly elucidate the validity of this immune model. This article reviews the evidence implicating inflammatory cytokines in AIWG and its potential clinical relevance.
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Affiliation(s)
- Trehani M Fonseka
- Department of Psychiatry, University Health Network, University of Toronto, Toronto, Ont., Canada; Department of Psychiatry, St. Michael's Hospital, University of Toronto, Toronto, Ont., Canada; Pharmacogenetics Research Clinic, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ont., Canada
| | - Daniel J Müller
- Pharmacogenetics Research Clinic, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ont., Canada
| | - Sidney H Kennedy
- Department of Psychiatry, University Health Network, University of Toronto, Toronto, Ont., Canada; Department of Psychiatry, St. Michael's Hospital, University of Toronto, Toronto, Ont., Canada
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29
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Martinez-Cengotitabengoa M, MacDowell KS, Alberich S, Diaz FJ, Garcia-Bueno B, Rodriguez-Jimenez R, Bioque M, Berrocoso E, Parellada M, Lobo A, Saiz PA, Matute C, Bernardo M, Gonzalez-Pinto A, Leza JC. BDNF and NGF Signalling in Early Phases of Psychosis: Relationship With Inflammation and Response to Antipsychotics After 1 Year. Schizophr Bull 2016; 42:142-51. [PMID: 26130821 PMCID: PMC4681544 DOI: 10.1093/schbul/sbv078] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Previous studies have indicated systemic deregulation of the proinflammatory or anti-inflammatory balance in individuals with first-episode psychosis (FEP) that persists 12 months later. To identify potential risk/protective factors and associations with symptom severity, we assessed possible changes in plasma levels of neurotrophins (brain-derived neurotrophic factor [BDNF] and nerve growth factor [NGF]) and their receptors in peripheral blood mononuclear cells (PBMCs). Expression of the 2 forms of BDNF receptors (active TrkB-FL and inactiveTrkB-T1) in PBMCs of FEP patients changed over time, TrkB-FL expression increasing by 1 year after diagnosis, while TrkB-T1 expression decreased. The TrkB-FL/TrkB-T1 ratio (hereafter FL/T1 ratio) increased during follow-up in the nonaffective psychosis group only, suggesting different underlying pathophysiological mechanisms in subgroups of FEP patients. Further, the expression of the main NGF receptor, TrkA, generally increased in patients at follow-up. After adjusting for potential confounders, baseline levels of inducible isoforms of nitric oxide synthase, cyclooxygenase, and nuclear transcription factor were significantly associated with the FL/T1 ratio, suggesting that more inflammation is associated with higher values of this ratio. Interestingly, the FL/T1 ratio might have a role as a predictor of functioning, a regression model of functioning at 1 year suggesting that the effect of the FL/T1 ratio at baseline on functioning at 1 year depended on whether patients were treated with antipsychotics. These findings may have translational relevance; specifically, it might be useful to assess the expression of TrkB receptor isoforms before initiating antipsychotic treatment in FEPs.
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Affiliation(s)
| | - K S MacDowell
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain; Department of Pharmacology, Faculty of Medicine, Universidad Complutense de Madrid, & Research Institute of Hospital 12 de Octubre (i+12), Madrid, Spain; These authors have contributed equally to the article
| | - S Alberich
- Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain; These authors have contributed equally to the article
| | - F J Diaz
- Department of Biostatistics, The University of Kansas Medical Center, Kansas City, KS
| | - B Garcia-Bueno
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain; Department of Pharmacology, Faculty of Medicine, Universidad Complutense de Madrid, & Research Institute of Hospital 12 de Octubre (i+12), Madrid, Spain
| | - R Rodriguez-Jimenez
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain; Research Institute of Hospital 12 de Octubre (i+12), Madrid, Spain
| | - M Bioque
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain; Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Spain; Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - E Berrocoso
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain; Department of Psychology, Psychobiology Area, Group of Research in Neuropsychopharmacology and Psychobiology (CTS-510), University of Cádiz, Spain
| | - M Parellada
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - A Lobo
- Department of Psychiatry, Instituto de Investigación Sanitaria Aragón and University of Zaragoza, Spain
| | - P A Saiz
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry, Faculty of Medicine, University of Oviedo. Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - C Matute
- University of the Basque Country (UPV-EHU), Bilbao, Spain; CIBERNED Neuroscience, Zamudio, Vizcaya, Spain
| | - M Bernardo
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain; Barcelona Clínic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Spain; Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - A Gonzalez-Pinto
- Araba University Hospital, Bioaraba Research Institute, Vitoria, Spain; Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain; University of the Basque Country (UPV-EHU), Bilbao, Spain; These authors have contributed equally to the article
| | - J C Leza
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain; Department of Pharmacology, Faculty of Medicine, Universidad Complutense de Madrid, & Research Institute of Hospital 12 de Octubre (i+12), Madrid, Spain; These authors have contributed equally to the article
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Penadés R, García-Rizo C, Bioque M, González-Rodríguez A, Cabrera B, Mezquida G, Bernardo M. The search for new biomarkers for cognition in schizophrenia. SCHIZOPHRENIA RESEARCH-COGNITION 2015; 2:172-178. [PMID: 29114461 PMCID: PMC5609637 DOI: 10.1016/j.scog.2015.10.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The search for biomarkers in cognition has been the focus of a large part of the research on patients suffering from schizophrenia. The scientific literature is heterogeneous, and few studies establishing an integrative model of pathogenesis and therapeutic response are available in this field. In this review, we aimed to summarize three essential aspects correlated with cognitive performance: 1) the relationship between inflammation and cognition in schizophrenia, 2) the role of prolactin in cognition, and 3) the association between cognition and neurotrophic factors, particularly brain-derived neurotrophic factor (BDNF). Several studies support the association of inflammatory markers with cognitive status in schizophrenia. In recent decades, the development of effective therapies for cognitive impairment in schizophrenia has focused on the search for anti-inflammatory and immunomodulatory medications. Conversely, the implications of prolactin and its functions in cognition, the transition to psychosis and the diagnosis and prognosis of schizophrenia have been established independent of antipsychotic treatment. With regard to neurotrophic factors, a recent study has correlated BDNF levels with cognitive recovery in schizophrenic patients treated with cognitive remediation. We conclude that although there is a diversity of biomarkers focused on cognitive function in schizophrenia, BDNF is the biomarker that has accumulated the vast majority of evidence in the current literature.
