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Chen P, Yang HD, Wang JJ, Zhu ZH, Zhao HM, Yin XY, Cai Y, Zhu HL, Fu JL, Zhang XZ, Sun WX, Hui L, Zhang XB. Association of serum interleukin-6 with negative symptoms in stable early-onset schizophrenia. World J Psychiatry 2024; 14:794-803. [PMID: 38984340 PMCID: PMC11230098 DOI: 10.5498/wjp.v14.i6.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/28/2024] [Accepted: 05/17/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND Accumulating evidence suggests that the inflammatory cytokine interleukin-6 (IL-6) contributes to the pathophysiology of psychiatric disorders. However, there was no study concerning the relationship between IL-6 concentrations and clinical features in the chronic phase of early-onset schizophrenia (EOS). AIM To investigate the relationship between serum IL-6 concentration and the clinical features of EOS. METHODS We measured serum IL-6 Levels from 74 patients with chronic schizophrenia, including 33 with age at onset < 21 years (EOS group) and 41 with onset ≥ 21 years in [adult-onset schizophrenia (AOS) group], and from 41 healthy controls. Symptom severities were evaluated using the Positive and Negative Syndrome Scale (PANSS). RESULTS Serum IL-6 concentrations were higher in both EOS and AOS groups than healthy controls (F = 22.32, P < 0.01), but did not differ significantly between EOS and AOS groups (P > 0.05) after controlling for age, body mass index, and other covariates. Negative symptom scores were higher in the EOS group than the AOS group (F = 6.199, P = 0.015). Serum IL-6 concentrations in the EOS group were negatively correlated with both total PANSS-negative symptom score (r = -0.389, P = 0.032) and avolition/asociality subscore (r = -0.387, P = 0.026). CONCLUSION Patients with EOS may have more severe negative symptoms than those with adult-onset schizophrenia during the chronic phase of the illness. IL-6 signaling may regulate negative symptoms and its avolition/asociality subsymptoms among the early-onset chronic schizophrenic patients.
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Affiliation(s)
- Peng Chen
- Suzhou Medical College of Soochow University, Suzhou 215123, Jiangsu Province, China
- Department of Psychiatry, Suzhou Psychiatric Hospital, Institute of Mental Health, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China
| | - Hai-Dong Yang
- Department of Psychiatry, The Fourth People’s Hospital of Lianyungang, The Affiliated Kangda College of Nanjing Medical University, Lianyungang 222003, Jiangsu Province, China
| | - Jun-Jie Wang
- Department of Psychiatry, Suzhou Psychiatric Hospital, Institute of Mental Health, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China
| | - Zhen-Hua Zhu
- Research Center of Biological Psychiatry, Suzhou Psychiatric Hospital, Institute of Mental Health, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China
| | - Hui-Min Zhao
- Department of Neurology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215002, Jiangsu Province, China
| | - Xu-Yuan Yin
- Research Center of Biological Psychiatry, Suzhou Psychiatric Hospital, Institute of Mental Health, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China
| | - Yuan Cai
- Research Center of Biological Psychiatry, Suzhou Psychiatric Hospital, Institute of Mental Health, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China
| | - Hong-Liang Zhu
- Department of Psychiatry, Suzhou Psychiatric Hospital, Institute of Mental Health, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China
| | - Jia-Lin Fu
- Department of Psychiatry, Suzhou Psychiatric Hospital, Institute of Mental Health, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China
| | - Xin-Zhu Zhang
- Department of Psychiatry, Suzhou Psychiatric Hospital, Institute of Mental Health, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China
| | - Wen-Xi Sun
- Department of Psychiatry, Suzhou Psychiatric Hospital, Institute of Mental Health, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China
| | - Li Hui
- Research Center of Biological Psychiatry, Suzhou Psychiatric Hospital, Institute of Mental Health, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China
| | - Xiao-Bin Zhang
- Department of Psychiatry, Suzhou Psychiatric Hospital, Institute of Mental Health, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, Jiangsu Province, China
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Shalaby R, Elmahdy A, Mikhail C. The effect of antipsychotic medication and the associated hyperprolactinemia as a risk factor for periodontal diseases in schizophrenic patients: a cohort retrospective study. BMC Oral Health 2023; 23:786. [PMID: 37875841 PMCID: PMC10594739 DOI: 10.1186/s12903-023-03404-1] [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: 04/17/2023] [Accepted: 09/11/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Periodontal disease is a major health problem that results in tooth loss and thus affects oral health, which affects quality of life. In particular, schizophrenic patients are at higher risk for periodontal disease due to several factors, including the effect of antipsychotic medications received by those patients. Accordingly, the aim of the present cohort retrospective study is to explore the effect of antipsychotics on periodontal health and the possible effect of antipsychotic-induced hyperprolactinemia as a risk factor for periodontal disease progression in schizophrenic patients. METHODS AND OUTCOMES The study population consisted of three groups: Group A (n = 21): schizophrenic patients that have been taking "prolactin-inducing" antipsychotics for at least 1 year; Group B (n = 21): schizophrenic patients who have been taking "prolactin-sparing" antipsychotics for at least 1 year; and Group C (n = 22): newly diagnosed schizophrenic patients and/or patients who did not receive any psychiatric treatment for at least 1 year. The study groups underwent assessment of periodontal conditions in terms of pocket depth (PD), clinical attachment loss (CAL), gingival recession, tooth mobility, and bleeding on probing (BOP). Also, bone mineral density was evaluated using DEXA scans, and the serum prolactin level was measured by automated immunoassay. RESULTS Results revealed a statistically significant difference in PD, CAL, and serum prolactin levels (P ≤ 0.001, P = 0.001, and P ≤ 0.001, respectively) among the 3 study groups. For both PD and CAL measurements, group A has shown significantly higher values than both groups B and C, whereas there was no statistically significant difference between the values of groups C and B. Concerning serum prolactin levels, group A had significantly higher values than groups B and C (P ≤ 0.001 and P ≤ 0.001 respectively). There was a statistically significant difference (P ≤ 0.001) between the 3 study groups in terms of bone mineral density. Moreover, there was a statistically significant direct relation between serum prolactin level and other parameters including clinical attachment loss, pocket depth measurements and bone mineral density. CONCLUSION According to our results, it could be concluded that all antipsychotics contribute to the progression of periodontal disease, with a higher risk for prolactin-inducing antipsychotics. However, further long term, large sampled, interventional and controlled studies are required to reach definitive guidelines to allow clinicians properly manage this group of patients.
