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Huang CC. Case report: Rare variants in the MTRR gene, 66GG and 524TT cause hyperhomocysteinemia and folic acid deficiency linked to schizophrenia. Front Psychiatry 2024; 15:1353308. [PMID: 39071225 PMCID: PMC11272478 DOI: 10.3389/fpsyt.2024.1353308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 07/01/2024] [Indexed: 07/30/2024] Open
Abstract
We present an adult patient with schizophrenia who was later found to have hyperhomocysteinemia, a condition that increases the risk of several diseases, due to a deficiency in folic acid. Although folic acid supplementation quickly normalized the hyperhomocysteinemia and folic acid levels, it did not significantly improve the overall mental and cognitive health. Genotype analysis was performed and the patient was found to have two pathogenic variants in the MTRR gene, 66GG and 524TT, which encodes for methionine synthase reductase (MSR), an enzyme crucial for homocysteine metabolism. The results can shed light on the reasons behind the patient's hyperhomocysteinemia and folic acid deficiency. Hyperhomocysteinemia confers an increased risk of several diseases. Indeed, the patient has neurodevelopment and cardiovascular health problems for decades. Given the rarity of the condition and the nonspecific nature of the symptoms, the detection of hyperhomocysteinemia or MSR deficiency can often be delayed or overlooked. Considering the potential irreversible and detrimental consequences of prolonged hyperhomocysteinemia and folic acid deficiency that our patient is likely experiencing, we suggest that clinicians be vigilant for associated signs when they encounter adolescents exhibiting psychotic symptoms, especially those with additional physical symptoms and a history of resistance to treatment.
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Affiliation(s)
- Chih-Chia Huang
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan
- Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
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Ben-Azu B, Adebayo OG, Fokoua AR, Oritsemuelebi B, Chidebe EO, Nwogueze CB, Kumanwee L, Uyere GE, Emuakpeje MT. Antipsychotic effect of diosgenin in ketamine-induced murine model of schizophrenia: Involvement of oxidative stress and cholinergic transmission. IBRO Neurosci Rep 2024; 16:86-97. [PMID: 38282757 PMCID: PMC10818187 DOI: 10.1016/j.ibneur.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/17/2023] [Accepted: 12/29/2023] [Indexed: 01/30/2024] Open
Abstract
A decrease in the levels of antioxidant arsenals exacerbate generation of reactive oxygen/nitrogen species, leading to neurochemical dysfunction, with significant impact on the pathogenesis of psychotic disorders such as schizophrenia. This study examined the preventive and reversal effects of diosgenin, a phyto-steroidal saponin with antioxidant functions in mice treated with ketamine which closely replicates schizophrenia-like symptoms in human and laboratory animals. In the preventive phase, adult mice cohorts were clustered into 5 groups (n = 9). Groups 1 and 2 received saline (10 mL/kg, i.p.), groups 3 and 4 were pretreated with diosgenin (25 and 50 mg/kg), and group 5 received risperidone (0.5 mg/kg) orally for 14 days. Mice in groups 2-5 additionally received a daily dose of ketamine (20 mg/kg, i.p.) or saline (10 mL/kg/day, i.p.). In the reversal phase, mice received intraperitoneal injection of ketamine or saline for 14 consecutive days prior to diosgenin (25 and 50 mg/kg/p.o./day) and risperidone (0.5 mg/kg/p.o./day) treatment from days 8-14. Mice were assessed for behavioral changes. Oxidative, nitrergic markers, and cholinergic (acetylcholinesterase activity) transmission were examined in the striatum, prefrontal-cortex and hippocampus. Diosgenin prevented and reversed hyperlocomotion, cognitive and social deficits in mice treated with ketamine relative to ketamine groups. The increased acetylcholinesterase, malondialdehyde and nitrite levels produced by ketamine were reduced by diosgenin in the striatum, prefrontal-cortex and hippocampus, but did not reverse striatal nitrite level. Diosgenin increased glutathione, and catalase levels, except for hippocampal catalase activity when compared with ketamine controls. Conclusively, these biochemical changes might be related to the behavioral deficits in ketamine-treated mice, which were prevented and reversed by diosgenin.
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Affiliation(s)
- Benneth Ben-Azu
- DELSU Joint Canada-Israel Neuroscience and Biopsychiatry Laboratory, Department of Pharmacology, Faculty of Basic Medical Sciences, College of Health Sciences, Delta State University, Abraka, Delta State, Nigeria
| | - Olusegun G. Adebayo
- DELSU Joint Canada-Israel Neuroscience and Biopsychiatry Laboratory, Department of Pharmacology, Faculty of Basic Medical Sciences, College of Health Sciences, Delta State University, Abraka, Delta State, Nigeria
- Neurophysiology Unit, Department of Physiology, Faculty of Basic Medical Sciences, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Aliance Romain Fokoua
- DELSU Joint Canada-Israel Neuroscience and Biopsychiatry Laboratory, Department of Pharmacology, Faculty of Basic Medical Sciences, College of Health Sciences, Delta State University, Abraka, Delta State, Nigeria
- Research unit of Neuroinflammatory and Cardiovascular Pharmacology, Department of Animal Biology, Faculty of Sciences, University of Dschang, Cameroon
| | - Benjamin Oritsemuelebi
- DELSU Joint Canada-Israel Neuroscience and Biopsychiatry Laboratory, Department of Pharmacology, Faculty of Basic Medical Sciences, College of Health Sciences, Delta State University, Abraka, Delta State, Nigeria
| | - Emmanuel O. Chidebe
- DELSU Joint Canada-Israel Neuroscience and Biopsychiatry Laboratory, Department of Pharmacology, Faculty of Basic Medical Sciences, College of Health Sciences, Delta State University, Abraka, Delta State, Nigeria
| | - Chukwuebuka B. Nwogueze
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, Delta State University, Abraka, Delta State, Nigeria
| | - Lenatababari Kumanwee
- DELSU Joint Canada-Israel Neuroscience and Biopsychiatry Laboratory, Department of Pharmacology, Faculty of Basic Medical Sciences, College of Health Sciences, Delta State University, Abraka, Delta State, Nigeria
| | - God'swill E. Uyere
- DELSU Joint Canada-Israel Neuroscience and Biopsychiatry Laboratory, Department of Pharmacology, Faculty of Basic Medical Sciences, College of Health Sciences, Delta State University, Abraka, Delta State, Nigeria
| | - Micheal T. Emuakpeje
- DELSU Joint Canada-Israel Neuroscience and Biopsychiatry Laboratory, Department of Pharmacology, Faculty of Basic Medical Sciences, College of Health Sciences, Delta State University, Abraka, Delta State, Nigeria
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Fuentes-Claramonte P, Estradé A, Solanes A, Ramella-Cravaro V, Garcia-Leon MA, de Diego-Adeliño J, Molins C, Fung E, Valentí M, Anmella G, Pomarol-Clotet E, Oliver D, Vieta E, Radua J, Fusar-Poli P. Biomarkers for Psychosis: Are We There Yet? Umbrella Review of 1478 Biomarkers. SCHIZOPHRENIA BULLETIN OPEN 2024; 5:sgae018. [PMID: 39228676 PMCID: PMC11369642 DOI: 10.1093/schizbullopen/sgae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
Background and Hypothesis This umbrella review aims to comprehensively synthesize the evidence of association between peripheral, electrophysiological, neuroimaging, neuropathological, and other biomarkers and diagnosis of psychotic disorders. Study Design We selected systematic reviews and meta-analyses of observational studies on diagnostic biomarkers for psychotic disorders, published until February 1, 2018. Data extraction was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Evidence of association between biomarkers and psychotic disorders was classified as convincing, highly suggestive, suggestive, weak, or non-significant, using a standardized classification. Quality analyses used the Assessment of Multiple Systematic Reviews (AMSTAR) tool. Study Results The umbrella review included 110 meta-analyses or systematic reviews corresponding to 3892 individual studies, 1478 biomarkers, and 392 210 participants. No factor showed a convincing level of evidence. Highly suggestive evidence was observed for transglutaminase autoantibodies levels (odds ratio [OR] = 7.32; 95% CI: 3.36, 15.94), mismatch negativity in auditory event-related potentials (standardized mean difference [SMD] = 0.73; 95% CI: 0.5, 0.96), P300 component latency (SMD = -0.6; 95% CI: -0.83, -0.38), ventricle-brain ratio (SMD = 0.61; 95% CI: 0.5, 0.71), and minor physical anomalies (SMD = 0.99; 95% CI: 0.64, 1.34). Suggestive evidence was observed for folate, malondialdehyde, brain-derived neurotrophic factor, homocysteine, P50 sensory gating (P50 S2/S1 ratio), frontal N-acetyl-aspartate, and high-frequency heart rate variability. Among the remaining biomarkers, weak evidence was found for 626 and a non-significant association for 833 factors. Conclusions While several biomarkers present highly suggestive or suggestive evidence of association with psychotic disorders, methodological biases, and underpowered studies call for future higher-quality research.