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Affiliation(s)
- Rafael Penadés
- Barcelona Clinic Schizophrenia Unit (BCSU).,Hospital Clínic Barcelona.,University of Barcelona.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS).,Centro de Investigación en Red de Salud Mental (CIBERSAM)
| | - Clemente García-Rizo
- Barcelona Clinic Schizophrenia Unit (BCSU).,Hospital Clínic Barcelona.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS).,Centro de Investigación en Red de Salud Mental (CIBERSAM)
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit (BCSU).,Hospital Clínic Barcelona.,Centro de Investigación en Red de Salud Mental (CIBERSAM)
| | | | - Bibiana Cabrera
- Barcelona Clinic Schizophrenia Unit (BCSU).,Centro de Investigación en Red de Salud Mental (CIBERSAM)
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit (BCSU).,Centro de Investigación en Red de Salud Mental (CIBERSAM)
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit (BCSU).,Hospital Clínic Barcelona.,University of Barcelona.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS).,Centro de Investigación en Red de Salud Mental (CIBERSAM)
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Penadés R, Garcia-Rizo C, Bioque M, González-Rodríguez A, Cabrera B, Mezquida G, Bernardo M. Búsqueda De Nuevos Biomarcadores De La Cognición En Esquizofrenia. Schizophr Res Cogn 2015. [DOI: 10.1016/j.scog.2015.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Xu R, Wang Q. PhenoPredict: A disease phenome-wide drug repositioning approach towards schizophrenia drug discovery. J Biomed Inform 2015; 56:348-55. [PMID: 26151312 PMCID: PMC4589865 DOI: 10.1016/j.jbi.2015.06.027] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 06/26/2015] [Accepted: 06/29/2015] [Indexed: 01/26/2023]
Abstract
Schizophrenia (SCZ) is a common complex disorder with poorly understood mechanisms and no effective drug treatments. Despite the high prevalence and vast unmet medical need represented by the disease, many drug companies have moved away from the development of drugs for SCZ. Therefore, alternative strategies are needed for the discovery of truly innovative drug treatments for SCZ. Here, we present a disease phenome-driven computational drug repositioning approach for SCZ. We developed a novel drug repositioning system, PhenoPredict, by inferring drug treatments for SCZ from diseases that are phenotypically related to SCZ. The key to PhenoPredict is the availability of a comprehensive drug treatment knowledge base that we recently constructed. PhenoPredict retrieved all 18 FDA-approved SCZ drugs and ranked them highly (recall=1.0, and average ranking of 8.49%). When compared to PREDICT, one of the most comprehensive drug repositioning systems currently available, in novel predictions, PhenoPredict represented clear improvements over PREDICT in Precision-Recall (PR) curves, with a significant 98.8% improvement in the area under curve (AUC) of the PR curves. In addition, we discovered many drug candidates with mechanisms of action fundamentally different from traditional antipsychotics, some of which had published literature evidence indicating their treatment benefits in SCZ patients. In summary, although the fundamental pathophysiological mechanisms of SCZ remain unknown, integrated systems approaches to studying phenotypic connections among diseases may facilitate the discovery of innovative SCZ drugs.
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Affiliation(s)
- Rong Xu
- Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, United States.
| | - QuanQiu Wang
- ThinTek, LLC, Palo Alto, CA 94306, United States.
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Neonatal levels of inflammatory markers and later risk of schizophrenia. Biol Psychiatry 2015; 77:548-55. [PMID: 25152432 DOI: 10.1016/j.biopsych.2014.07.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 06/27/2014] [Accepted: 07/15/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND There is a long-standing interest in investigating the impact of early-life immune abnormalities on later onset of psychosis. The aim of this study was to assess inflammatory marker levels in neonatal dried blood spots and their association with later risk of schizophrenia. METHODS This nested case-control study included 995 cases and 980 control subjects. Cases were identified using the Danish Psychiatric Central Register. Control subjects of same age and sex were identified using the Danish Civil Registration System. Samples for the identified individuals were retrieved from the Danish Neonatal Screening Biobank. Concentrations of 17 inflammatory markers were measured in eluates from dried blood spots using a bead-based multiplex assay. Incidence rate ratios were calculated using conditional logistic regression. Principal component analysis was used to capture the overall variation in the inflammatory markers' concentrations. RESULTS No significant differences were found for any of the analyzed interleukins. We did not find any association with schizophrenia for any of the other examined inflammatory markers. CONCLUSIONS Our results suggest that persons who develop schizophrenia do not have higher or lower levels of the examined inflammatory markers at the time of birth. Our findings differ from the studies of maternal inflammatory changes during the antenatal period for which associations with schizophrenia have previously been demonstrated.
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Hashimoto K. Targeting of α7 Nicotinic Acetylcholine Receptors in the Treatment of Schizophrenia and the Use of Auditory Sensory Gating as a Translational Biomarker. Curr Pharm Des 2015; 21:3797-806. [PMID: 26044974 PMCID: PMC5024727 DOI: 10.2174/1381612821666150605111345] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 06/04/2015] [Indexed: 11/22/2022]
Abstract
Accumulating evidence suggests that the α7 subtype of nicotinic acetylcholine receptors (nAChRs) plays a key role in inflammatory processes, thought to be involved in the pathophysiology of neuropsychiatric diseases, such as schizophrenia and Alzheimer's disease. Preclinical and clinical studies showed that the diminished suppression of P50 auditory evoked potentials in patients with schizophrenia may be associated with a decreased density of α7 nAChRs in the brain. This points to a role for auditory sensory gating (P50) as a translational biomarker. A number of agonists and positive allosteric modulators (PAMs) for α7 nAChR promoted beneficial effects in animal models with sensory gating and cognitive deficits. Additionally, several clinical studies showed that α7 nAChR agonists could improve suppression in auditory P50 evoked potentials, as well as cognitive deficits, and negative symptoms in patients with schizophrenia. Taken together, α7 nAChR presents as an extremely attractive therapeutic target for schizophrenia. In this article, the author discusses recent findings on α7 nAChR agonists such as DMXB-A, RG3487, TC-5619, tropisetron, EVP-6124 (encenicline), ABT-126, AQW051 and α7 nAChR PAMs such as JNJ-39393406, PNU- 120596 and AVL-3288 (also known as UCI-4083), and their potential as therapeutic drugs for neuropsychiatric diseases, such as schizophrenia.
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Affiliation(s)
- Kenji Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic, Mental Health, 1-8-1 Inohana, Chiba 260-8670, Japan.
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Brand SJ, Moller M, Harvey BH. A Review of Biomarkers in Mood and Psychotic Disorders: A Dissection of Clinical vs. Preclinical Correlates. Curr Neuropharmacol 2015; 13:324-68. [PMID: 26411964 PMCID: PMC4812797 DOI: 10.2174/1570159x13666150307004545] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 02/04/2015] [Accepted: 03/06/2015] [Indexed: 11/23/2022] Open
Abstract
Despite significant research efforts aimed at understanding the neurobiological underpinnings of mood (depression, bipolar disorder) and psychotic disorders, the diagnosis and evaluation of treatment of these disorders are still based solely on relatively subjective assessment of symptoms as well as psychometric evaluations. Therefore, biological markers aimed at improving the current classification of psychotic and mood-related disorders, and that will enable patients to be stratified on a biological basis into more homogeneous clinically distinct subgroups, are urgently needed. The attainment of this goal can be facilitated by identifying biomarkers that accurately reflect pathophysiologic processes in these disorders. This review postulates that the field of psychotic and mood disorder research has advanced sufficiently to develop biochemical hypotheses of the etiopathology of the particular illness and to target the same for more effective disease modifying therapy. This implies that a "one-size fits all" paradigm in the treatment of psychotic and mood disorders is not a viable approach, but that a customized regime based on individual biological abnormalities would pave the way forward to more effective treatment. In reviewing the clinical and preclinical literature, this paper discusses the most highly regarded pathophysiologic processes in mood and psychotic disorders, thereby providing a scaffold for the selection of suitable biomarkers for future studies in this field, to develope biomarker panels, as well as to improve diagnosis and to customize treatment regimens for better therapeutic outcomes.
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Affiliation(s)
| | | | - Brian H Harvey
- Division of Pharmacology and Center of Excellence for Pharmaceutical Sciences, School of Pharmacy, North-West University, Potchefstroom, South Africa.