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Affiliation(s)
- Rania Shalaby
- Department of Oral Medicine, Diagnosis and Periodontology, Faculty of Dentistry, Fayoum University, Fayoum, Egypt
| | | | - Christine Mikhail
- Department of Oral Medicine, Diagnosis and Periodontology, Faculty of Dentistry, Fayoum University, Fayoum, Egypt.
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Zhang T, Zeng J, Wei Y, Ye J, Tang X, Xu L, Hu Y, Cui H, Xie Y, Tang Y, Liu X, Liu H, Chen T, Li C, Wang J. Changes in inflammatory balance correlates with conversion to psychosis among individuals at clinical high-risk: A prospective cohort study. Psychiatry Res 2022; 318:114938. [PMID: 36334327 DOI: 10.1016/j.psychres.2022.114938] [Citation(s) in RCA: 11] [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: 09/04/2022] [Revised: 10/27/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
Previous studies have revealed that the imbalance between Th1 cytokines and Th2 cytokines plays a role in disturbance of cellular responses in the brain during psychosis. Cross-sectional studies have implied that inflammatory cytokine changes emerge in early psychosis, even at the at-risk stage. This study aimed to test the hypothesis that inflammatory imbalance in clinical high-risk (CHR) individuals is associated with an increased risk of future psychosis. A prospective case-control study was performed to assess the Th1(interleukin (IL)-1β)/Th2(IL-6) balance in 84 CHR individuals and 65 age- and sex-matched healthy controls (HC). Serum IL-1β and IL-6 levels were measured by enzyme-linked immunosorbent assay at baseline and 1-year after the completion of the clinical assessment. Sixteen (19.0%) CHR participants converted to full psychosis during the 1-year follow-up period. At baseline, serum IL-1β level was significantly lower in the CHR-converter group - resulting in decreased IL-1β/IL-6 ratios - compared to those of the CHR-non-converter and HC groups. At the 1-year follow-up, IL-1β level had decreased, and IL-1β/IL-6 ratios had decreased in the CHR-non-converter group, such that these were comparable to values in the CHR-converter at this time point. Analysis of the changes in IL-1β/IL-6 ratio between the baseline and 1-year follow-up measurements identified different trajectories in the CHR-converter and CHR-non-converter groups. Our findings demonstrate that a specific pattern of Th1/Th2 imbalance (decreased IL-1β/IL-6 ratios with lower serum IL-1β level) is associated with an increased risk of developing psychosis. Such specific pattern has potential for predicting conversion outcomes and selecting a distinct subgroup of CHR with immune-imbalanced-phenotype, that relevance in precise prevention.
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Affiliation(s)
- TianHong Zhang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, China.
| | - JiaHui Zeng
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, China
| | - YanYan Wei
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, China
| | - JiaYi Ye
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, China
| | - XiaoChen Tang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, China
| | - LiHua Xu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, China
| | - YeGang Hu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, China
| | - HuiRu Cui
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, China
| | - YuOu Xie
- The first clinical medical college of Nanjing Medical University, Nanjing, China
| | - YingYing Tang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, China
| | - XiaoHua Liu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, China
| | - HaiChun Liu
- Department of Automation, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Tao Chen
- Big Data Research Lab, University of Waterloo, Ontario, Canada; Labor and Worklife Program, Harvard University, Cambridge, Massachusetts, United States
| | - ChunBo Li
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, China
| | - JiJun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center (20DZ2253800), Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, China; Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, PR China; Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, PR China.
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Comparison of Serum Changes of Interleukin-17A and Interleukin-21 Between Schizophrenic Patients and Healthy Individuals. Rep Biochem Mol Biol 2022; 11:465-470. [PMID: 36718299 PMCID: PMC9883033 DOI: 10.52547/rbmb.11.3.465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 05/15/2022] [Indexed: 01/18/2023]
Abstract
Background Immunological alterations in schizophrenic patients have been considered during last decade. There are no remarkable reports on the changes of IL-17A and IL-21 in schizophrenic patients. Therefore, the purpose of this study was to evaluate changes of serum IL-17A and IL-21 in schizophrenic patients in comparison with healthy controls. Methods In the present study serum levels of IL-17A and IL-21 in 30 patients with schizophrenia before treatment and three months after treatment were measured by enzyme-linked immunosorbent assay (ELISA) and compare to 30 match healthy control group. Results Serum levels of IL-21 in schizophrenic patient was significantly higher than control group (P= 0.001). Serum levels of IL-17A in the schizophrenic patients had no significant changes than the control group (P= 0.4). Serum levels of IL-17A in patients with schizophrenia three months after treatment than before treatment had no significant change (P=0.7) and IL-21 serum levels in schizophrenic patient three month after treatment was not significant changed in comparison with this group before treatment (P= 0.06). Conclusion The serum levels of interlukine-21 is elevated in schizophrenic. Results of this study showed that IL-21 might be involved in the pathologic mechanism of schizophrenia.
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Golimbet V, Lezheiko T, Mikhailova V, Korovaitseva G, Kolesina N, Plakunova V, Kostyuk G. A study of the association between polymorphisms in the genes for interleukins IL-6 and IL-10 and negative symptoms subdomains in schizophrenia. Indian J Psychiatry 2022; 64:484-488. [PMID: 36458089 PMCID: PMC9707661 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_212_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/07/2022] [Accepted: 07/29/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Schizophrenia is a severe mental illness manifested by various symptoms. Negative symptoms (NS) are associated with disability and poor function of patients. The study of NS neurobiology is complicated by their heterogeneity. Factor analysis revealed two distinct NS subdomains with different pathophysiological mechanisms: volitional pathology, including avolition and apathy (AA), and diminished expression (DE). Inflammation is one mechanism that may underlie NS, including their heterogeneity. AIMS To search for the association between genes for interleukins (IL-6 -174 G/C, IL-10 -592 C/A, and IL-10 -1082 G/A) and NS subdomains. MATERIALS AND METHODS The study included 275 patients with schizophrenia. NS factors were calculated based on the Positive and Negative Syndromes Scale. RESULTS There was a significant main effect of IL-10 polymorphisms on the AA, but not the DE subdomain. Mean score on the AA subdomain was higher in the IL-10 -592 AA compared to the CC genotype. Differences between IL-10 -1082 G/A genotypes were dose dependent. The lowest score was observed for the IL-10 -1082 GG genotype. The association between the IL-6 -174 G/C polymorphism and AA scores was close to the level of significance. Patients with the IL-6 -174 GG genotype had higher score compared to the AA genotype. CONCLUSION The results provide further neurobiological evidence for the validity of the NS factor categorization. An imbalance between pro-inflammatory and anti-inflammatory cytokines because of genetic variations is associated with the AA NS subdomain that is supposed to be a more severe aspect of psychopathology compared to the DE.