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Affiliation(s)
- Paola Fuentes-Claramonte
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
| | - Andrés Estradé
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
| | - Aleix Solanes
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Barcelona Autonomous University (UAB), Barcelona, Spain
| | - Valentina Ramella-Cravaro
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
| | - Maria Angeles Garcia-Leon
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
| | - Javier de Diego-Adeliño
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Barcelona Autonomous University (UAB), Barcelona, Spain
- Sant Pau Mental Health Research Group, Institut de Recerca Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Conrad Molins
- Psychiatric Service, Hospital Universitari Santa Maria, Lleida, Catalonia, Spain
| | - Eric Fung
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Marc Valentí
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Gerard Anmella
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
| | - Dominic Oliver
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
- NIHR Oxford Health Biomedical Research Centre, Oxford OX3 7JX, UK
- OPEN Early Detection Service, Oxford Health NHS Foundation Trust, Oxford OX3 7JX, UK
| | - Eduard Vieta
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Joaquim Radua
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Barcelona, Spain
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
- OASIS Service, South London and the Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Zhilyaeva TV, Kasyanov ED, Rukavishnikov GV, Piatoikina AS, Bavrina AP, Kostina OV, Zhukova ES, Shcherbatyuk TG, Mazo GE. Pterin metabolism, inflammation and oxidative stress biochemical markers in schizophrenia: Factor analysis and assessment of clinical symptoms associations. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110823. [PMID: 37437837 DOI: 10.1016/j.pnpbp.2023.110823] [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: 04/13/2023] [Revised: 06/30/2023] [Accepted: 07/07/2023] [Indexed: 07/14/2023]
Abstract
Various aspects of folate and tetrahydrobiopterin (BH4) metabolism disturbances have been detected in patients with schizophrenia.Data were obtained that disturbances in the pterins (folates and BH4) metabolism can be associated with oxidative stress and inflammation, but has not yet been confirmed in clinical studies in schizophrenia. Within the framework of this study, a correlation and factor analysis of biochemical markersof pterin metabolism, inflammation and redox imbalance in patients with schizophrenia was performed in order to test the hypothesis of the single etiopathogenetic node, including the studied biochemical processes. Methods: 125 patients with schizophrenia and 95 healthy volunteers were randomly selected and evaluated with a biochemical examination of BH4, folate, B12, homocysteine, C-reactive protein, interleukin-6, reduced glutathione levels in the blood serum; activity of superoxide dismutase and catalase - in erythrocytes; malondialdehyde - in blood plasma. All patients underwent an examination using standardized psychopathology rating scales. Spearman rank coefficient (ρ) with Benjamini-Hochberg correction was used for the correlation analysis. The principal components analysis (PCA) was used as a factor analysis. Results: Significant correlations were found within groups of pterin metabolism, inflammatory markers and redox-imbalance, and also between separate inflammation, oxidative stress and markers of pterin metabolism. The performed factor analysis made it possible to distinguish two components: 1 - pterin metabolism, 2 - oxidativeinflammatory markers. Despite the weak statistical associations and, possibly, functional relationships between pterin metabolism and oxidative/inflammation markers, each of the components has its own clinical correlates and, probably, a separate contribution to the pathology of schizophrenia.
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Affiliation(s)
- T V Zhilyaeva
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia; V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia.
| | - E D Kasyanov
- V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - G V Rukavishnikov
- V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - A S Piatoikina
- Nizhny Novgorod Clinical Psychiatric, Hospital No. 1, Nizhny Novgorod, Russia
| | - A P Bavrina
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - O V Kostina
- Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - E S Zhukova
- Nizhny Novgorod Research Institute for Hygiene and Occupational Pathology, Nizhny Novgorod, Russia
| | - T G Shcherbatyuk
- Nizhny Novgorod Research Institute for Hygiene and Occupational Pathology, Nizhny Novgorod, Russia; Pushchino State Institute of Natural Science, Pushchino, Russia
| | - G E Mazo
- V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Russia
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徐 龙, 曹 峰, 仝 瑞, 王 臣, 张 迎. [Relationship between coronavirus disease 2019 vaccination and the risk of immune thrombocytopenia]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:966-970. [PMID: 37718404 PMCID: PMC10511229 DOI: 10.7499/j.issn.1008-8830.2302074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/08/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVES To study the relationship between coronavirus disease 2019 (COVID-19) vaccination and the risk of immune thrombocytopenia (ITP). METHODS A retrospective analysis was conducted on children aged 3-17 years with newly diagnosed ITP who were hospitalized in Children's Hospital Affiliated to Zhengzhou University from November 2021 to December 2022. Clinical data and COVID-19 vaccination status were compared among three groups: ITP patients vaccinated within 12 weeks before onset, vaccinated more than 12 weeks before onset, and unvaccinated. Changes in serum immunoglobulin and complement levels were analyzed among five groups: ITP patients vaccinated <4 weeks before onset, 4-<8 weeks before onset, 8-<12 weeks before onset, ≥12 weeks before onset, and unvaccinated. A case-control design was used to estimate the risk of ITP: 387 children aged 3-17 years with fractures hospitalized during the same period in the emergency department of the hospital were selected as the control group, and the exposure to COVID-19 vaccination within 12, 8, and 4 weeks before onset in ITP children was compared to estimate the risk of ITP. RESULTS Among 129 ITP children, there were no statistically significant differences in age, gender, rate of preceding infections, absolute platelet count at initial diagnosis, absolute lymphocyte count at initial diagnosis, bleeding score, positive anti-nuclear antibody rate, absolute platelet count after 4 days of treatment, recurrence rate, and proportion of patients with disease duration ≥3 months among the three groups vaccinated within 12 weeks before onset, vaccinated more than 12 weeks before onset, and unvaccinated (P>0.05). There was a statistically significant difference in serum immunoglobulin G, immunoglobulin A, and complement component 3 levels among the groups vaccinated <4 weeks, 4-<8 weeks, 8-<12 weeks, and ≥12 weeks before onset, and unvaccinated (P<0.05). The risk estimation results showed that COVID-19 vaccination within 12 weeks, 8 weeks, and 4 weeks before onset did not increase the risk of ITP (P>0.05). CONCLUSIONS COVID-19 vaccination does not increase the risk of ITP.
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Frajerman A, Urban M, Rivollier F, Plaze M, Chaumette B, Krebs MO, Scoriels L. Abnormalities in one-carbon metabolism in young patients with psychosis. Front Psychiatry 2023; 14:1128890. [PMID: 36816414 PMCID: PMC9928860 DOI: 10.3389/fpsyt.2023.1128890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/16/2023] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Folates, the main actors in one-carbon (C1) metabolism, are involved in synthesising monoamines and maintaining genomic stability. Previous studies support the association between C1 metabolism and schizophrenia. The main purpose of this study was to assess the prevalence of plasma folate, and/or vitamin B12 deficiencies and hyperhomocysteinemia in young patients with psychotic disorders. METHODS We included young inpatients (15-30 years old) with psychosis between 2014 and 2017 from Sainte-Anne Hospital in Paris. Plasma folate, vitamin B12 deficiency and homocysteinemia dosages were done at admission. Clinical data were extracted retrospectively, and patients diagnosed with a first-episode psychosis (FEP), schizophrenia, schizoaffective disorder, or persistent delusional disorder were retained for the analysis. RESULTS Among the 334 inpatients, 188 (56%) had C1 dosages available (135 males; 53 females). From the 188 patients, 32% had a C1 abnormality. This abnormality reached 38% of FEP patients. The most frequent abnormality was folate deficiency: 21% of all patients and 27% of FEP. Lower levels of folates were found in males compared to females (p = 0.02) and were correlated with more severe disorder, as assessed by Clinical Global Impression - Severity (CGI-S; p = 0.009). Antipsychotic dosage was positively associated with B12 levels (p = 0.013) and negatively with homocysteinemia (p = 0.034). CONCLUSION One-carbon metabolism anomalies in young patients with psychotic disorders are highly prevalent, reaching almost half of the patients with FEP. Potential protective effects from females and antipsychotics have emerged. These results spotlight the need for new therapeutic prospects, such as folate supplementation, to achieve personalised medical approaches to the early stages of psychotic disorders.