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García-Bueno B, Bioque M, MacDowell KS, Santabárbara J, Martínez-Cengotitabengoa M, Moreno C, Sáiz PA, Berrocoso E, Gassó P, Fe Barcones M, González-Pinto A, Parellada M, Bobes J, Micó JA, Bernardo M, Leza JC. Pro-/antiinflammatory dysregulation in early psychosis: results from a 1-year follow-up study. Int J Neuropsychopharmacol 2014; 18:pyu037. [PMID: 25577666 PMCID: PMC4368893 DOI: 10.1093/ijnp/pyu037] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 06/27/2014] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Previous studies indicated a systemic deregulation of the pro-/antiinflammatory balance in subjects after 6 months of a first psychotic episode. This disruption was reexamined 12 months after diagnosis to identify potential risk/protective factors and associations with symptom severity. METHODS Eighty-five subjects were followed during 12 months and the determination of the same pro-/antiinflammatory mediators was carried out in plasma and peripheral blood mononuclear cells. Multivariate logistic regression analyses were used to identify risk/protective factors. Multiple linear regression models were performed to detect the change of each biological marker during follow-up in relation to clinical characteristics and confounding factors. RESULTS This study suggests a more severe systemic pro-/antiinflammatory deregulation than in earlier pathological stages in first psychotic episode, because not only were intracellular components of the inflammatory response increased but also the majority of soluble elements. Nitrite plasma levels and cyclooxygenase-2 expression in peripheral blood mononuclear cells are reliable potential risk factors and 15d-prostaglandin-J2 plasma levels a protection biomarker. An interesting relationship exists between antipsychotic dose and the levels of prostaglandin-E2 (inverse) and 15d-prostaglandin-J2 (direct). An inverse relationship between the Global Assessment of Functioning scale and lipid peroxidation is also present. CONCLUSIONS Summing up, pro-/antiinflammatory mediators can be used as risk/protection biomarkers. The inverse association between oxidative/nitrosative damage and the Global Assessment of Functioning scale, and the possibility that one of the targets of antipsychotics could be the restoration of the pro-/antiinflammatory balance support the use of antiinflammatory drugs as coadjuvant to antipsychotics.
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Affiliation(s)
- Borja García-Bueno
- Department of Pharmacology, Faculty of Medicine, Complutense University, Instituto de Investigación Sanitaria -IIS- Hospital 12 de Octubre (i+12), Madrid, Spain (Drs García-Bueno, MacDowell, and Leza); Unitat d'Esquizofrènia Clínic, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain (Drs Bioque and Bernardo); Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain (Dr Santabárbara); Hospital Universitario, Alava, EHU/UPV and National Distance Education University, Vitoria, Spain (Drs Martínez-Cengotitabengoa and González-Pinto); Child and Adolescent Psychiatry Department IIS Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain (Drs Moreno and Parellada); Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain (Drs Sáiz and Bobes); Department of Pharmacology, Faculty of Medicine, University of Cádiz, Cádiz, Spain (Drs Berrocoso and Micó); Department of Pharmacology, Faculty of Medicine, University of Barcelona, Barcelona, Spain (Dr Gassó); Hospital Clínico Universitario, Zaragoza, Spain (Dr Fe Barcones)
| | - Miquel Bioque
- Department of Pharmacology, Faculty of Medicine, Complutense University, Instituto de Investigación Sanitaria -IIS- Hospital 12 de Octubre (i+12), Madrid, Spain (Drs García-Bueno, MacDowell, and Leza); Unitat d'Esquizofrènia Clínic, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain (Drs Bioque and Bernardo); Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain (Dr Santabárbara); Hospital Universitario, Alava, EHU/UPV and National Distance Education University, Vitoria, Spain (Drs Martínez-Cengotitabengoa and González-Pinto); Child and Adolescent Psychiatry Department IIS Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain (Drs Moreno and Parellada); Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain (Drs Sáiz and Bobes); Department of Pharmacology, Faculty of Medicine, University of Cádiz, Cádiz, Spain (Drs Berrocoso and Micó); Department of Pharmacology, Faculty of Medicine, University of Barcelona, Barcelona, Spain (Dr Gassó); Hospital Clínico Universitario, Zaragoza, Spain (Dr Fe Barcones)
| | - Karina S MacDowell
- Department of Pharmacology, Faculty of Medicine, Complutense University, Instituto de Investigación Sanitaria -IIS- Hospital 12 de Octubre (i+12), Madrid, Spain (Drs García-Bueno, MacDowell, and Leza); Unitat d'Esquizofrènia Clínic, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain (Drs Bioque and Bernardo); Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain (Dr Santabárbara); Hospital Universitario, Alava, EHU/UPV and National Distance Education University, Vitoria, Spain (Drs Martínez-Cengotitabengoa and González-Pinto); Child and Adolescent Psychiatry Department IIS Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain (Drs Moreno and Parellada); Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain (Drs Sáiz and Bobes); Department of Pharmacology, Faculty of Medicine, University of Cádiz, Cádiz, Spain (Drs Berrocoso and Micó); Department of Pharmacology, Faculty of Medicine, University of Barcelona, Barcelona, Spain (Dr Gassó); Hospital Clínico Universitario, Zaragoza, Spain (Dr Fe Barcones)
| | - Javier Santabárbara
- Department of Pharmacology, Faculty of Medicine, Complutense University, Instituto de Investigación Sanitaria -IIS- Hospital 12 de Octubre (i+12), Madrid, Spain (Drs García-Bueno, MacDowell, and Leza); Unitat d'Esquizofrènia Clínic, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain (Drs Bioque and Bernardo); Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain (Dr Santabárbara); Hospital Universitario, Alava, EHU/UPV and National Distance Education University, Vitoria, Spain (Drs Martínez-Cengotitabengoa and González-Pinto); Child and Adolescent Psychiatry Department IIS Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain (Drs Moreno and Parellada); Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain (Drs Sáiz and Bobes); Department of Pharmacology, Faculty of Medicine, University of Cádiz, Cádiz, Spain (Drs Berrocoso and Micó); Department of Pharmacology, Faculty of Medicine, University of Barcelona, Barcelona, Spain (Dr Gassó); Hospital Clínico Universitario, Zaragoza, Spain (Dr Fe Barcones)
| | - Mónica Martínez-Cengotitabengoa
- Department of Pharmacology, Faculty of Medicine, Complutense University, Instituto de Investigación Sanitaria -IIS- Hospital 12 de Octubre (i+12), Madrid, Spain (Drs García-Bueno, MacDowell, and Leza); Unitat d'Esquizofrènia Clínic, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain (Drs Bioque and Bernardo); Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain (Dr Santabárbara); Hospital Universitario, Alava, EHU/UPV and National Distance Education University, Vitoria, Spain (Drs Martínez-Cengotitabengoa and González-Pinto); Child and Adolescent Psychiatry Department IIS Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain (Drs Moreno and Parellada); Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain (Drs Sáiz and Bobes); Department of Pharmacology, Faculty of Medicine, University of Cádiz, Cádiz, Spain (Drs Berrocoso and Micó); Department of Pharmacology, Faculty of Medicine, University of Barcelona, Barcelona, Spain (Dr Gassó); Hospital Clínico Universitario, Zaragoza, Spain (Dr Fe Barcones)
| | - Carmen Moreno
- Department of Pharmacology, Faculty of Medicine, Complutense University, Instituto de Investigación Sanitaria -IIS- Hospital 12 de Octubre (i+12), Madrid, Spain (Drs García-Bueno, MacDowell, and Leza); Unitat d'Esquizofrènia Clínic, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain (Drs Bioque and Bernardo); Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain (Dr Santabárbara); Hospital Universitario, Alava, EHU/UPV and National Distance Education University, Vitoria, Spain (Drs Martínez-Cengotitabengoa and González-Pinto); Child and Adolescent Psychiatry Department IIS Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain (Drs Moreno and Parellada); Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain (Drs Sáiz and Bobes); Department of Pharmacology, Faculty of Medicine, University of Cádiz, Cádiz, Spain (Drs Berrocoso and Micó); Department of Pharmacology, Faculty of Medicine, University of Barcelona, Barcelona, Spain (Dr Gassó); Hospital Clínico Universitario, Zaragoza, Spain (Dr Fe Barcones)
| | - Pilar A Sáiz
- Department of Pharmacology, Faculty of Medicine, Complutense University, Instituto de Investigación Sanitaria -IIS- Hospital 12 de Octubre (i+12), Madrid, Spain (Drs García-Bueno, MacDowell, and Leza); Unitat d'Esquizofrènia Clínic, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain (Drs Bioque and Bernardo); Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain (Dr Santabárbara); Hospital Universitario, Alava, EHU/UPV and National Distance Education University, Vitoria, Spain (Drs Martínez-Cengotitabengoa and González-Pinto); Child and Adolescent Psychiatry Department IIS Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain (Drs Moreno and Parellada); Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain (Drs Sáiz and Bobes); Department of Pharmacology, Faculty of Medicine, University of Cádiz, Cádiz, Spain (Drs Berrocoso and Micó); Department of Pharmacology, Faculty of Medicine, University of Barcelona, Barcelona, Spain (Dr Gassó); Hospital Clínico Universitario, Zaragoza, Spain (Dr Fe Barcones)