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Affiliation(s)
- Vera Golimbet
- Laboratory of Clinical Genetics, Mental Health Research Center, Moscow, Russia
| | - Tatyana Lezheiko
- Laboratory of Clinical Genetics, Mental Health Research Center, Moscow, Russia
| | - Vera Mikhailova
- Laboratory of Clinical Genetics, Mental Health Research Center, Moscow, Russia
| | - Galina Korovaitseva
- Laboratory of Clinical Genetics, Mental Health Research Center, Moscow, Russia
| | - Nadezhda Kolesina
- Laboratory of Clinical Genetics, Mental Health Research Center, Moscow, Russia
| | - Victoria Plakunova
- Laboratory of Clinical Genetics, Mental Health Research Center, Moscow, Russia
| | - Georgy Kostyuk
- Moscow Healthcare Department, Clinical Research Center, Mental-Health Clinic No. 1 Named After N.A. Alexeev, Moscow, Russia
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Tanra AJ, Liaury K, Hajai N, Zainuddin AA, Lisal ST, Soraya GV, Syamsuddin S. Comparison between Interleukin-2 Serum Levels and Positive and Negative Syndrome Scale Scores of Schizophrenia Patients that Received Haloperidol with Risperidone Therapy. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7631] [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
BACKGROUND: There is a possibility of interleukin-2 (IL-2) being involved in the pathophysiology of Schizophrenia. The increase of IL-2 levels has been discovered in the serum of schizophrenic patients in earlier studies. An amount of antipsychotic has been associated with the decrease of IL-2.
AIM: Therefore, this study was intended to compare the serum IL-2 levels of schizophrenic patients who received Haloperidol therapy with patients who received Risperidone as well as examine the relationship between serum IL-2 levels with the positive and negative syndrome scale (PANSS) score of schizophrenic patients receiving Haloperidol and Risperidone therapy.
METHODS: This study is an observational study with a prospective cohort design consisting of 36 patients who have met the Diagnostic and Statistical Manual of Mental Disorders 5th Edition criteria for Schizophrenic patients who did not take antipsychotic drugs for 2 weeks and were hospitalized at the Special Hospital of South Sulawesi Province. Afterwards, the patients were grouped into two groups, where each group consisted of 18 people, namely, the group of patients who received Haloperidol and the group of patients who received Risperidone, and then were furtherly evaluated until the 4th week. The sample examination method used was enzyme-linked immunosorbent assay to see the blood serum IL-2 levels. Clinical symptoms of Schizophrenia were assessed using the PANSS score.
RESULTS: The study showed that serum IL-2 levels decreased at the 4th week after conducting antipsychotic therapy among both groups. The decrease in PANSS scores in the Risperidone group was greater compared to the Haloperidol group at week 3 and week 4. In the serum IL-2 levels difference of the group who received Risperidone therapy, the decrease was greater than those receiving Haloperidol therapy (3.72 ± 1.30 ng/ml vs. 2.43 ± 1.39 ng/ml, p = 0.008). In addition, based on the correlation test, no significant correlation was present between the difference in the total PANSS score and the difference in the serum IL-2 levels within the Haloperidol group (p = 0.059, r = 0.453) and the Risperidone group (p = 0.518, r = 0.113). Schizophrenic patients have higher serum IL-2 levels than healthy people. Schizophrenic patients who received antipsychotics for 4 weeks experienced a decrease in serum IL-2 levels. Risperidone administration had a higher decrease in serum IL-2 levels than Haloperidol.
CONCLUSION: Changes in serum IL-2 levels as a consideration of one of the Biomarkers are still needed for further evaluation. The therapeutic role of Haloperidol and Risperidone can be attributed as anti-inflammatory in Schizophrenia but cannot be attributed to improvement in the psychopathological status of Schizophrenic patients.
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Li N, Yang P, Tang M, Liu Y, Guo W, Lang B, Wang J, Wu H, Tang H, Yu Y, Wu X, Zeng C, Cao T, Cai H. Reduced erythrocyte membrane polyunsaturated fatty acid levels indicate diminished treatment response in patients with multi- versus first-episode schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:7. [PMID: 35217671 PMCID: PMC8881498 DOI: 10.1038/s41537-022-00214-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 02/01/2022] [Indexed: 11/09/2022]
Abstract
Antipsychotic effects seem to decrease in relapsed schizophrenia patients and the underlying mechanisms remain to be elucidated. Based on the essential role of polyunsaturated fatty acids in brain function and the treatment of schizophrenia, we hypothesize that disordered fatty acid metabolism may contribute to treatment resistance in multi-episode patients. We analyzed the erythrocyte membrane fatty acids in 327 schizophrenia patients under various episodes (numbers of patients: first-episode drug naïve 89; 2–3 episodes 110; 4–6 episodes 80; over 6 episodes 48) and 159 age- and gender-matched healthy controls. Membrane fatty acid levels and PANSS scales were assessed at baseline of antipsychotic-free period and one-month of follow-up after treatment. Totally, both saturated and unsaturated fatty acids were reduced at baseline when compared to healthy controls. Subgroup analyses among different episodes indicated that in response to atypical antipsychotic treatment, the membrane fatty acids were only increased in patients within 3 episodes, and this therapeutic effects on omega-3 index were merely present in the first episode. Results of fatty acid ratios suggested that dysregulations of enzymes such as D6 desaturase, D5 desaturase, and elongases for polyunsaturated fatty acids in patients with multi-episode schizophrenia could account for the differences. Additionally, certain fatty acid level/ratio changes were positively correlated with symptom improvement. The alterations of C22:5n3 and omega-3 index, gender, and the number of episodes were significant risk factors correlated with treatment responsiveness. Using targeted metabolomic approach, we revealed the potential mechanisms underlying abnormal fatty acid metabolism responsible for reduced treatment response in patients with multi-episode schizophrenia.