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Affiliation(s)
- Ariel Frajerman
- Université de Paris, INSERM U1266, Institute of Psychiatry and Neuroscience of Paris (IPNP), CNRS GDR3557, Paris, France.,MOODS Team, INSERM, CESP, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin-Bicêtre, France.,Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France
| | - Marie Urban
- Groupe Hospitalier Universitaire (GHU) Paris Psychiatrie et Neurosciences, Paris, France
| | - Fabrice Rivollier
- Université de Paris, INSERM U1266, Institute of Psychiatry and Neuroscience of Paris (IPNP), CNRS GDR3557, Paris, France.,Groupe Hospitalier Universitaire (GHU) Paris Psychiatrie et Neurosciences, Paris, France
| | - Marion Plaze
- Groupe Hospitalier Universitaire (GHU) Paris Psychiatrie et Neurosciences, Paris, France
| | - Boris Chaumette
- Université de Paris, INSERM U1266, Institute of Psychiatry and Neuroscience of Paris (IPNP), CNRS GDR3557, Paris, France.,Groupe Hospitalier Universitaire (GHU) Paris Psychiatrie et Neurosciences, Paris, France.,Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Marie-Odile Krebs
- Université de Paris, INSERM U1266, Institute of Psychiatry and Neuroscience of Paris (IPNP), CNRS GDR3557, Paris, France.,Groupe Hospitalier Universitaire (GHU) Paris Psychiatrie et Neurosciences, Paris, France
| | - Linda Scoriels
- Université de Paris, INSERM U1266, Institute of Psychiatry and Neuroscience of Paris (IPNP), CNRS GDR3557, Paris, France.,Groupe Hospitalier Universitaire (GHU) Paris Psychiatrie et Neurosciences, Paris, France
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Halting the Metabolic Complications of Antipsychotic Medication in Patients with a First Episode of Psychosis: How Far Can We Go with the Mediterranean Diet? A Pilot Study. Nutrients 2022; 14:nu14235012. [PMID: 36501042 PMCID: PMC9738803 DOI: 10.3390/nu14235012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/20/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
Patients with first-episode psychosis (FEP) often adopt unhealthy dietary patterns, with a risk of weight gain and metabolic and cardiovascular disease. In 21 FEP patients receiving nutritional intervention based on the Mediterranean diet (MedDiet), we explored differences in anthropometric and biometric parameters, according to their antipsychotic (AP) medication: AP1, associated with a lower risk, or AP2, associated with a higher risk of weight gain and metabolic complications. The blood biochemical profile was recorded before and after dietary intervention, and dietary habits and body composition were monitored for six months. Following intervention, all of the patients recorded significant increases in the consumption of fruit and vegetables and decreases in red meat and poultry consumption, with closer adherence to the MedDiet and a reduction in the daily intake of calories, carbohydrates, and sodium. Vegetable consumption and energy, protein, and carbohydrate intake were lower in AP1 patients than in AP2 patients. There was no significant weight gain overall. A reduction was demonstrated in total and LDL cholesterol, sodium, urea, and iron (lower in AP1 patients). It was evident that AP medication affected blood levels of lipids, urea, and iron of FEP patients, but MedDiet nutritional intervention led to a significant improvement in their eating habits, with a restriction in weight gain and a decrease in blood sodium and urea.
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Amada N, Kakumoto Y, Futamura T, Maeda K. Prenatal methotrexate injection increases behaviors possibly associated with depression and/or autism in rat offspring; A new animal model for mental disorder, based on folate metabolism deficit during pregnancy. Neuropsychopharmacol Rep 2022; 42:263-271. [PMID: 35502620 PMCID: PMC9515720 DOI: 10.1002/npr2.12255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/18/2022] [Accepted: 04/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background Deficiency of folate, an essential vitamin for DNA synthesis and methylation, is reported as a risk factor for mental disorders. Considering a possibility that folate metabolism deficit during pregnancy may disturb CNS development and increase mental disorders in offspring, we treated pregnant rats with methotrexate (MTX), an inhibitor of folate metabolic enzyme, and evaluated offspring behaviors. Methods Saline or MTX was intraperitoneally administered to female SD rats on gestational day 17. Offspring behaviors were evaluated during approximately 6–9 weeks old; prepulse inhibition (PPI), social interaction (SI), locomotor activity (LA), and forced swimming test (FST) for evaluation of schizophrenia, depression, and autism related behaviors; the elevated plus maze (EPM) and the light–dark box (LD) test for evaluation of anxiety. Results Compared to saline‐treated group, MTX‐treated group showed decrease of SI and increase of immobility time in FST. In addition, increases of time spent in the light box and shuttling between the light–dark boxes were observed in LD test. On the other hand, no changes were confirmed in EPM, LA, and PPI. Conclusion Decrease of SI and increase of immobility time in FST may suggest association of this animal model with depression and/or autism. Increase of time spent in the light box and shuttling between the light–dark boxes may indicate changes in anxiety or cognitive level to environment, or repetitive behaviors in autism. Although further studies are warranted to characterize this animal model, at least we can say that prenatal MTX exposure, possibly causing folate metabolism deficit, affects offspring behaviors.
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Affiliation(s)
- Naoki Amada
- Department of CNS Research, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
| | - Yusuke Kakumoto
- Department of Lead Discovery Research, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
| | - Takashi Futamura
- Department of CNS Research, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
| | - Kenji Maeda
- Department of Lead Discovery Research, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
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Zhilyaeva T, Chekanina O, Rukavishnikov G, Blagonravova A, Mazo G. Methylenetetrahydrofolate dehydrogenase-1 (MTHFD1) 1958 G>A genetic polymorphism (rs2236225) is associated with lower schizophrenia risk: Preliminary study. GENE REPORTS 2022. [DOI: 10.1016/j.genrep.2022.101625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jusup I, Murtantyo H, Woroasih S, Fitrikasari A. Folic Acid as the Adjuvant Therapy for Chronic Schizophrenia: A Comprehensive Study on Glutathione Reductase. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
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Zhilyaeva T, Kasyanov E, Pyatoikina A, Blagonravova A, Mazo G. The association of serum folate levels with schizophrenia symptoms. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:128-135. [DOI: 10.17116/jnevro2022122081128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Robinson N, Bergen SE. Environmental Risk Factors for Schizophrenia and Bipolar Disorder and Their Relationship to Genetic Risk: Current Knowledge and Future Directions. Front Genet 2021; 12:686666. [PMID: 34262598 PMCID: PMC8273311 DOI: 10.3389/fgene.2021.686666] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 05/20/2021] [Indexed: 12/16/2022] Open
Abstract
Schizophrenia (SZ) and bipolar disorder (BD) are severe psychiatric disorders which result from complex interplay between genetic and environmental factors. It is well-established that they are highly heritable disorders, and considerable progress has been made identifying their shared and distinct genetic risk factors. However, the 15-40% of risk that is derived from environmental sources is less definitively known. Environmental factors that have been repeatedly investigated and often associated with SZ include: obstetric complications, infections, winter or spring birth, migration, urban living, childhood adversity, and cannabis use. There is evidence that childhood adversity and some types of infections are also associated with BD. Evidence for other risk factors in BD is weaker due to fewer studies and often smaller sample sizes. Relatively few environmental exposures have ever been examined for SZ or BD, and additional ones likely remain to be discovered. A complete picture of how genetic and environmental risk factors confer risk for these disorders requires an understanding of how they interact. Early gene-by-environment interaction studies for both SZ and BD often involved candidate genes and were underpowered. Larger samples with genome-wide data and polygenic risk scores now offer enhanced prospects to reveal genetic interactions with environmental exposures that contribute to risk for these disorders. Overall, although some environmental risk factors have been identified for SZ, few have been for BD, and the extent to which these account for the total risk from environmental sources remains unknown. For both disorders, interactions between genetic and environmental risk factors are also not well understood and merit further investigation. Questions remain regarding the mechanisms by which risk factors exert their effects, and the ways in which environmental factors differ by sex. Concurrent investigations of environmental and genetic risk factors in SZ and BD are needed as we work toward a more comprehensive understanding of the ways in which these disorders arise.