| | - Esther Berrocoso
- Department of Pharmacology, Faculty of Medicine, Complutense University, Instituto de Investigación Sanitaria -IIS- Hospital 12 de Octubre (i+12), Madrid, Spain (Drs García-Bueno, MacDowell, and Leza); Unitat d'Esquizofrènia Clínic, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain (Drs Bioque and Bernardo); Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain (Dr Santabárbara); Hospital Universitario, Alava, EHU/UPV and National Distance Education University, Vitoria, Spain (Drs Martínez-Cengotitabengoa and González-Pinto); Child and Adolescent Psychiatry Department IIS Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain (Drs Moreno and Parellada); Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain (Drs Sáiz and Bobes); Department of Pharmacology, Faculty of Medicine, University of Cádiz, Cádiz, Spain (Drs Berrocoso and Micó); Department of Pharmacology, Faculty of Medicine, University of Barcelona, Barcelona, Spain (Dr Gassó); Hospital Clínico Universitario, Zaragoza, Spain (Dr Fe Barcones)
| | - Patricia Gassó
- Department of Pharmacology, Faculty of Medicine, Complutense University, Instituto de Investigación Sanitaria -IIS- Hospital 12 de Octubre (i+12), Madrid, Spain (Drs García-Bueno, MacDowell, and Leza); Unitat d'Esquizofrènia Clínic, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain (Drs Bioque and Bernardo); Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain (Dr Santabárbara); Hospital Universitario, Alava, EHU/UPV and National Distance Education University, Vitoria, Spain (Drs Martínez-Cengotitabengoa and González-Pinto); Child and Adolescent Psychiatry Department IIS Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain (Drs Moreno and Parellada); Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain (Drs Sáiz and Bobes); Department of Pharmacology, Faculty of Medicine, University of Cádiz, Cádiz, Spain (Drs Berrocoso and Micó); Department of Pharmacology, Faculty of Medicine, University of Barcelona, Barcelona, Spain (Dr Gassó); Hospital Clínico Universitario, Zaragoza, Spain (Dr Fe Barcones)
| | - M Fe Barcones
- Department of Pharmacology, Faculty of Medicine, Complutense University, Instituto de Investigación Sanitaria -IIS- Hospital 12 de Octubre (i+12), Madrid, Spain (Drs García-Bueno, MacDowell, and Leza); Unitat d'Esquizofrènia Clínic, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain (Drs Bioque and Bernardo); Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain (Dr Santabárbara); Hospital Universitario, Alava, EHU/UPV and National Distance Education University, Vitoria, Spain (Drs Martínez-Cengotitabengoa and González-Pinto); Child and Adolescent Psychiatry Department IIS Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain (Drs Moreno and Parellada); Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain (Drs Sáiz and Bobes); Department of Pharmacology, Faculty of Medicine, University of Cádiz, Cádiz, Spain (Drs Berrocoso and Micó); Department of Pharmacology, Faculty of Medicine, University of Barcelona, Barcelona, Spain (Dr Gassó); Hospital Clínico Universitario, Zaragoza, Spain (Dr Fe Barcones)
| | - Ana González-Pinto
- Department of Pharmacology, Faculty of Medicine, Complutense University, Instituto de Investigación Sanitaria -IIS- Hospital 12 de Octubre (i+12), Madrid, Spain (Drs García-Bueno, MacDowell, and Leza); Unitat d'Esquizofrènia Clínic, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain (Drs Bioque and Bernardo); Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain (Dr Santabárbara); Hospital Universitario, Alava, EHU/UPV and National Distance Education University, Vitoria, Spain (Drs Martínez-Cengotitabengoa and González-Pinto); Child and Adolescent Psychiatry Department IIS Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain (Drs Moreno and Parellada); Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain (Drs Sáiz and Bobes); Department of Pharmacology, Faculty of Medicine, University of Cádiz, Cádiz, Spain (Drs Berrocoso and Micó); Department of Pharmacology, Faculty of Medicine, University of Barcelona, Barcelona, Spain (Dr Gassó); Hospital Clínico Universitario, Zaragoza, Spain (Dr Fe Barcones)
| | - Mara Parellada
- Department of Pharmacology, Faculty of Medicine, Complutense University, Instituto de Investigación Sanitaria -IIS- Hospital 12 de Octubre (i+12), Madrid, Spain (Drs García-Bueno, MacDowell, and Leza); Unitat d'Esquizofrènia Clínic, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain (Drs Bioque and Bernardo); Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain (Dr Santabárbara); Hospital Universitario, Alava, EHU/UPV and National Distance Education University, Vitoria, Spain (Drs Martínez-Cengotitabengoa and González-Pinto); Child and Adolescent Psychiatry Department IIS Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain (Drs Moreno and Parellada); Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain (Drs Sáiz and Bobes); Department of Pharmacology, Faculty of Medicine, University of Cádiz, Cádiz, Spain (Drs Berrocoso and Micó); Department of Pharmacology, Faculty of Medicine, University of Barcelona, Barcelona, Spain (Dr Gassó); Hospital Clínico Universitario, Zaragoza, Spain (Dr Fe Barcones)
| | - Julio Bobes
- Department of Pharmacology, Faculty of Medicine, Complutense University, Instituto de Investigación Sanitaria -IIS- Hospital 12 de Octubre (i+12), Madrid, Spain (Drs García-Bueno, MacDowell, and Leza); Unitat d'Esquizofrènia Clínic, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain (Drs Bioque and Bernardo); Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain (Dr Santabárbara); Hospital Universitario, Alava, EHU/UPV and National Distance Education University, Vitoria, Spain (Drs Martínez-Cengotitabengoa and González-Pinto); Child and Adolescent Psychiatry Department IIS Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain (Drs Moreno and Parellada); Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain (Drs Sáiz and Bobes); Department of Pharmacology, Faculty of Medicine, University of Cádiz, Cádiz, Spain (Drs Berrocoso and Micó); Department of Pharmacology, Faculty of Medicine, University of Barcelona, Barcelona, Spain (Dr Gassó); Hospital Clínico Universitario, Zaragoza, Spain (Dr Fe Barcones)
| | - Juan A Micó
- Department of Pharmacology, Faculty of Medicine, Complutense University, Instituto de Investigación Sanitaria -IIS- Hospital 12 de Octubre (i+12), Madrid, Spain (Drs García-Bueno, MacDowell, and Leza); Unitat d'Esquizofrènia Clínic, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain (Drs Bioque and Bernardo); Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain (Dr Santabárbara); Hospital Universitario, Alava, EHU/UPV and National Distance Education University, Vitoria, Spain (Drs Martínez-Cengotitabengoa and González-Pinto); Child and Adolescent Psychiatry Department IIS Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain (Drs Moreno and Parellada); Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain (Drs Sáiz and Bobes); Department of Pharmacology, Faculty of Medicine, University of Cádiz, Cádiz, Spain (Drs Berrocoso and Micó); Department of Pharmacology, Faculty of Medicine, University of Barcelona, Barcelona, Spain (Dr Gassó); Hospital Clínico Universitario, Zaragoza, Spain (Dr Fe Barcones)
| | - Miguel Bernardo
- Department of Pharmacology, Faculty of Medicine, Complutense University, Instituto de Investigación Sanitaria -IIS- Hospital 12 de Octubre (i+12), Madrid, Spain (Drs García-Bueno, MacDowell, and Leza); Unitat d'Esquizofrènia Clínic, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain (Drs Bioque and Bernardo); Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain (Dr Santabárbara); Hospital Universitario, Alava, EHU/UPV and National Distance Education University, Vitoria, Spain (Drs Martínez-Cengotitabengoa and González-Pinto); Child and Adolescent Psychiatry Department IIS Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain (Drs Moreno and Parellada); Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain (Drs Sáiz and Bobes); Department of Pharmacology, Faculty of Medicine, University of Cádiz, Cádiz, Spain (Drs Berrocoso and Micó); Department of Pharmacology, Faculty of Medicine, University of Barcelona, Barcelona, Spain (Dr Gassó); Hospital Clínico Universitario, Zaragoza, Spain (Dr Fe Barcones)
| | - Juan C Leza
- Department of Pharmacology, Faculty of Medicine, Complutense University, Instituto de Investigación Sanitaria -IIS- Hospital 12 de Octubre (i+12), Madrid, Spain (Drs García-Bueno, MacDowell, and Leza); Unitat d'Esquizofrènia Clínic, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain (Drs Bioque and Bernardo); Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain (Dr Santabárbara); Hospital Universitario, Alava, EHU/UPV and National Distance Education University, Vitoria, Spain (Drs Martínez-Cengotitabengoa and González-Pinto); Child and Adolescent Psychiatry Department IIS Gregorio Marañón (IISGM), Hospital General Universitario Gregorio Marañón, Madrid, Spain (Drs Moreno and Parellada); Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain (Drs Sáiz and Bobes); Department of Pharmacology, Faculty of Medicine, University of Cádiz, Cádiz, Spain (Drs Berrocoso and Micó); Department of Pharmacology, Faculty of Medicine, University of Barcelona, Barcelona, Spain (Dr Gassó); Hospital Clínico Universitario, Zaragoza, Spain (Dr Fe Barcones).