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Affiliation(s)
- Nana Li
- Department of Pharmacy, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.,Institute of Clinical Pharmacy, Central South University, Changsha, Hunan Province, China
| | - Ping Yang
- Department of Psychiatry, the Second People's Hospital of Hunan Province, Changsha, Hunan Province, China
| | - Mimi Tang
- Department of Pharmacy, Xiangya Hospital of Central South University, Changsha, Hunan Province, China.,Institute of Hospital Pharmacy, Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Yong Liu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.,National Clinical Research Center on Mental Disorders, Changsha, Hunan Province, China
| | - Wenbin Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.,National Clinical Research Center on Mental Disorders, Changsha, Hunan Province, China
| | - Bing Lang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.,National Clinical Research Center on Mental Disorders, Changsha, Hunan Province, China
| | - Jianjian Wang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.,National Clinical Research Center on Mental Disorders, Changsha, Hunan Province, China
| | - Haishan Wu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.,National Clinical Research Center on Mental Disorders, Changsha, Hunan Province, China
| | - Hui Tang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.,National Clinical Research Center on Mental Disorders, Changsha, Hunan Province, China
| | - Yan Yu
- Department of Psychiatry, Changsha Psychiatric Hospital, Changsha, Hunan Province, China
| | - Xiangxin Wu
- Department of Pharmacy, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.,Institute of Clinical Pharmacy, Central South University, Changsha, Hunan Province, China
| | - Cuirong Zeng
- Department of Pharmacy, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.,Institute of Clinical Pharmacy, Central South University, Changsha, Hunan Province, China
| | - Ting Cao
- Department of Pharmacy, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.,Institute of Clinical Pharmacy, Central South University, Changsha, Hunan Province, China
| | - Hualin Cai
- Department of Pharmacy, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China. .,Institute of Clinical Pharmacy, Central South University, Changsha, Hunan Province, China.
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Lee D, Seo J, Jeong HC, Lee H, Lee SB. The Perspectives of Early Diagnosis of Schizophrenia Through the Detection of Epigenomics-Based Biomarkers in iPSC-Derived Neurons. Front Mol Neurosci 2021; 14:756613. [PMID: 34867186 PMCID: PMC8633873 DOI: 10.3389/fnmol.2021.756613] [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: 08/10/2021] [Accepted: 10/20/2021] [Indexed: 12/11/2022] Open
Abstract
The lack of early diagnostic biomarkers for schizophrenia greatly limits treatment options that deliver therapeutic agents to affected cells at a timely manner. While previous schizophrenia biomarker research has identified various biological signals that are correlated with certain diseases, their reliability and practicality as an early diagnostic tool remains unclear. In this article, we discuss the use of atypical epigenetic and/or consequent transcriptional alterations (ETAs) as biomarkers of early-stage schizophrenia. Furthermore, we review the viability of discovering and applying these biomarkers through the use of cutting-edge technologies such as human induced pluripotent stem cell (iPSC)-derived neurons, brain models, and single-cell level analyses.
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Affiliation(s)
- Davin Lee
- Department of Brain and Cognitive Sciences, Daegu Gyeongbuk Institute of Science and Technology, Daegu, South Korea
| | - Jinsoo Seo
- Department of Brain and Cognitive Sciences, Daegu Gyeongbuk Institute of Science and Technology, Daegu, South Korea
| | - Hae Chan Jeong
- Department of Brain and Cognitive Sciences, Daegu Gyeongbuk Institute of Science and Technology, Daegu, South Korea
| | - Hyosang Lee
- Department of Brain and Cognitive Sciences, Daegu Gyeongbuk Institute of Science and Technology, Daegu, South Korea
| | - Sung Bae Lee
- Department of Brain and Cognitive Sciences, Daegu Gyeongbuk Institute of Science and Technology, Daegu, South Korea
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Yang X, Li M, Jiang J, Hu X, Qing Y, Sun L, Yang T, Wang D, Cui G, Gao Y, Zhang J, Li X, Shen Y, Qin S, Wan C. Dysregulation of phospholipase and cyclooxygenase expression is involved in Schizophrenia. EBioMedicine 2021; 64:103239. [PMID: 33581645 PMCID: PMC7892797 DOI: 10.1016/j.ebiom.2021.103239] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 01/22/2021] [Accepted: 01/26/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Schizophrenia (SZ) is a severe mental disease with highly heterogeneous clinical manifestations and pathological mechanisms. Schizophrenia is linked to abnormalities in cell membrane phospholipids and blunting of the niacin skin flush response, but the associations between these phenotypes and its molecular pathogenesis remain unclear. This study aimed to describe the PLA2/COX pathway, the key link between phospholipids and niacin flush, and to illustrate the pathogenic mechanisms in schizophrenia that mediate the above phenotypes. METHODS A total of 166 patients with schizophrenia and 54 healthy controls were recruited in this study and assigned to a discovery set and a validation set. We assessed the mRNA levels of 19 genes related to the PLA2/COX cascade in leukocytes by real-time PCR. Plasma IL-6 levels were measured with an ELISA kit. Genetic association analysis was performed on PLA2G4A and PTGS2 to investigate their potential relationship with blunted niacin-skin response in an independent sample set. FINDINGS Six of the 19 genes in the PLA2/COX pathway exhibited significant differences between schizophrenia and healthy controls. The disturbance of the pathway indicates the activation of arachidonic acid (AA) hydrolysis and metabolization, resulting in the abnormalities of membrane lipid homeostasis and immune function, further increasing the risk of schizophrenia. On the other hand, the active process of AA hydrolysis from cell membrane phospholipids and decreased transcription of CREB1, COX-2 and PTGER4 may explain the reported findings of a blunted niacin response in schizophrenia. The significant genetic associations between PLA2G4A and PTGS2 with the niacin-skin responses further support the inference. INTERPRETATION These results suggested that the activation of AA hydrolysis and the imbalance in COX-1 and COX-2 expression are involved in the pathogenesis of schizophrenia and blunting of the niacin flush response. FUNDING This work was supported by the National Key R&D Program of China (2016YFC1306900, 2016YFC1306802); the National Natural Science Foundation of China (81971254, 81771440, 81901354); Interdisciplinary Program of Shanghai Jiao Tong University (ZH2018ZDA40, YG2019GD04, YG2016MS48); Grants of Shanghai Brain-Intelligence Project from STCSM (16JC1420500); Shanghai Key Laboratory of Psychotic Disorders (13DZ2260500); and Shanghai Municipal Science and Technology Major Project (2017SHZDZX01); China Postdoctoral Science Foundation (2018M642029, 2018M630442, 2019M661526, 2020T130407); Natural Science Foundation of Shanghai (20ZR1426700); and Startup Fund for Youngman Research at SJTU (19 × 100040033).
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Affiliation(s)
- Xuhan Yang
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Minghui Li
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Jie Jiang
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaowen Hu
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Ying Qing
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Liya Sun
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Tianqi Yang
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Dandan Wang
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Gaoping Cui
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Gao
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Juan Zhang
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Xingwang Li
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Yuhua Shen
- The Fourth People's Hospital of Wuhu, Wuhu, China
| | - Shengying Qin
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China; Shanghai Mental Health Center, Shanghai Key Laboratory of Psychiatry Disorders, Shanghai Jiao Tong University, Shanghai, China
| | - Chunling Wan
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Ministry of Education, Shanghai Jiao Tong University, Shanghai, China; Shanghai Mental Health Center, Shanghai Key Laboratory of Psychiatry Disorders, Shanghai Jiao Tong University, Shanghai, China.