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Affiliation(s)
| | - Sarah E. Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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13
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Brusač E, Jeličić ML, Cvetnić M, Amidžić Klarić D, Nigović B, Mornar A. A Comprehensive Approach to Compatibility Testing Using Chromatographic, Thermal and Spectroscopic Techniques: Evaluation of Potential for a Monolayer Fixed-Dose Combination of 6-Mercaptopurine and Folic Acid. Pharmaceuticals (Basel) 2021; 14:ph14030274. [PMID: 33802871 PMCID: PMC8002671 DOI: 10.3390/ph14030274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/01/2021] [Accepted: 03/04/2021] [Indexed: 11/17/2022] Open
Abstract
In this work, a systematical compatibility investigation of 6-mercaptopurine and folic acid, two commonly used medications in the treatment of inflammatory bowel disease, for the needs of a fixed-dose combination development strategy is shown. Various techniques and approaches, such as differential scanning calorimetry, isothermal stress testing, attenuated total reflectance–Fourier-transform infrared spectroscopy, dissolution medium stability and forced degradation studies, were used to elucidate the possible interactions from different aspects. The results predominantly point to the absence of physicochemical interactions between the examined substances in a variety of possible conditions. However, the forced degradation of the blend of substances and excipients in basic conditions showed a drastic degradation of 6-mercaptopurine, signifying that attention needs to be directed to the careful selection of the excipients for the formulation. To sum up, our findings indicate that a fixed-dose combination of 6-mercaptopurine and folic acid could be produced using one formulation blend, immensely simplifying its manufacture.
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Affiliation(s)
- Edvin Brusač
- Faculty of Pharmacy and Biochemistry, University of Zagreb, A. Kovačića 1, 10000 Zagreb, Croatia; (E.B.); (M.-L.J.); (D.A.K.); (B.N.)
| | - Mario-Livio Jeličić
- Faculty of Pharmacy and Biochemistry, University of Zagreb, A. Kovačića 1, 10000 Zagreb, Croatia; (E.B.); (M.-L.J.); (D.A.K.); (B.N.)
| | - Matija Cvetnić
- Faculty of Chemical Engineering and Technology, University of Zagreb, Marulićev trg 19, 10000 Zagreb, Croatia;
| | - Daniela Amidžić Klarić
- Faculty of Pharmacy and Biochemistry, University of Zagreb, A. Kovačića 1, 10000 Zagreb, Croatia; (E.B.); (M.-L.J.); (D.A.K.); (B.N.)
| | - Biljana Nigović
- Faculty of Pharmacy and Biochemistry, University of Zagreb, A. Kovačića 1, 10000 Zagreb, Croatia; (E.B.); (M.-L.J.); (D.A.K.); (B.N.)
| | - Ana Mornar
- Faculty of Pharmacy and Biochemistry, University of Zagreb, A. Kovačića 1, 10000 Zagreb, Croatia; (E.B.); (M.-L.J.); (D.A.K.); (B.N.)
- Correspondence: ; Tel.: +385-1-481-8288
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14
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Semennov IV, Zhilyaeva TV, Kasyanov ED, Mishanov GA, Chekanina OM, Blagonravova AS, Mazo GE. Association of tetrahydrobiopterin deficiency with disturbances in one-carbon metabolism in patients with schizophrenia. Schizophr Res 2021; 229:132-133. [PMID: 33234426 DOI: 10.1016/j.schres.2020.11.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/14/2020] [Accepted: 11/15/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Ilya Vladimirovich Semennov
- Federal State Budgetary Educational Institution of Higher Education "Privolzhsky Research Medical University", Ministry of Health of the Russian Federation, 10/1 Minin and Pozharsky sq., Nizhny Novgorod 603005, Russia
| | - Tatyana Vladimirovna Zhilyaeva
- Federal State Budgetary Educational Institution of Higher Education "Privolzhsky Research Medical University", Ministry of Health of the Russian Federation, 10/1 Minin and Pozharsky sq., Nizhny Novgorod 603005, Russia.
| | - Evgeny Dmitrievich Kasyanov
- Federal State Budgetary Institution "Bekhterev National Medical Research Center for Psychiatry and Neurology", Ministry of Health of the Russian Federation, 3 Bekhtereva st., St. Petersburg 192019, Russia
| | - Georgy Aleksandrovich Mishanov
- Federal State Budgetary Educational Institution of Higher Education "Privolzhsky Research Medical University", Ministry of Health of the Russian Federation, 10/1 Minin and Pozharsky sq., Nizhny Novgorod 603005, Russia
| | - Oksana Mikhailovna Chekanina
- Federal State Budgetary Educational Institution of Higher Education "Privolzhsky Research Medical University", Ministry of Health of the Russian Federation, 10/1 Minin and Pozharsky sq., Nizhny Novgorod 603005, Russia
| | - Anna Sergeevna Blagonravova
- Federal State Budgetary Educational Institution of Higher Education "Privolzhsky Research Medical University", Ministry of Health of the Russian Federation, 10/1 Minin and Pozharsky sq., Nizhny Novgorod 603005, Russia
| | - Galina Elevna Mazo
- Federal State Budgetary Institution "Bekhterev National Medical Research Center for Psychiatry and Neurology", Ministry of Health of the Russian Federation, 3 Bekhtereva st., St. Petersburg 192019, Russia
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15
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Ermakov EA, Dmitrieva EM, Parshukova DA, Kazantseva DV, Vasilieva AR, Smirnova LP. Oxidative Stress-Related Mechanisms in Schizophrenia Pathogenesis and New Treatment Perspectives. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:8881770. [PMID: 33552387 PMCID: PMC7847339 DOI: 10.1155/2021/8881770] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 12/15/2020] [Accepted: 01/02/2021] [Indexed: 02/07/2023]
Abstract
Schizophrenia is recognized to be a highly heterogeneous disease at various levels, from genetics to clinical manifestations and treatment sensitivity. This heterogeneity is also reflected in the variety of oxidative stress-related mechanisms contributing to the phenotypic realization and manifestation of schizophrenia. At the molecular level, these mechanisms are supposed to include genetic causes that increase the susceptibility of individuals to oxidative stress and lead to gene expression dysregulation caused by abnormal regulation of redox-sensitive transcriptional factors, noncoding RNAs, and epigenetic mechanisms favored by environmental insults. These changes form the basis of the prooxidant state and lead to altered redox signaling related to glutathione deficiency and impaired expression and function of redox-sensitive transcriptional factors (Nrf2, NF-κB, FoxO, etc.). At the cellular level, these changes lead to mitochondrial dysfunction and metabolic abnormalities that contribute to aberrant neuronal development, abnormal myelination, neurotransmitter anomalies, and dysfunction of parvalbumin-positive interneurons. Immune dysfunction also contributes to redox imbalance. At the whole-organism level, all these mechanisms ultimately contribute to the manifestation and development of schizophrenia. In this review, we consider oxidative stress-related mechanisms and new treatment perspectives associated with the correction of redox imbalance in schizophrenia. We suggest that not only antioxidants but also redox-regulated transcription factor-targeting drugs (including Nrf2 and FoxO activators or NF-κB inhibitors) have great promise in schizophrenia. But it is necessary to develop the stratification criteria of schizophrenia patients based on oxidative stress-related markers for the administration of redox-correcting treatment.