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Tian L, Tan Y, Chen D, Lv M, Tan S, Soares JC, Zhang XY. Reduced serum TNF alpha level in chronic schizophrenia patients with or without tardive dyskinesia. Prog Neuropsychopharmacol Biol Psychiatry 2014; 54:259-64. [PMID: 24995685 DOI: 10.1016/j.pnpbp.2014.06.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 05/21/2014] [Accepted: 06/26/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Mounting evidences have demonstrated the association of altered immune factors with neurodevelopmental and pathological progression of schizophrenia. However, whether immune factors play any role in the pathogenesis of tardive dyskinesia (TD) has been underexplored. To our best knowledge, ours is among the piloting studies examining the association of TNF alpha with extrapyramidal symptoms of schizophrenic patients so far. OBJECTIVE The aim of this study was to assess the clinical significance of serum TNF alpha level in chronic schizophrenia, especially its potential association with TD. METHODS Serum TNF alpha level was measured in a sandwich enzyme-linked immunosorbent assay (ELISA) from 46 medicated chronic schizophrenia patients with TD, 43 chronic schizophrenia patients without TD, and 43 healthy control subjects. The symptoms of schizophrenia were assessed by the positive and negative syndrome scale (PANSS). RESULTS Chronic patients both with TD and without TD had significantly lower serum level of TNF alpha than controls (TD=9.5±2.1pg/ml, non-TD=10.7±1.8pg/ml, control=37.8±3.4pg/ml, p<0.001). Compared to patients without TD, TD patients showed marginally significant reduction in the serum TNF alpha level (p=0.05). The reduced TNF alpha level was not significantly affected by daily dose or duration of antipsychotic drugs (p>0.05). Serum TNF alpha level was negatively correlated with the PANSS total score in the whole schizophrenia patients (p<0.01), but no significant association with TD severity was observed. CONCLUSIONS Our results suggested that at chronic stage, serum TNF activity is associated with psychopathology of schizophrenia patients, but whether it can be a biomarker for TD needs further clarification in the future.
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Affiliation(s)
- Li Tian
- Neuroscience Center, Viikinkaari 4, FIN-00014, University of Helsinki, Helsinki, Finland; Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yunlong Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Dachun Chen
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Menghan Lv
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Shuping Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, Harris County Psychiatric Center, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Xiang Yang Zhang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China; Department of Psychiatry and Behavioral Sciences, Harris County Psychiatric Center, The University of Texas Health Science Center at Houston, Houston, TX, USA.
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Gil-Pisa I, Cebrián C, Ortega JE, Meana JJ, Sulzer D. Cytokine pathway disruption in a mouse model of schizophrenia induced by Munc18-1a overexpression in the brain. J Neuroinflammation 2014; 11:128. [PMID: 25069615 PMCID: PMC4128549 DOI: 10.1186/1742-2094-11-128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 06/26/2014] [Indexed: 01/17/2023] Open
Abstract
Background An accumulating body of evidence points to the significance of neuroinflammation and immunogenetics in schizophrenia, and an imbalance of cytokines in the central nervous system (CNS) has been suggested to be associated with the disorder. Munc18-overexpressing mice (Munc18-OE) have provided a model for the study of the alterations that may underlie the symptoms of subjects with schizophrenia. The aim of the present study was to elucidate the involvement of neuroinflammation and cytokine imbalance in this model. Methods Cytokines were evaluated in the cortex and the striatum of Munc18-OE and wild-type (WT) mice by enzyme-linked immunosorbent assay (ELISA). Protein levels of specific microglia and macrophage, astrocytic and neuroinflammation markers were quantified by western blot in the cortex and the striatum of Munc18-OE and WT mice. Results Each cytokine evaluated (Interferon-gamma (IFN-γ), Tumor Necrosis Factor-alpha (TNF-α), Interleukin-2 (IL-2) and CCL2 chemokine) was present at higher levels in the striatum of Munc18-OE mice than WT. Cortical TNF-α and IL-2 levels were significantly lower in Munc18-OE mice than WT mice. The microglia and macrophage marker CD11b was lower in the cortexes of Munc18-OE mice than WT, but no differences were observed in the striatum. Glial Fibrillary Acidic Protein (GFAP) and Nuclear Factor-kappaB (NF-κB)p65 levels were not different between the groups. Interleukin-1beta (IL-1β) and IL-6 levels were beneath detection limits. Conclusions The disrupted levels of cytokines detected in the brain of Munc18-OE mice was found to be similar to clinical reports and endorses study of this type for analysis of this aspect of the disorder. The lower CD11b expression in the cortex but not in the striatum of the Munc18-OE mice may reflect differences in physiological activity. The cytokine expression pattern observed in Munc18-OE mice is similar to a previously published model of schizophrenia caused by maternal immune activation. Together, these data suggest a possible role for an immune imbalance in this disorder.
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Affiliation(s)
- Itziar Gil-Pisa
- Department of Neurology, Columbia University Medical Center, 710 W, 168th Street, New York, NY 10032, USA.