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10
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Dai N, Jie H, Duan Y, Xiong P, Xu X, Chen P, Kang M, Li M, Li T, Huang Z, Chen H. Different serum protein factor levels in first-episode drug-naive patients with schizophrenia characterized by positive and negative symptoms. Psychiatry Clin Neurosci 2020; 74:472-479. [PMID: 32478952 DOI: 10.1111/pcn.13078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 05/13/2020] [Accepted: 05/22/2020] [Indexed: 01/03/2023]
Abstract
AIM The clinical features of schizophrenia can be mainly divided into two symptom domains: positive and negative. Patients in each symptom domain respond differently to treatments, and their prognoses vary accordingly. Serum protein factors, such as nerve growth factor (NGF), neurotrophin-3 (NT-3), interleukin-6 (IL-6), interleukin-1 beta (IL-1β), and the calcium-binding protein, S100β, have been reported to be involved in the pathogenesis of schizophrenia. However, their roles in the positive and negative symptom domains have not been determined. In this study, we investigated whether the serum levels of these five protein factors differed among first-episode drug-naive schizophrenia patients in each symptom domain and in healthy controls. METHODS Double-antibody sandwich ELISA were used to quantify the amounts of the five protein factors in serum. RESULTS Compared with the levels in the controls (n = 60), increased serum levels of IL-6, IL-1β, and S100β and decreased serum levels of NGF and NT-3 were observed in first-episode drug-naive schizophrenia patients. Additionally, the serum levels of IL-6 and IL-1β were significantly higher in schizophrenia patients characterized by negative symptoms (negative group, n = 37) than in those characterized by positive symptoms (positive group, n = 46). Based on multivariate regression analyses, serum levels of IL-1β were positively associated with the Negative Symptom subscore of the Positive and Negative Syndrome Scale in the negative group and in all patients with schizophrenia. CONCLUSION The two subtypes of schizophrenia may have different pathological mechanisms. Patients characterized by negative symptoms probably have more serious disturbances in neuroimmunology.
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Affiliation(s)
- Nan Dai
- The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Huijin Jie
- The Third People's Hospital of Huzhou, Huzhou, China
| | - Yong Duan
- Yunnan Key Laboratory of Laboratory Medicine, Kunming, China
| | - Peng Xiong
- The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiufeng Xu
- The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Peng Chen
- The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Minmin Kang
- The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ming Li
- The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ting Li
- The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zhengyuan Huang
- The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hongxu Chen
- The First Affiliated Hospital of Kunming Medical University, Kunming, China
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11
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Wang Y, Wei Y, Edmiston EK, Womer FY, Zhang X, Duan J, Zhu Y, Zhang R, Yin Z, Zhang Y, Jiang X, Wei S, Liu Z, Zhang Y, Tang Y, Wang F. Altered structural connectivity and cytokine levels in Schizophrenia and Genetic high-risk individuals: Associations with disease states and vulnerability. Schizophr Res 2020; 223:158-165. [PMID: 32684357 DOI: 10.1016/j.schres.2020.05.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/26/2020] [Accepted: 05/17/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Alterations of white matter (WM) integrity have been observed in both schizophrenia (SZ) and individuals at genetic high risk for SZ (GHR-SZ); however, the molecular mechanisms underlying WM disruption remain unclear. Cytokines are chemical messengers of the immune system that are closely related to inflammation and neurogenesis in the brain. This study aimed to identify abnormalities in WM integrity, cytokine levels, and their association in SZ and GHR-SZ. METHODS A total of 355 participants (126 with SZ, 99 GHR-SZ, and 130 healthy controls [HCs]) were recruited. All participants underwent diffusion tensor imaging and blood samples were obtained from 113 participants within 24 h of imaging. RESULTS In SZ, there was decreased fractional anisotropy(FA) in the genu and body of the corpus callosum (GCC/BCC), anterior corona radiata, anterior and posterior limbs of the internal capsule (ALIC/PLIC), superior fronto-occipital fasciculus, external capsule, and fornix, and elevated IL-6 levels. In both SZ and GHR-SZ, decreased FA in the splenium of the corpus callosum (SCC), posterior corona radiate (PCR), and posterior thalamic radiation (PTR) was observed, and elevated leptin levels were present. Additionally, the IL-6 levels were negatively correlated with FA in the GCC and ALIC in SZ, and leptin levels were negatively correlated with the SCC, PCR, and PTR in SZ and GHR-SZ. CONCLUSIONS Abnormal WM integrity in SZ may reflect the state of disease and is associated with increased IL-6 levels. In addition, these leptin-associated WM integrity abnormalities in both SZ and GHR-SZ may reflect a genetic vulnerability to SZ.
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Affiliation(s)
- Yang Wang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Yange Wei
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - E Kale Edmiston
- Department of Psychiatry, University of Pittsburgh Medical Center, USA
| | - Fay Y Womer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Xizhe Zhang
- School of Computer Science and Engineering, Northeastern University, Shenyang, Liaoning, PR China
| | - Jia Duan
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Yue Zhu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Ran Zhang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Zhiyang Yin
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Yifan Zhang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Xiaowei Jiang
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Shengnan Wei
- Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Zhuang Liu
- School of Public Health, China Medical University, Shenyang, Liaoning, PR China
| | - Yanbo Zhang
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Canada
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China.
| | - Fei Wang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
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12
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He X, Ma Q, Fan Y, Zhao B, Wang W, Zhu F, Ma X, Zhou L. The Role of Cytokines in Predicting the Efficacy of Acute Stage Treatment in Patients with Schizophrenia. Neuropsychiatr Dis Treat 2020; 16:191-199. [PMID: 32021213 PMCID: PMC6982444 DOI: 10.2147/ndt.s218483] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 12/20/2019] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Inflammatory response in schizophrenia (SCz) is related to its underlying pathological mechanism and might be significant in deciding a patient's prognosis. The current study aims to investigate the differences in the serum inflammation level between schizophrenic patients and healthy controls and identify inflammatory markers that can predict clinical therapeutic effects in early-stage SCz patients at the 6-month follow-up. PATIENTS AND METHODS In total, 71 subjects were recruited in this study, including 35 patients with Scz and 36 healthy controls. The 35 Scz patients, who were in the first-episode or acute relapse state at admission, had completed the 6-month follow-up. The Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression (CGI) assessment results, demographic details, and blood samples were collected at the baseline and at follow-up. Data were analyzed using the Spearman correlation and multiple linear regression. RESULTS Serum interleukin (IL-1β, IL-4, IL-6, and IL-8) levels were significantly elevated in SCz patients at baseline compared with healthy controls, with a reduced IL-8 level at the follow-up. Furthermore, a higher IL-6 level and lower IL-8 level was found to predict better improvement in negative symptoms. The higher IL-6 level also predicted lesser improvement in depressive symptoms. Finally, a higher interferon (IFN)-γ level predicted a lower therapeutic effect for excitatory symptoms. CONCLUSION The serum levels of inflammatory markers were higher in patients with SCz than in healthy controls. These markers can be considered accurate predictors of therapeutic effects in patients with SCz.