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Affiliation(s)
- Evgeny A. Ermakov
- Laboratory of Repair Enzymes, Institute of Chemical Biology and Fundamental Medicine, Siberian Division of Russian Academy of Sciences, Novosibirsk 630090, Russia
| | - Elena M. Dmitrieva
- Laboratory of Molecular Genetics and Biochemistry, Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk 634014, Russia
| | - Daria A. Parshukova
- Laboratory of Molecular Genetics and Biochemistry, Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk 634014, Russia
| | | | | | - Liudmila P. Smirnova
- Laboratory of Molecular Genetics and Biochemistry, Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk 634014, Russia
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Semennov IV, Pyatoikina AS, Zagryazhskaya YS, Rukavishnikov GV, Kas’yanov ED, Zhilyaeva TV, Blagonravova AS, Mazo GE. Biochemical Markers of Folate Metabolism Disorders in Schizophrenia in the Russian Population. NEUROCHEM J+ 2021. [DOI: 10.1134/s1819712421010116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Madireddy S, Madireddy S. Regulation of Reactive Oxygen Species-Mediated Damage in the Pathogenesis of Schizophrenia. Brain Sci 2020; 10:brainsci10100742. [PMID: 33081261 PMCID: PMC7603028 DOI: 10.3390/brainsci10100742] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/06/2020] [Accepted: 10/15/2020] [Indexed: 12/16/2022] Open
Abstract
The biochemical integrity of the brain is paramount to the function of the central nervous system, and oxidative stress is a key contributor to cerebral biochemical impairment. Oxidative stress, which occurs when an imbalance arises between the production of reactive oxygen species (ROS) and the efficacy of the antioxidant defense mechanism, is believed to play a role in the pathophysiology of various brain disorders. One such disorder, schizophrenia, not only causes lifelong disability but also induces severe emotional distress; however, because of its onset in early adolescence or adulthood and its progressive development, consuming natural antioxidant products may help regulate the pathogenesis of schizophrenia. Therefore, elucidating the functions of ROS and dietary antioxidants in the pathogenesis of schizophrenia could help formulate improved therapeutic strategies for its prevention and treatment. This review focuses specifically on the roles of ROS and oxidative damage in the pathophysiology of schizophrenia, as well as the effects of nutrition, antipsychotic use, cognitive therapies, and quality of life on patients with schizophrenia. By improving our understanding of the effects of various nutrients on schizophrenia, it may become possible to develop nutritional strategies and supplements to treat the disorder, alleviate its symptoms, and facilitate long-term recovery.
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Affiliation(s)
- Samskruthi Madireddy
- Independent Researcher, 1353 Tanaka Drive, San Jose, CA 95131, USA
- Correspondence: ; Tel.: +1-408-9214162
| | - Sahithi Madireddy
- Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139, USA;
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18
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Tomioka Y, Kinoshita M, Umehara H, Nakayama T, Watanabe SY, Nakataki M, Numata S, Ohmori T. Association between serum folate levels and schizophrenia based on sex. Psychiatry Clin Neurosci 2020; 74:466-471. [PMID: 32445495 DOI: 10.1111/pcn.13074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/17/2020] [Accepted: 05/10/2020] [Indexed: 02/06/2023]
Abstract
AIM Sex differences in serum folate concentrations are well known, but no studies have investigated the association between serum folate levels and schizophrenia based on sex. With this study in a Japanese population, we examined the difference in serum folate levels between patients with schizophrenia and non-psychiatric controls stratified by sex. The relations among serum folate levels, plasma total homocysteine (tHcy), and serum vitamin B6 (pyridoxal) levels were also examined using data from our previous studies. METHODS The serum folate concentrations of 482 patients diagnosed with schizophrenia and 1350 non-psychiatric control subjects were measured. We conducted an analysis of covariance to examine the differences in serum folate levels between the two groups based on sex. Spearman's rank correlation was used to evaluate the relations among folate, tHcy, and vitamin B6 levels. RESULTS In the control group, serum folate concentrations were higher in women than in men. Lower levels of serum folate were observed in both male and female patients with schizophrenia. An inverse correlation between serum folate and plasma tHcy and a weak positive correlation between serum folate and vitamin B6 were observed in the combined cohort. CONCLUSION Our findings suggest that: (i) a low serum folate level may be associated with schizophrenia regardless of sex; and (ii) folate administration may be beneficial for the treatment of schizophrenia. In schizophrenic patients with low serum folate levels, folate administration might result in improvements in high tHcy and an increase in low vitamin B6 levels.
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Affiliation(s)
- Yukiko Tomioka
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Makoto Kinoshita
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Hidehiro Umehara
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Tomohiko Nakayama
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Shin-Ya Watanabe
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Masahito Nakataki
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Shusuke Numata
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Tetsuro Ohmori
- Department of Psychiatry, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
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19
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Carvalho AF, Solmi M, Sanches M, Machado MO, Stubbs B, Ajnakina O, Sherman C, Sun YR, Liu CS, Brunoni AR, Pigato G, Fernandes BS, Bortolato B, Husain MI, Dragioti E, Firth J, Cosco TD, Maes M, Berk M, Lanctôt KL, Vieta E, Pizzagalli DA, Smith L, Fusar-Poli P, Kurdyak PA, Fornaro M, Rehm J, Herrmann N. Evidence-based umbrella review of 162 peripheral biomarkers for major mental disorders. Transl Psychiatry 2020; 10:152. [PMID: 32424116 PMCID: PMC7235270 DOI: 10.1038/s41398-020-0835-5] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/03/2020] [Accepted: 05/01/2020] [Indexed: 01/03/2023] Open
Abstract
The literature on non-genetic peripheral biomarkers for major mental disorders is broad, with conflicting results. An umbrella review of meta-analyses of non-genetic peripheral biomarkers for Alzheimer's disease, autism spectrum disorder, bipolar disorder (BD), major depressive disorder, and schizophrenia, including first-episode psychosis. We included meta-analyses that compared alterations in peripheral biomarkers between participants with mental disorders to controls (i.e., between-group meta-analyses) and that assessed biomarkers after treatment (i.e., within-group meta-analyses). Evidence for association was hierarchically graded using a priori defined criteria against several biases. The Assessment of Multiple Systematic Reviews (AMSTAR) instrument was used to investigate study quality. 1161 references were screened. 110 met inclusion criteria, relating to 359 meta-analytic estimates and 733,316 measurements, on 162 different biomarkers. Only two estimates met a priori defined criteria for convincing evidence (elevated awakening cortisol levels in euthymic BD participants relative to controls and decreased pyridoxal levels in participants with schizophrenia relative to controls). Of 42 estimates which met criteria for highly suggestive evidence only five biomarker aberrations occurred in more than one disorder. Only 15 meta-analyses had a power >0.8 to detect a small effect size, and most (81.9%) meta-analyses had high heterogeneity. Although some associations met criteria for either convincing or highly suggestive evidence, overall the vast literature of peripheral biomarkers for major mental disorders is affected by bias and is underpowered. No convincing evidence supported the existence of a trans-diagnostic biomarker. Adequately powered and methodologically sound future large collaborative studies are warranted.