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Li Z, Ma L, Kulesskaya N, Võikar V, Tian L. Microglia are polarized to M1 type in high-anxiety inbred mice in response to lipopolysaccharide challenge. Brain Behav Immun 2014; 38:237-48. [PMID: 24561490 DOI: 10.1016/j.bbi.2014.02.008] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 02/11/2014] [Accepted: 02/12/2014] [Indexed: 12/11/2022] Open
Abstract
Immune activation in the brain has been shown to contribute to neurodevelopmental and pathological progression of mental disorders, and microglia play a central role in these processes. But how genetic predisposition and environmental risk factors may act in combination to affect microglial activation and the underlying molecular mechanisms are largely unclear. In this work, we studied the inflammatory profile of microglia across four inbred strains of mice with different anxiety traits: C57BL/6J, FVB/N, DBA/2J, and 129S2/Sv. Importantly, we found that a high-anxiety strain, naïve DBA/2J mice, had significantly more M1 (MHCII(+)CD206(-))-polarized microglia, whereas another high-anxiety strain, naïve 129S2/Sv mice, expressed significantly more activated (MHCII(+)) perivascular macrophages than the other strains. After a systemic LPS challenge, polarization to M1 microglia in DBA/2J and 129S2/Sv mice was even more prominent than in C57BL/6J and FVB/N mice, and was correlated with their anxiety-like behaviors. Macrophage M1/M2 polarization in the spleen showed a similar pattern in DBA/2J and 129S2/Sv mice in response to LPS stimulation. Furthermore, DBA/2J mice expressed higher mRNA levels of Il1b, Il6, and Tnf, and higher Nos2/Arg1 ratio but lower Chi3l3 level in the hypothalamus before and after LPS stimulation, respectively. In comparison, 129S1/Sv, a sibling line of 129S2/Sv, expressed significantly higher levels of other immune-related genes in the brain. We further discovered a group of myeloid transcription factors that may underpin the strain-specific differences in microglial activation. We conclude that proinflammatory microglial activation reflects anxiety traits in mice, especially after a peripheral innate immune challenge. Our work sheds new light in understanding the potential molecular mechanisms of stress-induced microglial activation and polarization.
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Affiliation(s)
- Zhilin Li
- Neuroscience Center, University of Helsinki, Helsinki, Finland
| | - Li Ma
- Neuroscience Center, University of Helsinki, Helsinki, Finland
| | | | - Vootele Võikar
- Neuroscience Center, University of Helsinki, Helsinki, Finland; Laboratory Animal Center, University of Helsinki, Helsinki, Finland
| | - Li Tian
- Neuroscience Center, University of Helsinki, Helsinki, Finland.
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Abstract
OBJECTIVES The purpose of this review is to analyse, sum up and discuss the available literature on the role of inflammation and inflammatory cytokines in the pathogenesis of schizophrenia. METHODS An electronic literature search of peer-reviewed English language articles using Pubmed was undertaken. These articles together with those published by us provided the background for the present review. RESULTS An overview of the available literature on this issue clearly demonstrated the alterations in mRNA and protein expression levels of several proinflammatory and chemotactic cytokines in patients with schizophrenia. Importantly, some of these changes are genetically determined. It was noteworthy that, depending on the study population, some variations of the data obtained are detected. CONCLUSIONS Altered inflammatory cytokine production, both genetically and environmentally determined, is implicated in schizophrenia and contributes to disease-associated low-grade systemic inflammation. Proinflammatory and chemotactic cytokines and their receptors may represent additional therapeutic targets for treatment of schizophrenia.
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Chemokines and chemokine receptors in mood disorders, schizophrenia, and cognitive impairment: a systematic review of biomarker studies. Neurosci Biobehav Rev 2014; 42:93-115. [PMID: 24513303 DOI: 10.1016/j.neubiorev.2014.02.001] [Citation(s) in RCA: 181] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 12/22/2013] [Accepted: 02/02/2014] [Indexed: 12/24/2022]
Abstract
The search for immune biomarkers in psychiatric disorders has primarily focused on pro-inflammatory cytokines. Other immune proteins including chemokines have been relatively neglected in such studies. Recent evidence has implicated chemokines in many neurobiological processes potentially relevant to psychiatric disorders, beyond their classical chemotactic functions. These may include neuromodulator effects, neurotransmitter-like effects, and direct/indirect regulation of neurogenesis. This systematic review presents the existing early evidence which supports an association of many chemokines with the psychiatric disorders: depression, bipolar disorder, schizophrenia, mild cognitive impairment and Alzheimer's disease. The non-specific association of chemokines including CXCL8 (IL-8), CCL2 (MCP-1), CCL3 (MIP-1α) and CCL5 (RANTES) with these disorders across diagnostic categories implies a generalised involvement of many chemokine systemic with psychiatric disease. Additional chemokines with great mechanistic relevance including CXCL12 (SDF-1) and CX3CL1 (fractalkine) have been rarely reported in the existing human literature and should be included in future clinical studies. The potential utility of these proteins as pathologically relevant biomarkers or therapeutic targets should be considered by future clinical and translational research.
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Kroken RA, Løberg EM, Drønen T, Grüner R, Hugdahl K, Kompus K, Skrede S, Johnsen E. A critical review of pro-cognitive drug targets in psychosis: convergence on myelination and inflammation. Front Psychiatry 2014; 5:11. [PMID: 24550848 PMCID: PMC3912739 DOI: 10.3389/fpsyt.2014.00011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 01/20/2014] [Indexed: 12/19/2022] Open
Abstract
Antipsychotic drugs have thus far focused on dopaminergic antagonism at the D2 receptors, as counteracting the hyperdopaminergia in nigrostriatal and mesolimbic projections has been considered mandatory for the antipsychotic action of the drugs. Current drugs effectively target the positive symptoms of psychosis such as hallucinations and delusions in the majority of patients, whereas effect sizes are smaller for negative symptoms and cognitive dysfunctions. With the understanding that neurocognitive dysfunction associated with schizophrenia have a greater impact on functional outcome than the positive symptoms, the focus in pharmacotherapy for schizophrenia has shifted to the potential effect of future drugs on cognitive enhancement. A major obstacle is, however, that the biological underpinnings of cognitive dysfunction remain largely unknown. With the availability of increasingly sophisticated techniques in molecular biology and brain imaging, this situation is about to change with major advances being made in identifying the neuronal substrates underlying schizophrenia, and putative pro-cognitive drug targets may be revealed. In relation to cognitive effects, this review focuses on evidence from basic neuroscience and clinical studies, taking two separate perspectives. One perspective is the identification of previously under-recognized treatment targets for existing antipsychotic drugs, including myelination and mediators of inflammation. A second perspective is the development of new drugs or novel treatment targets for well-known drugs, which act on recently discovered treatment targets for cognitive enhancement, and which may complement the existing drugs. This might pave the way for personalized treatment regimens for patients with schizophrenia aimed at improved functional outcome. The review also aims at identifying major current constraints for pro-cognitive drug development for patients with schizophrenia.
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Affiliation(s)
- Rune A. Kroken
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Else-Marie Løberg
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Tore Drønen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Renate Grüner
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
- Department of Physics and Technology, University of Bergen, Bergen, Norway
| | - Kenneth Hugdahl
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
- NORMENT Center of Excellence, University of Bergen, Bergen, Norway
| | - Kristiina Kompus
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Silje Skrede
- NORMENT Center of Excellence, University of Bergen, Bergen, Norway
- Dr. Einar Martens’ Research Group for Biological Psychiatry, Centre for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, K.G. Jebsen Centre for Psychosis Research, University of Bergen, Bergen, Norway
| | - Erik Johnsen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Abstract
Accumulating evidence suggests that neuroinflammation affecting microglia plays an important role in the etiology of schizophrenia, and appropriate control of microglial activation may be a promising therapeutic strategy for schizophrenia. Minocycline, a second-generation tetracycline that inhibits microglial activation, has been shown to have a neuroprotective effect in various models of neurodegenerative disease, including anti-inflammatory, antioxidant, and antiapoptotic properties, and an ability to modulate glutamate-induced excitotoxicity. Given that these mechanisms overlap with neuropathologic pathways, minocycline may have a potential role in the adjuvant treatment of schizophrenia, and improve its negative symptoms. Here, we review the relevant studies of minocycline, ranging from preclinical research to human clinical trials.