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Affiliation(s)
- Xiaoyan He
- Department of Psychiatry, The First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Qingyan Ma
- Department of Psychiatry, The First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Yajuan Fan
- Department of Psychiatry, The First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Binbin Zhao
- Department of Psychiatry, The First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Wei Wang
- Department of Psychiatry, The First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Feng Zhu
- Center for Translational Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Xiancang Ma
- Department of Psychiatry, The First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
| | - Lina Zhou
- Department of Psychiatry, The First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
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13
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Roomruangwong C, Noto C, Kanchanatawan B, Anderson G, Kubera M, Carvalho AF, Maes M. The Role of Aberrations in the Immune-Inflammatory Response System (IRS) and the Compensatory Immune-Regulatory Reflex System (CIRS) in Different Phenotypes of Schizophrenia: the IRS-CIRS Theory of Schizophrenia. Mol Neurobiol 2019; 57:778-797. [PMID: 31473906 DOI: 10.1007/s12035-019-01737-z] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 08/16/2019] [Indexed: 12/20/2022]
Abstract
Several lines of evidence indicate that aberrations in immune-inflammatory pathways may contribute to the pathophysiology of schizophrenia spectrum disorders. Here, we propose a novel theoretical framework that was previously developed for major depression and bipolar disorder, namely, the compensatory immune-regulatory reflex system (CIRS), as applied to the neuro-immune pathophysiology of schizophrenia and its phenotypes, including first-episode psychosis (FEP), acute relapses, chronic and treatment-resistant schizophrenia (TRS), comorbid depression, and deficit schizophrenia. These schizophrenia phenotypes and manifestations are accompanied by increased production of positive acute-phase proteins, including haptoglobin and α2-macroglobulin, complement factors, and macrophagic M1 (IL-1β, IL-6, and TNF-α), T helper (Th)-1 (interferon-γ and IL-2R), Th-2 (IL-4, IL-5), Th-17 (IL-17), and T regulatory (Treg; IL-10 and transforming growth factor (TGF)-β1) cytokines, cytokine-induced activation of the tryptophan catabolite (TRYCAT) pathway, and chemokines, including CCL-11 (eotaxin), CCL-2, CCL-3, and CXCL-8. While the immune profiles in the different schizophrenia phenotypes indicate the activation of the immune-inflammatory response system (IRS), there are simultaneous signs of CIRS activation, including increased levels of the IL-1 receptor antagonist (sIL-1RA), sIL-2R and tumor necrosis factor-α receptors, Th-2 and Treg phenotypes with increased IL-4 and IL-10 production, and increased levels of TRYCATs and haptoglobin, α2-macroglobulin, and other acute-phase reactants, which have immune-regulatory and anti-inflammatory effects. Signs of activated IRS and CIRS pathways are also detected in TRS, chronic, and deficit schizophrenia, indicating that these conditions are accompanied by a new homeostatic setpoint between upregulated IRS and CIRS components. In FEP, increased baseline CIRS activity is a protective factor that may predict favorable clinical outcomes. Moreover, impairments in the CIRS are associated with deficit schizophrenia and greater impairments in semantic and episodic memory. It is concluded that CIRS plays a key role in the pathophysiology of schizophrenia by negatively regulating the primary IRS and contributing to recovery from the acute phase of illness. Therefore, components of the CIRS may offer promising therapeutic targets for schizophrenia.
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Affiliation(s)
- Chutima Roomruangwong
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Cristiano Noto
- Schizophrenia Program (PROESQ), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- GAPi (Early Psychosis Group), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Buranee Kanchanatawan
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Marta Kubera
- Department of Experimental Endocrinology, Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
| | - Andre F Carvalho
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Addiction & Mental Health (CAMH), Toronto, ON, M6J 1H4, Canada
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
- Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria.
- IMPACT Strategic Research Centre, Deakin University, Geelong, Vic, Australia.
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14
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Amoli MM, Khatami F, Arzaghi SM, Enayati S, Nejatisafa AA. Over-expression of TGF-β1 gene in medication free Schizophrenia. Psychoneuroendocrinology 2019; 99:265-270. [PMID: 30389222 DOI: 10.1016/j.psyneuen.2018.10.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 10/13/2018] [Accepted: 10/14/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Immunological pathways play a crucial role in developing and precipitating neuropsychiatric disorders. Although the exact pathogenesis of schizophrenia is unknown, the possible role of genetic and biomarker involvement of the immune system is gaining attention. Here we quantified the mRNA expression of cytokines as a key role player of the immune system from the peripheral blood mononuclear cells of patients with schizophrenia and healthy controls to identify the differentially expressed genes. METHODS Sixteen medication-free schizophrenia patients and 16 healthy subjects were enrolled in the current study. To investigate the desired expression level of mRNAs including TGF-β1, IL-1β, IL-23, TNF-α, NF-κB, and BDNF, quantitative real-time PCR was performed using specific oligonucleotide primers and the Applied Bio systems StepOne™ real time PCR system. DNA methylation was also analyzed through methylation-specific polymerase chain reaction (MSP). RESULTS TGF-β1 was significantly up-regulated in peripheral blood mononuclear cells of patients vs. healthy individuals (P value = 0.03). In addition, we found a significant correlation between the positive symptom scale and TGF-β1 gene overexpression (r = 0.536, P = 0.039). However, we did not observe any statistically significant differences for the methylation status of CpG Islands 1 and 2 between the patients and normal group. No statistical significance was found either for gene expression of IL-1β (P = 0.32), IL-23 (P = 0.12), TNF-α (P = 0.87), NF-κB (P = 0.07), and BDNF (P = 0.33). CONCLUSIONS Although the number of medication-free schizophrenia patients is extremely limited, our data highlighted the potential role of TGF-β1 as a regulatory cytokine in complex inflammatory mechanism involved in medication-free schizophrenia. In addition, we observed that increased level of TGF-β1 mRNA in this disease might not be under methylation as an epigenetic control element at the genomic level.