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Affiliation(s)
- André F. Carvalho
- grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Addiction & Mental Health (CAMH), Toronto, ON Canada
| | - Marco Solmi
- grid.5608.b0000 0004 1757 3470Neuroscience Department, University of Padova, Padova, Italy ,grid.5608.b0000 0004 1757 3470Neuroscience Center, University of Padova, Padova, Italy ,grid.13097.3c0000 0001 2322 6764Early Psychosis: Interventions and Clinical-detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Marcos Sanches
- grid.155956.b0000 0000 8793 5925Centre for Addiction & Mental Health (CAMH), Toronto, ON Canada ,Krembil Centre for NeuroInformatics, Toronto, ON Canada
| | - Myrela O. Machado
- grid.417199.30000 0004 0474 0188Division of Dermatology, Women’s College Hospital, Toronto, ON Canada
| | - Brendon Stubbs
- grid.37640.360000 0000 9439 0839Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK ,grid.13097.3c0000 0001 2322 6764Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London, UK
| | - Olesya Ajnakina
- grid.13097.3c0000 0001 2322 6764Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Chelsea Sherman
- grid.17063.330000 0001 2157 2938Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON Canada
| | - Yue Ran Sun
- grid.17063.330000 0001 2157 2938Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON Canada
| | - Celina S. Liu
- grid.17063.330000 0001 2157 2938Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON Canada
| | - Andre R. Brunoni
- grid.11899.380000 0004 1937 0722Service of Interdisciplinary Neuromodulation, Laboratory of Neurosciences (LIM-27) and National Institute of Biomarkers in Psychiatry (INBioN), Department and Institute of Psychiatry, University of São Paulo, São Paulo, SP Brazil ,grid.11899.380000 0004 1937 0722Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Giorgio Pigato
- grid.5608.b0000 0004 1757 3470Neuroscience Department, University of Padova, Padova, Italy ,grid.5608.b0000 0004 1757 3470Neuroscience Center, University of Padova, Padova, Italy
| | - Brisa S. Fernandes
- grid.267308.80000 0000 9206 2401Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center, Houston, TX USA
| | | | - Muhammad I. Husain
- grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Addiction & Mental Health (CAMH), Toronto, ON Canada
| | - Elena Dragioti
- grid.5640.70000 0001 2162 9922Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, SE-581 85 Linköping, Sweden
| | - Joseph Firth
- grid.1029.a0000 0000 9939 5719NICM Health Research Institute, Western Sydney University, Westmead, Australia ,grid.5379.80000000121662407Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Theodore D. Cosco
- grid.61971.380000 0004 1936 7494Gerontology Research Center, Simon Fraser University, Vancouver, Canada ,grid.4991.50000 0004 1936 8948Oxford Institute of Population Ageing, University of Oxford, Oxford, UK
| | - Michael Maes
- grid.7922.e0000 0001 0244 7875Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ,grid.1021.20000 0001 0526 7079IMPACT Strategic Research Center, Deakin University, Geelong, Australia
| | - Michael Berk
- grid.1021.20000 0001 0526 7079IMPACT Strategic Research Center, Deakin University, Geelong, Australia ,grid.488501.0Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, VIC Australia ,grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, University of Melbourne, Melbourne, VIC Australia ,grid.1008.90000 0001 2179 088XFlorey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC Australia
| | - Krista L. Lanctôt
- grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Centre for Addiction & Mental Health (CAMH), Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Sunnybrook Research Institute, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON Canada
| | - Eduard Vieta
- grid.418264.d0000 0004 1762 4012Psychiatry and Psychology Department of the Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia Spain
| | - Diego A. Pizzagalli
- grid.38142.3c000000041936754XDepartment of Psychiatry & McLean Hospital, Harvard Medical School, Belmont, MA 02478 USA
| | - Lee Smith
- grid.5115.00000 0001 2299 5510The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Paolo Fusar-Poli
- grid.13097.3c0000 0001 2322 6764Early Psychosis: Interventions and Clinical-detection (EPIC) lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,OASIS Service, South London and Maudsley National Health Service Foundation Trust, London, UK ,grid.8982.b0000 0004 1762 5736Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Paul A. Kurdyak
- grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada ,grid.418647.80000 0000 8849 1617Canada Institute for Clinical Evaluative Sciences (ICES), Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Michele Fornaro
- grid.4691.a0000 0001 0790 385XDepartment of Neuroscience, Reproductive Science and Dentistry, Section of Psychiatr, University School of Medicine Federico II, Naples, Italy
| | - Jürgen Rehm
- grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada ,grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, CAMH, Toronto, Canada ,grid.17063.330000 0001 2157 2938Addiction Policy, Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada ,grid.4488.00000 0001 2111 7257Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany ,grid.17063.330000 0001 2157 2938Institute of Medical Science, University of Toronto, Toronto, Canada ,grid.448878.f0000 0001 2288 8774Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Nathan Herrmann
- grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Neuropsychopharmacology Research Group, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Sunnybrook Research Institute, Toronto, ON Canada
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20
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Teasdale S, Mörkl S, Müller-Stierlin AS. Nutritional psychiatry in the treatment of psychotic disorders: Current hypotheses and research challenges. Brain Behav Immun Health 2020; 5:100070. [PMID: 34589852 PMCID: PMC8474162 DOI: 10.1016/j.bbih.2020.100070] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/10/2020] [Accepted: 04/16/2020] [Indexed: 02/07/2023] Open
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21
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Hadizadeh H, Salehi M, Bozorgnia AR, Ahmadkhaniha HR. Lower folate levels in methamphetamine-induced psychosis: A cross-sectional study. Drug Alcohol Depend 2020; 207:107682. [PMID: 31841749 DOI: 10.1016/j.drugalcdep.2019.107682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 10/08/2019] [Accepted: 10/08/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Folate deficiency is shown to be associated with schizophrenia. Folate profile in patients with psychosis due to stimulant use has not been investigated. We aim to determine whether there is an association between serum folate level and the presence of psychosis in patients with methamphetamine (METH) use disorder. METHODS Forty patients diagnosed with METH-use disorder were included in this cross-sectional study. Serum folate levels were measured using enzyme immunoassay technique and compared between psychotic and non-psychotic subgroups (N = 25 and 15, respectively). We designed a logistic regression model to measure the extent of any association and also to adjust for potential confounders. RESULTS We detected lower serum folate level in the psychotics [3.4 (IQR = 5.3)] compared to non-psychotic METH users [8.9 (IQR = 2.5)], p = 0.01. The model demonstrated that every 1-unit increase in serum folate decreases the odds of presence of psychosis by 27% (R2 = 53.5%, CI 12-64%, p = 0.006). The observed difference was not associated with the duration of METH use, patient's age at first METH use, or concurrent use of other substances. CONCLUSIONS Our findings suggest that low folate level in psychotic METH users does not correlate with previously established risk factors for meth-induced psychosis such as duration of use, age of onset of using, and poly-drug use. We assume that low folate levels may play a crucial role in the pathophysiology of psychosis.
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Affiliation(s)
- Hasti Hadizadeh
- Research Center for Addiction and Risky Behaviors (ReCARB), Department of Psychiatry, Iran University of Medical Sciences, Tehran, Iran; Department of Clinical Research, Nikan Health Researchers Institute (NHRI), Tehran, Iran
| | - Masoud Salehi
- Research Center for Addiction and Risky Behaviors (ReCARB), Department of Psychiatry, Iran University of Medical Sciences, Tehran, Iran; Department of Clinical Research, Nikan Health Researchers Institute (NHRI), Tehran, Iran
| | - Amir Reza Bozorgnia
- Research Center for Addiction and Risky Behaviors (ReCARB), Department of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Ahmadkhaniha
- Research Center for Addiction and Risky Behaviors (ReCARB), Department of Psychiatry, Iran University of Medical Sciences, Tehran, Iran.
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22
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Simamora RH, Loebis B, Husada MS, Effendy E. Folic Acid and Vitamin B12 Supplementation on Male Patients with Schizophrenia Predominant Negative Symptoms. CURRENT NUTRITION & FOOD SCIENCE 2020. [DOI: 10.2174/1573401314666180620142607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Schizophrenia is a chronic mental disorder that affects approximately 1% of
the world’s population. Particularly, negative symptoms are frequently resistant and are the main contributors
to the disability on schizophrenia patients. Folic acid and vitamin B12 supplementation is the
safe and affordable approach, which can significantly improve the outcome on the patients with residual
symptoms.
Objectives:
We aimed to understand the difference of negative subscale of Positive and Negative Syndrome
Scale (PANSS) Score on patients with schizophrenia who receive risperidone with the addition
folic acid and Vitamin B12 and patients who receive only risperidone after 6 weeks.
Methods:
This study is a quasi experimental pre-test and post-test designs that are divided into two
groups, they are group receiving risperidone with the addition of folic acid and vitamin B12 and the
group receiving only risperidone. Diagnosis of schizophrenia according to the International Classification
of Diseases (ICD-10) criteria and negative symptoms assessed by using negative subscale of
PANSS Scores are observed. Statistical analysis is conducted using Statistical Package for the Social
Sciences (SPSS) software.