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Affiliation(s)
- Lulu Zhang
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, People's Republic of China ; Department of Psychology, Guangzhou First People's Hospital, Guangzhou, Guangdong, People's Republic of China
| | - Jingping Zhao
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, People's Republic of China
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Nitta M, Kishimoto T, Müller N, Weiser M, Davidson M, Kane JM, Correll CU. Adjunctive use of nonsteroidal anti-inflammatory drugs for schizophrenia: a meta-analytic investigation of randomized controlled trials. Schizophr Bull 2013; 39:1230-41. [PMID: 23720576 PMCID: PMC3796088 DOI: 10.1093/schbul/sbt070] [Citation(s) in RCA: 137] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To meta-analytically assess the efficacy and tolerability of nonsteroidal anti-inflammatory drugs (NSAIDs) vs placebo in schizophrenia. METHOD Searching PubMed, PsycINFO, ISI Web of Science, and the US National Institute of Mental Health clinical trials registry from database inception to December 31, 2012, we conducted a systematic review/meta-analysis of randomized placebo-controlled studies assessing the efficacy of adjunctive NSAIDs. Primary outcome was the change in Positive and Negative Syndrome Scale (PANSS) total score. Secondary outcomes included change in PANSS positive and negative subscores, all-cause discontinuation, and tolerability outcomes. Random effects, pooled, standardized mean changes (Hedges' g) and risk ratios were calculated. RESULTS Across 8 studies, including 3 unpublished reports (n = 774), the mean effect size for PANSS total score was -0.236 (95% CI: -0.484 to 0.012, P = .063, I(2) = 60.6%), showing only trend-level superiority for NSAIDs over placebo. The mean effect sizes for the PANSS positive and negative scores were -0.189 (95% CI: -0.373 to -0.005, P = .044) and -0.026 (95% CI: -0.169 to 0.117, P = .72), respectively. The relative risk for all-cause discontinuation was 1.13 (95% CI: 0.794 to 1.599, P = .503). Significant superiority of NSAIDs over placebo regarding PANSS total scores was moderated by aspirin treatment (N = 2, P = .017), inpatient status (N = 4, P = .029), first-episode status (N = 2, P = .048), and (in meta-regression analyses) lower PANSS negative subscores (N = 6, P = .026). INTERPRETATION These results indicate that adjunctive NSAIDs for schizophrenia may not benefit patients treated with first-line antipsychotics judged by PANSS total score change. NSAIDs may have benefits for positive symptoms, but the effect was minimal/small. However, due to a limited database, further controlled studies are needed, especially in first-episode patients.
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Affiliation(s)
- Masahiro Nitta
- *To whom correspondence should be addressed; Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, 75-59 263rd Street, Glen Oaks, NY 11004; tel: (718) 470-4812, fax: (718) 343-1659, e-mail:
| | - Taishiro Kishimoto
- Psychiatry Research, The Zucker Hillside Hospital, North Shore—Long Island Jewish Health System, Geln Oaks, NY
| | - Norbert Müller
- Hospital for Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität, München, Germany
| | - Mark Weiser
- Department of Psychiatry, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michael Davidson
- Department of Psychiatry, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - John M. Kane
- Psychiatry Research, The Zucker Hillside Hospital, North Shore—Long Island Jewish Health System, Geln Oaks, NY; ,Department of Psychiatry and Molecular Medicine, Hofstra North Shore LIJ School of Medicine, Hempstead, NY;,The Feinstein Institute for Medical Research, Psychiatric Neuroscience Center of Excellence, Manhasset, NY;,Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY
| | - Christoph U. Correll
- Psychiatry Research, The Zucker Hillside Hospital, North Shore—Long Island Jewish Health System, Geln Oaks, NY; ,Department of Psychiatry and Molecular Medicine, Hofstra North Shore LIJ School of Medicine, Hempstead, NY;,The Feinstein Institute for Medical Research, Psychiatric Neuroscience Center of Excellence, Manhasset, NY;,Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY,*To whom correspondence should be addressed; Psychiatry Research, The Zucker Hillside Hospital, North Shore—Long Island Jewish Health System, 75-59 263rd Street, Glen Oaks, NY 11004; tel: (718) 470–4812, fax: (718) 343–1659, e-mail:
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Ratnayake U, Quinn T, Walker DW, Dickinson H. Cytokines and the neurodevelopmental basis of mental illness. Front Neurosci 2013; 7:180. [PMID: 24146637 PMCID: PMC3797953 DOI: 10.3389/fnins.2013.00180] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 09/19/2013] [Indexed: 11/21/2022] Open
Abstract
Epidemiological studies suggest that prenatal exposure to different types of viral or bacterial infections may be associated with similar outcomes; i.e., an increased risk of mental illness disorders in the offspring. Infections arising from various causes have similar debilitating effects in later life, suggesting that the exact pathogen may not be the critical factor in determining the neurological and cognitive outcome in the offspring. Instead, it is thought that response of the innate immune system, specifically the increased production of inflammatory cytokines, may be the critical mediator in altering fetal brain development pre-disposing the offspring to mental illness disorders later in life. Inflammatory cytokines are essential for normal brain development. Factors such as the site of cytokine production, a change in balance between anti- and pro- inflammatory cytokines, placental transfer of cytokines, the effects of cytokines on glial cells, and the effects of glucocorticoids are important when evaluating the impact of maternal infection on fetal brain development. Although it is clear that cytokines are altered in the fetal brain following maternal infection, further evidence is required to determine if cytokines are the critical factor that alters the trajectory of brain development, subsequently leading to postnatal behavioral and neurological abnormalities.
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Affiliation(s)
- Udani Ratnayake
- Ritchie Centre, Monash Institute of Medical Research, Monash University Clayton, Australia
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van de Veerdonk FL, Netea MG. New Insights in the Immunobiology of IL-1 Family Members. Front Immunol 2013; 4:167. [PMID: 23847614 PMCID: PMC3703542 DOI: 10.3389/fimmu.2013.00167] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Accepted: 06/12/2013] [Indexed: 12/28/2022] Open
Abstract
The interleukin-1 (IL 1) family of ligands is associated with acute and chronic inflammation, and plays an essential role in the non-specific innate response to infection. The biological properties of IL 1 family ligands are typically pro-inflammatory. The IL 1 family has 11 family members and can be categorized into subfamilies according to the length of their precursor and the length of the propiece for each precursor (Figure 1). The IL 1 subfamily consists of IL 1α, IL 1β, and IL 33, with the longest propieces of the IL 1 family. IL 18 and IL 37 belong to the IL 18 subfamily and contain smaller propieces than IL 1 and IL-33. Since IL 37 binds to the IL 18Rα chain it is part of the IL 18 subfamily, however it remains to be elucidated how the propiece of IL 37 is removed. IL 36α, β, and γ as well as IL 36 Ra belong to the IL 36 subfamily. In addition, IL 38 likely belongs to this family since it has the ability to bind to the IL 36R. The IL 36 subfamily has the shortest propiece. The one member of the IL 1 family that cannot be categorized in these subfamilies is IL 1 receptor antagonist (IL 1Ra), which has a signal peptide and is readily secreted. In the present review we will describe the biological functions of the IL-1F members and new insights in their biology.