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Affiliation(s)
- Mahsa M Amoli
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Khatami
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Arzaghi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Samaneh Enayati
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali-Akbar Nejatisafa
- Psychiatry & Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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15
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Romeo B, Brunet-Lecomte M, Martelli C, Benyamina A. Kinetics of Cytokine Levels during Antipsychotic Treatment in Schizophrenia: A Meta-Analysis. Int J Neuropsychopharmacol 2018; 21:828-836. [PMID: 30016466 PMCID: PMC6119290 DOI: 10.1093/ijnp/pyy062] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 07/16/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Immune system dysfunction is a hypothesis in the psychopathology of schizophrenia, but the impact of antipsychotic treatment within this system is not clear. The aim of this meta-analysis was to investigate the impact of antipsychotic treatment on cytokine levels in in vivo studies on schizophrenia. METHODS After a systematic database search, original data were extracted with the help of certain authors. Means and SDs were extracted to calculate standardized mean differences. Cytokine levels were compared in vivo in schizophrenia patients, before and after antipsychotic treatment. Meta-regressions were performed to explore the influence of demographic and clinical variables on cytokine level standardized mean differences. Stratifications by treatment and diagnosis were also performed. RESULTS Forty-seven studies were included in this meta-analysis. Proinflammatory cytokine level decreases were found for interleukin-1 β levels (P<.0001) and interferon-γ (P=.01) and a statistical trend towards a decrease in interleukin-6 (P=.08) and tumor necrosis factor-α (P=.07) levels. An antiinflammatory cytokine level increase was found for soluble tumor necrosis factor-R2 (P<.001) and soluble interleukin 2-R (P=.03) levels. A meta-regression analysis found a correlation between interleukin-6 level standardized mean differences and positive schizophrenia symptom score standardized mean differences before and after treatment (P=.01). Stratification by diagnosis or treatment found a possible impact of the kinetics of cytokine levels. CONCLUSIONS The present meta-analysis provides evidence that antipsychotic treatment has an antiinflammatory effect and could normalize immune balance dysfunction in schizophrenia. Interleukin-6 level normalization could be a marker of illness equilibration and thus used in clinical practice.
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Affiliation(s)
- Bruno Romeo
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France,Paris Sud University, Faculte de Medecine, Le Kremlin-Bicetre, Île-de-France, France,Institut National de la Santé et de la Recherche Médicale, Paris, France,Correspondence: Bruno Romeo, MD, Département de psychiatrie et d’addictologie, Hôpital Paul Brousse, 12 Avenue Paul Vaillant Couturier, 94800 Villejuif, France ()
| | - Marine Brunet-Lecomte
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France
| | - Catherine Martelli
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France,Institut National de la Santé et de la Recherche Médicale U1000, Research unit, NeuroImaging and Psychiatry, Paris Sud University- Paris Saclay University, Paris Descartes University, Digiteo Labs, Bâtiment, Gif-sur- Yvette, France
| | - Amine Benyamina
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France,Paris Sud University, Faculte de Medecine, Le Kremlin-Bicetre, Île-de-France, France,Institut National de la Santé et de la Recherche Médicale, Paris, France
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16
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Cattane N, Richetto J, Cattaneo A. Prenatal exposure to environmental insults and enhanced risk of developing Schizophrenia and Autism Spectrum Disorder: focus on biological pathways and epigenetic mechanisms. Neurosci Biobehav Rev 2018; 117:253-278. [PMID: 29981347 DOI: 10.1016/j.neubiorev.2018.07.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 06/11/2018] [Accepted: 07/01/2018] [Indexed: 12/15/2022]
Abstract
When considering neurodevelopmental disorders (NDDs), Schizophrenia (SZ) and Autism Spectrum Disorder (ASD) are considered to be among the most severe in term of prevalence, morbidity and impact on the society. Similar features and overlapping symptoms have been observed at multiple levels, suggesting common pathophysiological bases. Indeed, recent genome-wide association studies (GWAS) and epidemiological data report shared vulnerability genes and environmental triggers across the two disorders. In this review, we will discuss the possible biological mechanisms, including glutamatergic and GABAergic neurotransmissions, inflammatory signals and oxidative stress related systems, which are targeted by adverse environmental exposures and that have been associated with the development of SZ and ASD. We will also discuss the emerging role of the gut microbiome as possible interplay between environment, immune system and brain development. Finally, we will describe the involvement of epigenetic mechanisms in the maintenance of long-lasting effects of adverse environments early in life. This will allow us to better understand the pathophysiology of these NDDs, and also to identify novel targets for future treatment strategies.
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Affiliation(s)
- Nadia Cattane
- Biological Psychiatry Unit, IRCCS Fatebenefratelli San Giovanni di Dio, via Pilastroni 4, Brescia, Italy
| | - Juliet Richetto
- Institute of Pharmacology and Toxicology, University of Zurich-Vetsuisse, Zurich, Switzerland
| | - Annamaria Cattaneo
- Biological Psychiatry Unit, IRCCS Fatebenefratelli San Giovanni di Dio, via Pilastroni 4, Brescia, Italy; Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, 125 Coldharbour Lane, SE5 9NU, London, UK.
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Can interleukin-2 and interleukin-1β be specific biomarkers of negative symptoms in schizophrenia? REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2018; 12:9-16. [PMID: 29724678 DOI: 10.1016/j.rpsm.2018.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Evidence suggests the existence of cytokine disturbances in patients with schizophrenia but their association with psychopathology is still unclear. The aim of the current study was to determine if pro-inflammatory cytokine levels (tumor necrosis factor-α, interleukin (IL)-6, IL-2, IL-1β, IL-1RA) are increased in stable outpatients compared with healthy subjects, and to analyze if they could be specific biomarkers of clinical dimensions in schizophrenia. METHODS We studied 73 stable outpatients with schizophrenia in their first 10 years of illness and 73 age- and sex-matched healthy controls. An accurate assessment of clinical dimensions (positive, negative, depressive, cognitive) was performed in patients. RESULTS Only IL-6 levels were significantly increased in patients after controlling for body mass index, waist circumference, smoking, and psychopharmacological treatment, compared with healthy subjects. After adjusting for several confounders, multiple linear regression models identified that Positive and Negative Syndrome Scale negative symptoms, general psychopathology, and global severity are predicted by IL-1β concentrations, while motivation and pleasure domain of Clinical Assessment Interview for Negative Symptoms and Personal and Social Performance global functioning scores are predicted by IL-2 levels. Cognitive performance, positive, and depressive symptom severity did not correlate with any cytokine. CONCLUSIONS Our findings suggested that IL-6 concentrations are elevated in stable patients with schizophrenia. Whereas IL-2 specifically marks severity of the motivation and pleasure domain of negative symptoms, IL-1β is not specific to this dimension as it also predicts severity of general and global symptomatology.