Results:
There was a significant difference in the mean score of negative-scale PANSS scores at the
end of week 6 between the group receiving folic acid and vitamin B12 supplementation and the group
receiving only risperidone with p = 0.002; p <0.05.
Conclusion:
Folic acid and vitamin B12 Supplementation provide benefits to patients schizophrenia.
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Affiliation(s)
- Rona Hanani Simamora
- Department of Psychiatry, Faculty of Medicine, University of Sumatera Utara, Medan, Indonesia
| | - Bahagia Loebis
- Department of Psychiatry, Faculty of Medicine, University of Sumatera Utara, Medan, Indonesia
| | - Muhammad Surya Husada
- Department of Psychiatry, Faculty of Medicine, University of Sumatera Utara, Medan, Indonesia
| | - Elmeida Effendy
- Department of Psychiatry, Faculty of Medicine, University of Sumatera Utara, Medan, Indonesia
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23
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Costa R, Teasdale S, Abreu S, Bastos T, Probst M, Rosenbaum S, Ward PB, Corredeira R. Dietary Intake, Adherence to Mediterranean Diet and Lifestyle-Related Factors in People with Schizophrenia. Issues Ment Health Nurs 2019; 40:851-860. [PMID: 31339786 DOI: 10.1080/01612840.2019.1642426] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The purpose of this study was to examine the dietary intake of both inpatients and outpatients with schizophrenia in the Portuguese population as a potential key contributing factor to the poor physical health profiles, and understand the relationship of diet quality to other lifestyle factors. Participants of this cross-sectional study completed a semi quantitative food frequency questionnaire. Diet quality was determined by adherence to the Mediterranean Diet. In addition participants completed the International Physical Activity Questionnaire-Short-Form and Pittsburgh Sleep Quality Index. Tobacco smoking was assessed through a series of general questions. A total of 100 patients (50% inpatients and 28% female) with schizophrenia were included in the final analysis. Patients reported a high consumption of caffeine, while deficits were evident for fibre and folate intakes, when compared to the European Food Safety Authority recommendations. Both inpatients and outpatients reported poor to moderate diet quality. Smokers reported poorer diet quality when compared to non-smokers (p < 0.001). Dietary intake, and its relationship to other lifestyle components, should be considered for intervention, in order to improve physical health of people living with schizophrenia.
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Affiliation(s)
- Raquel Costa
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto , Porto , Portugal
| | - Scott Teasdale
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District , Bondi Junction , Australia.,School of Psychiatry, UNSW Sydney , Australia
| | - Sandra Abreu
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto , Porto , Portugal
| | - Tânia Bastos
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto , Porto , Portugal.,Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, ISMAI , Maia , Portugal
| | - Michel Probst
- Faculty of Kinesiology and Rehabilitation Sciences, Research Group for Adapted Physical Activity and Psychomotor Rehabilitation , KU Leuven , Leuven , Belgium
| | - Simon Rosenbaum
- School of Psychiatry, UNSW Sydney , Australia.,Black Dog Institute, Prince of Wales Hospital, Sydney , Randwick , Australia
| | - Philip B Ward
- School of Psychiatry, UNSW Sydney , Australia.,Schizophrenia Research Unit, South Western Sydney Local Health District & Ingham Institute for Applied Medical Research , Liverpool , Australia
| | - Rui Corredeira
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto , Porto , Portugal
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24
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Zhilyaeva TV, Sergeeva AV, Blagonravova AS, Mazo GE, Kibitov AO. One-Carbon Metabolism Disorders in Schizophrenia: Genetic and Therapeutic Aspects. NEUROCHEM J+ 2019. [DOI: 10.1134/s1819712419020156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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25
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Arranz B, Sanchez-Autet M, San L, Safont G, Fuente-Tomás LDL, Hernandez C, Bogas JL, García-Portilla MP. Are plasma 25-hydroxyvitamin D and retinol levels and one-carbon metabolism related to metabolic syndrome in patients with a severe mental disorder? Psychiatry Res 2019; 273:22-29. [PMID: 30639560 DOI: 10.1016/j.psychres.2019.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 12/15/2018] [Accepted: 01/01/2019] [Indexed: 11/27/2022]
Abstract
There is a scarcity of studies assessing the influence of biomarkers in metabolic syndrome in psychiatric patients. Our aim was to correlate serum or plasma levels of 25-hydroxyvitamin D (25-OH-VD), retinol, vitamin B12 (VB12), folate and homocysteine (Hcy), with the metabolic status, in a sample of 289 outpatients with Schizophrenia or Bipolar Disorder. Logistic regression and multiple linear regressions were performed to assess the ability of biomarkers to predict the presence of MetS, the number of risk factors for MetS, and insulin resistance indexes (HOMA and QUICKI). Regarding the association between biomarkers and the QUICKI index, the model explained 6.8% of the variance, with folate and 25-OH-VD levels contributing significantly to the model. The model predicting the number of MetS risk factors was significant and explained 21.7% of the variance, being 25-OH-VD and retinol the statistically significant factors. As for the impact of biomarkers on MetS, the model was statistically significant, being 25-OH-VD and retinol levels the significant factors. We report for the first time an association between MetS and both low 25-OH-VD and high retinol concentrations. Inflammation-related biomarkers may help identify patients with a high risk of MetS who might benefit from healthy lifestyle counselling and early intervention.
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Affiliation(s)
- Belén Arranz
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Mónica Sanchez-Autet
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; University of Barcelona, Barcelona, Spain.
| | - Luis San
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; University of Barcelona, Barcelona, Spain
| | - Gemma Safont
- Hospital Universitari Mutua Terrassa, Terrassa, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; University of Barcelona, Barcelona, Spain
| | - Lorena De La Fuente-Tomás
- Department of Psychiatry, University of Oviedo, Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | | | | | - María Paz García-Portilla
- Department of Psychiatry, University of Oviedo, Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
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26
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Firth J, Carney R, Stubbs B, Teasdale SB, Vancampfort D, Ward PB, Berk M, Sarris J. Nutritional Deficiencies and Clinical Correlates in First-Episode Psychosis: A Systematic Review and Meta-analysis. Schizophr Bull 2018; 44:1275-1292. [PMID: 29206972 PMCID: PMC6192507 DOI: 10.1093/schbul/sbx162] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective Diet is increasingly recognized as a potentially modifiable factor influencing the onset and outcomes of psychiatric disorders. Whereas, previous research has shown long-term schizophrenia is associated with various nutritional deficiencies, this meta-analysis aimed to determine the prevalence and extent of nutritional deficits in first-episode psychosis (FEP). Method A search of electronic databases conducted in July 2017 identified 28 eligible studies, examining blood levels of 6 vitamins and 10 minerals across 2612 individuals: 1221 individuals with FEP and 1391 control subjects. Meta-analyses compared nutrient levels in FEP to nonpsychiatric controls. Clinical correlates of nutritional status in patient samples were systematically reviewed. Results Significantly lower blood levels of folate (N = 6, n = 827, g = -0.624, 95% confidence interval [CI] = -1.176 to -0.072, P = .027) and vitamin D (N = 7, n = 906, g = -1.055, 95% CI = -1.99 to -0.119, P = .027) were found in FEP compared to healthy controls. Synthesis of clinical correlates found both folate and vitamin D held significant inverse relationships with psychiatric symptoms in FEP. There was also limited evidence for serum level reductions of vitamin C (N = 2, n = 96, g = -2.207, 95% CI = -3.71 to -0.71, P = .004). No differences were found for other vitamins or minerals. Conclusions Deficits in vitamin D and folate previously observed in long-term schizophrenia appear to exist from illness onset, and are associated with worse symptomology. Further research must examine the direction and nature of these relationships (ie, mediator, moderator, or marker) with clinical status in FEP. Future trials assessing efficacy of nutrient supplementation in FEP samples should consider targeting and stratifying for baseline deficiency.