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Affiliation(s)
- Frank L van de Veerdonk
- Department of Medicine, Radboud University Nijmegen Medical Center, Nijmegen Institute for Infection, Inflammation and Immunity (N4i) , Nijmegen , Netherlands
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Antipsychotics can modulate the cytokine profile in schizophrenia: attenuation of the type-2 inflammatory response. Schizophr Res 2013; 147:103-109. [PMID: 23602340 DOI: 10.1016/j.schres.2013.03.027] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Revised: 03/13/2013] [Accepted: 03/21/2013] [Indexed: 12/30/2022]
Abstract
OBJECTIVE We recently reported that the type-2 cytokine response is increased in schizophrenia. The aim of this study was to analyse the effects of antipsychotic drugs on the serum levels of type-1 (TNF-α, IFN-γ), type-2 (IL-4, IL-10), type-17 (IL-17) and regulatory cytokines (TGF-β, IL-27 and IL-6). METHODS Cytokine measurements in the patients were performed on day 0 and day 30 of the treatment using standard ELISA assays. Three groups of subjects were studied: patients that were unmedicated with First Episode Psychosis (FEP; n=88), patients that were treated with antipsychotics with Schizophrenia in relapse (SC in relapse; n=45) and healthy controls (n=36). RESULTS TGF-β levels were increased in both patient groups and were further enhanced after treatment in the FEP group (p=0.014) but not in the SC relapse group. Antipsychotic treatment was correlated with lower levels of IL-4, IL-6 and IL-27 (p<0.005) in the FEP group. Finally, the serum levels of IL-17 were not significantly altered between the two measurements but were significantly lower in the FEP group (p<0.001) when compared with healthy controls. After therapy, patients with SC who were in relapse had decreased serum levels of IL-4 (p=0.006) and IL-6 (p=0.007). We also observed a weak negative correlation between the IFN-γ/TGF-β ratio and the total PANSS score and between the IL-17/TGF-β ratio and the negative and general psychopathology subscales. CONCLUSION The increased type-2 cytokine serum levels in schizophrenia appear to be downregulated by antipsychotic treatment.
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Fineberg AM, Ellman LM. Inflammatory cytokines and neurological and neurocognitive alterations in the course of schizophrenia. Biol Psychiatry 2013; 73:951-66. [PMID: 23414821 PMCID: PMC3641168 DOI: 10.1016/j.biopsych.2013.01.001] [Citation(s) in RCA: 148] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 12/07/2012] [Accepted: 01/02/2013] [Indexed: 02/07/2023]
Abstract
A growing body of evidence suggests that immune alterations, especially those related to inflammation, are associated with increased risk of schizophrenia and schizophrenia-related brain alterations. Much of this work has focused on the prenatal period, because infections during pregnancy have been repeatedly (albeit inconsistently) linked to risk of schizophrenia. Given that most infections do not cross the placenta, cytokines associated with inflammation (proinflammatory cytokines) have been targeted as potential mediators of the damaging effects of infection on the fetal brain in prenatal studies. Moreover, additional evidence from both human and animal studies suggests links between increased levels of proinflammatory cytokines, immune-related genes, and schizophrenia as well as brain alterations associated with the disorder. Additional support for the role of altered immune factors in the etiology of schizophrenia comes from neuroimaging studies, which have linked proinflammatory cytokine gene polymorphisms with some of the structural and functional abnormalities repeatedly found in schizophrenia. These findings are reviewed and discussed with a life course perspective, examining the contribution of inflammation from the fetal period to disorder presentation. Unexplored areas and future directions, such as the interplay between inflammation, genes, and individual-level environmental factors (e.g., stress, sleep, and nutrition), are also discussed.
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Kneeland RE, Fatemi SH. Viral infection, inflammation and schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2013; 42:35-48. [PMID: 22349576 PMCID: PMC3408569 DOI: 10.1016/j.pnpbp.2012.02.001] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 01/06/2012] [Accepted: 02/02/2012] [Indexed: 12/16/2022]
Abstract
Schizophrenia is a severe neurodevelopmental disorder with genetic and environmental etiologies. Prenatal viral/bacterial infections and inflammation play major roles in the genesis of schizophrenia. In this review, we describe a viral model of schizophrenia tested in mice whereby the offspring of mice prenatally infected with influenza at E7, E9, E16, and E18 show significant gene, protein, and brain structural abnormalities postnatally. Similarly, we describe data on rodents exposed to bacterial infection or injected with a synthetic viral mimic (PolyI:C) also demonstrating brain structural and behavioral abnormalities. Moreover, human serologic data has been indispensible in supporting the viral theory of schizophrenia. Individuals born seropositive for bacterial and viral agents are at a significantly elevated risk of developing schizophrenia. While the specific mechanisms of prenatal viral/bacterial infections and brain disorder are unclear, recent findings suggest that the maternal inflammatory response may be associated with fetal brain injury. Preventive and therapeutic treatment options are also proposed. This review presents data related to epidemiology, human serology, and experimental animal models which support the viral model of schizophrenia.
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Affiliation(s)
- Rachel E. Kneeland
- Department of Psychiatry, Division of Neuroscience Research, University of Minnesota Medical School, 420 Delaware St. SE, MMC 392, Minneapolis, MN 55455, United States
| | - S. Hossein Fatemi
- Department of Psychiatry, Division of Neuroscience Research, University of Minnesota Medical School, 420 Delaware St. SE, MMC 392, Minneapolis, MN 55455, United States,Department of Pharmacology, University of Minnesota Medical School, 310 Church St. SE, Minneapolis, MN 55455, United States and Department of Neuroscience, University of Minnesota Medical School, 310 Church St. SE, Minneapolis, MN 55455, United States,Corresponding author at: 420 Delaware Street SE, MMC 392, Minneapolis, MN 55455. Tel.: +1 612 626 3633; fax: +1 612 624 8935. (R.E. Kneeland), (S.H. Fatemi)
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Updating the mild encephalitis hypothesis of schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2013; 42:71-91. [PMID: 22765923 DOI: 10.1016/j.pnpbp.2012.06.019] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 06/11/2012] [Accepted: 06/25/2012] [Indexed: 12/13/2022]
Abstract
Schizophrenia seems to be a heterogeneous disorder. Emerging evidence indicates that low level neuroinflammation (LLNI) may not occur infrequently. Many infectious agents with low overall pathogenicity are risk factors for psychoses including schizophrenia and for autoimmune disorders. According to the mild encephalitis (ME) hypothesis, LLNI represents the core pathogenetic mechanism in a schizophrenia subgroup that has syndromal overlap with other psychiatric disorders. ME may be triggered by infections, autoimmunity, toxicity, or trauma. A 'late hit' and gene-environment interaction are required to explain major findings about schizophrenia, and both aspects would be consistent with the ME hypothesis. Schizophrenia risk genes stay rather constant within populations despite a resulting low number of progeny; this may result from advantages associated with risk genes, e.g., an improved immune response, which may act protectively within changing environments, although they are associated with the disadvantage of increased susceptibility to psychotic disorders. Specific schizophrenic symptoms may arise with instances of LLNI when certain brain functional systems are involved, in addition to being shaped by pre-existing liability factors. Prodrome phase and the transition to a diseased status may be related to LLNI processes emerging and varying over time. The variability in the course of schizophrenia resembles the varying courses of autoimmune disorders, which result from three required factors: genes, the environment, and the immune system. Preliminary criteria for subgrouping neurodevelopmental, genetic, ME, and other types of schizophrenias are provided. A rare example of ME schizophrenia may be observed in Borna disease virus infection. Neurodevelopmental schizophrenia due to early infections has been estimated by others to explain approximately 30% of cases, but the underlying pathomechanisms of transition to disease remain in question. LLNI (e.g. from reactivation related to persistent infection) may be involved and other pathomechanisms including dysfunction of the blood-brain barrier or the blood-CSF barrier, CNS-endogenous immunity and the volume transmission mode balancing wiring transmission (the latter represented mainly by synaptic transmission, which is often described as being disturbed in schizophrenia). Volume transmission is linked to CSF signaling; and together could represent a common pathogenetic link for the distributed brain dysfunction, dysconnectivity, and brain structural abnormalities observed in schizophrenia. In addition, CSF signaling may extend into peripheral tissues via the CSF outflow pathway along brain nerves and peripheral nerves, and it may explain the peripheral topology of neuronal dysfunctions found, like in olfactory dysfunction, dysautonomia, and even in peripheral tissues, i.e., the muscle lesions that were found in 50% of cases. Modulating factors in schizophrenia, such as stress, hormones, and diet, are also modulating factors in the immune response. Considering recent investigations of CSF, the ME schizophrenia subgroup may constitute approximately 40% of cases.
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