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Affiliation(s)
- Joseph Firth
- NICM, School of Science and Health, University of Western Sydney, Sydney, Australia
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Rebekah Carney
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Scott B Teasdale
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- KU Leuven Department of Neurosciences, UPC KU Leuven, Leuven, Belgium
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, Australia
| | - Michael Berk
- Deakin University, School of Medicine, IMPACT Strategic Research Centre, Barwon Health, Geelong, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health and Orygen Youth Health Research Centre, Melbourne, Australia
| | - Jerome Sarris
- NICM, School of Science and Health, University of Western Sydney, Sydney, Australia
- Department of Psychiatry, University of Melbourne, The Melbourne Clinic, Melbourne, Australia
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27
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Davison J, O'Gorman A, Brennan L, Cotter DR. A systematic review of metabolite biomarkers of schizophrenia. Schizophr Res 2018; 195:32-50. [PMID: 28947341 DOI: 10.1016/j.schres.2017.09.021] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 09/01/2017] [Accepted: 09/14/2017] [Indexed: 12/23/2022]
Abstract
Current diagnosis of schizophrenia relies exclusively on the potentially subjective interpretation of clinical symptoms and social functioning as more objective biological measurement and medical diagnostic tests are not presently available. The use of metabolomics in the discovery of disease biomarkers has grown in recent years. Metabolomic methods could aid in the discovery of diagnostic biomarkers of schizophrenia. This systematic review focuses on biofluid metabolites associated with schizophrenia. A systematic search of Web of Science and Ovid Medline databases was conducted and 63 studies investigating metabolite biomarkers of schizophrenia were included. A review of these studies revealed several potential metabolite signatures of schizophrenia including reduced levels of essential polyunsaturated fatty acids (EPUFAs), vitamin E and creatinine; and elevated levels of lipid peroxidation metabolites and glutamate. Further research is needed to validate these biomarkers and would benefit from large cohort studies and more homogeneous and well-defined subject groups.
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Affiliation(s)
- Jennifer Davison
- RCSI Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre Beaumont Hospital, Dublin 9, Ireland; Institute of Food & Health, UCD School of Agriculture and Food Science, University College Dublin, Dublin 4, Ireland
| | - Aoife O'Gorman
- RCSI Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre Beaumont Hospital, Dublin 9, Ireland; Institute of Food & Health, UCD School of Agriculture and Food Science, University College Dublin, Dublin 4, Ireland
| | - Lorraine Brennan
- Institute of Food & Health, UCD School of Agriculture and Food Science, University College Dublin, Dublin 4, Ireland
| | - David R Cotter
- RCSI Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre Beaumont Hospital, Dublin 9, Ireland.
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28
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Prenatal one-carbon metabolism dysregulation programs schizophrenia-like deficits. Mol Psychiatry 2018; 23:282-294. [PMID: 28809400 PMCID: PMC6432924 DOI: 10.1038/mp.2017.164] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/20/2017] [Accepted: 06/21/2017] [Indexed: 12/13/2022]
Abstract
The methionine-folate cycle-dependent one-carbon metabolism is implicated in the pathophysiology of schizophrenia. Since schizophrenia is a developmental disorder, we examined the effects that perturbation of the one-carbon metabolism during gestation has on mice progeny. Pregnant mice were administered methionine equivalent to double their daily intake during the last week of gestation. Their progeny (MET mice) exhibited schizophrenia-like social deficits, cognitive impairments and elevated stereotypy, decreased neurogenesis and synaptic plasticity, and abnormally reduced local excitatory synaptic connections in CA1 neurons. Neural transcript expression of only one gene, encoding the Npas4 transcription factor, was >twofold altered (downregulated) in MET mice; strikingly, similar Npas4 downregulation occurred in the prefrontal cortex of human patients with schizophrenia. Finally, therapeutic actions of typical (haloperidol) and atypical (clozapine) antipsychotics in MET mice mimicked effects in human schizophrenia patients. Our data support the validity of MET mice as a model for schizophrenia, and uncover methionine metabolism as a potential preventive and/or therapeutic target.
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29
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Belbasis L, Köhler CA, Stefanis N, Stubbs B, van Os J, Vieta E, Seeman MV, Arango C, Carvalho AF, Evangelou E. Risk factors and peripheral biomarkers for schizophrenia spectrum disorders: an umbrella review of meta-analyses. Acta Psychiatr Scand 2018; 137:88-97. [PMID: 29288491 DOI: 10.1111/acps.12847] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study aimed to systematically appraise the meta-analyses of observational studies on risk factors and peripheral biomarkers for schizophrenia spectrum disorders. METHODS We conducted an umbrella review to capture all meta-analyses and Mendelian randomization studies that examined associations between non-genetic risk factors and schizophrenia spectrum disorders. For each eligible meta-analysis, we estimated the summary effect size estimate, its 95% confidence and prediction intervals and the I2 metric. Additionally, evidence for small-study effects and excess significance bias was assessed. RESULTS Overall, we found 41 eligible papers including 98 associations. Sixty-two associations had a nominally significant (P-value <0.05) effect. Seventy-two of the associations exhibited large or very large between-study heterogeneity, while 13 associations had evidence for small-study effects. Excess significance bias was found in 18 associations. Only five factors (childhood adversities, cannabis use, history of obstetric complications, stressful events during adulthood, and serum folate level) showed robust evidence. CONCLUSION Despite identifying 98 associations, there is only robust evidence to suggest that cannabis use, exposure to stressful events during childhood and adulthood, history of obstetric complications, and low serum folate level confer a higher risk for developing schizophrenia spectrum disorders. The evidence on peripheral biomarkers for schizophrenia spectrum disorders remains limited.
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Affiliation(s)
- L Belbasis
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - C A Köhler
- Translational Psychiatry Research Group, Department of Clinical Medicine, Federal University of Ceará Medical School, Fortaleza, Brazil
| | - N Stefanis
- Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - B Stubbs
- Department of Physiotherapy, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London, UK
| | - J van Os
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands.,Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - E Vieta
- Bipolar Disorder Unit, Institute of Neuroscience, University of Barcelona, IDIBAPS and CIBERSAM, Barcelona, Spain
| | - M V Seeman
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - C Arango
- Department of Child and Adolescent Psychiatry, University Hospital Gregorio Marañón, Complutense University of Madrid Medical School, CIBERSAM, Madrid, Spain
| | - A F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada
| | - E Evangelou
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
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30
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Barnett H, D’Cunha NM, Georgousopoulou EN, Kellett J, Mellor DD, McKune AJ, Naumovski N. Effect of Folate Supplementation on Inflammatory Markers in Individuals Susceptible to Depression: A Systematic Review. EXPLORATORY RESEARCH AND HYPOTHESIS IN MEDICINE 2017; 2:1-15. [DOI: 10.14218/erhm.2017.00025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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31
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Wang D, Zhai JX, Liu DW. Serum folate, vitamin B12 levels and diabetic peripheral neuropathy in type 2 diabetes: A meta-analysis. Mol Cell Endocrinol 2017; 443:72-79. [PMID: 28081987 DOI: 10.1016/j.mce.2017.01.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 12/21/2016] [Accepted: 01/07/2017] [Indexed: 12/27/2022]
Abstract
The association between serum folate and vitamin B12 levels and the risk of diabetic peripheral neuropathy (DPN) remains unclear. This meta-analysis included 16 studies of serum folate levels (1190 cases and 1501 controls) and 18 studies of serum vitamin B12 levels (1239 cases and 1562 controls) in patients with type 2 diabetes mellitus (T2DM). Reduced serum levels of folate and vitamin B12 were found in patients with T2DM and DPN compared with patients with T2DM but without DPN; weighted mean difference (WMD) = -1.64 (95% confidence interval [CI] = -2.46, -0.81) and WMD = -70.86 (95% CI = -101.55, -40.17), respectively. A subgroup analysis confirmed these associations in the Chinese population, but not in the Caucasian and mixed populations. In conclusion, these findings support the need for further controlled studies in defined patient populations and the importance of monitoring serum folate and vitamin B12 levels in patients with T2DM.
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Affiliation(s)
- Dan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China; Library, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China
| | - Jun-Xia Zhai
- Department of Novelty Retrieval, Institute of Hebei Medical Information, Shijiazhuang 050071, Hebei Province, China
| | - Dian-Wu Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China.
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