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Pringproa K, Srivorakul S, Tantilertcharoen R, Thanawongnuwech R. Restricted Infection and Cytokine Expression in Primary Murine Astrocytes Induced by the H5N1 Influenza Virus. NEUROCHEM J+ 2018. [DOI: 10.1134/s1819712418010129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Strzelecki D, Urban-Kowalczyk M, Wysokiński A. Serum levels of interleukin 6 in schizophrenic patients during treatment augmentation with sarcosine (results of the PULSAR study). Hum Psychopharmacol 2018; 33:e2652. [PMID: 29417623 DOI: 10.1002/hup.2652] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 10/10/2017] [Accepted: 01/02/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Augmentation of sarcosine, a natural inhibitor of the glycine transporter type I, normalizes glutamatergic neurotransmission, having beneficial impact on primary negative symptoms in schizophrenia and may also influence immune system and interleukin 6 (IL-6) levels. AIM Finding a relationship between initial IL-6 serum concentrations or its changes and severity of symptoms as a result of sarcosine addition to stable antipsychotic treatment. METHOD Fifity-eight individuals with schizophrenia with predominantly negative symptoms completed a 6-month randomized, double-blind placebo-controlled prospective study. Patients received 2 g of sarcosine (n = 29) or placebo (n = 30) daily per os. We measured IL-6 levels and severity of symptoms at the beginning, after 6 weeks and 6 months. As main clinical tools, we used Positive and Negative Syndrome Scale (PANSS) and Calgary depression scale for schizophrenia (CDSS). RESULTS Augmentation with sarcosine had no effect on IL-6 serum levels in all time points. We noted significant improvements in negative symptoms, general psychopathology, and total PANSS score in the sarcosine group. We found correlation of initial serum IL-6 with severity of positive symptoms and negative association between IL-6 levels reduction and positive symptoms reduction. CONCLUSIONS Sarcosine does not significantly affect IL-6 concentrations but IL-6 may be involved in mechanisms related to the presence of positive symptoms.
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Affiliation(s)
- Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Łódź, Łódź, Poland
| | | | - Adam Wysokiński
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Łódź, Łódź, Poland
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Dell’Osso B, Carlotta Palazzo M, Carlo Altamura A. Neurodevelopmental and Neurodegenerative Alterations in the Pathophysiology of Schizophrenia: Focus on Neuro-Immuno-Inflammation. NEURODEGENER DIS 2018. [DOI: 10.1007/978-3-319-72938-1_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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21
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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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Serum galectin-3, but not galectin-1, levels are elevated in schizophrenia: implications for the role of inflammation. Psychopharmacology (Berl) 2017; 234:2919-2927. [PMID: 28698921 DOI: 10.1007/s00213-017-4683-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Accepted: 06/27/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND Previous studies have reported that galectin-3 is involved in inflammatory processes in the central nervous system and that neuroinflammation may play a role in the pathogenesis of schizophrenia. However, the link between schizophrenia and various galectins is unclear. OBJECTIVE The objective of the present study is to determine whether galectin, a well-known lectin protein that binds to μ-galactoside, is associated with chronic schizophrenia. METHODS Thirty-six patients with schizophrenia and 36 healthy controls participated in this study. Schizophrenia symptoms were assessed using the Brief Psychiatry Rating Scale (BPRS). Serum galectin-1 and galectin-3 levels were evaluated using ELISA and compared between the participant groups. Correlation analyses were also performed to examine the relationship between BPRS scores and each galectin level. RESULTS Serum galectin-3 levels were significantly higher in patients with schizophrenia than they were in controls (p = 0.009, d = 0.640); however, serum galectin-1 levels were not significantly different between the groups (p = 0.513). No significant correlation was identified between serum galectin-3 level and the total BPRS score; however, a significant positive correlation was found between the serum galectin-3 level and the positive symptom score of the BPRS (ρ = 0.355; p = 0.033). Additionally, a significant negative correlation was identified between serum galectin-3 levels and the negative symptom score of the BPRS (ρ = -0.387; p = 0.020). CONCLUSIONS Given the high serum levels of galectin-3 found in patients with schizophrenia compared with that in controls, these findings may support the inflammation hypothesis of schizophrenia.
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Bridging Autism Spectrum Disorders and Schizophrenia through inflammation and biomarkers - pre-clinical and clinical investigations. J Neuroinflammation 2017; 14:179. [PMID: 28870209 PMCID: PMC5584030 DOI: 10.1186/s12974-017-0938-y] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 08/08/2017] [Indexed: 12/15/2022] Open
Abstract
In recent years, evidence supporting a link between inflammation and neuropsychiatric disorders has been mounting. Autism spectrum disorders (ASD) and schizophrenia share some clinical similarities which we hypothesize might reflect the same biological basis, namely, in terms of inflammation. However, the diagnosis of ASD and schizophrenia relies solely on clinical symptoms, and to date, there is no clinically useful biomarker to diagnose or monitor the course of such illnesses. The focus of this review is the central role that inflammation plays in ASD and schizophrenia. It spans from pre-clinical animal models to clinical research and excludes in vitro studies. Four major areas are covered: (1) microglia, the inflammatory brain resident myeloid cells, (2) biomarkers, including circulating cytokines, oxidative stress markers, and microRNA players, known to influence cellular processes at brain and immune levels, (3) effect of anti-psychotics on biomarkers and other predictors of response, and (4) impact of gender on response to immune activation, biomarkers, and response to anti-psychotic treatments.
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Mahadevan J, Sundaresh A, Rajkumar RP, Muthuramalingam A, Menon V, Negi VS, Sridhar MG. An exploratory study of immune markers in acute and transient psychosis. Asian J Psychiatr 2017; 25:219-223. [PMID: 28262155 DOI: 10.1016/j.ajp.2016.11.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 11/22/2016] [Accepted: 11/22/2016] [Indexed: 12/27/2022]
Abstract
The aim of this study was to look into the balance of pro-inflammatory (TNF-α, IL-6) and anti-inflammatory (TGF-β) cytokines and their association with stress, alterations in HPA axis activity and the disease severity in acute psychosis. Socio-demographic and clinical details were collected from 41 in-patients with a diagnosis of Acute and Transient Psychotic Disorder. Holmes and Rahe Stress Scale for stress in the preceding year, and Brief Psychiatric Rating Scale at baseline and follow up (4-12 weeks) for psychopathology were applied. IL-6, TNF-α (pro-inflammatory), TGF-β (anti-inflammatory) and Cortisol (morning and afternoon values) were measured at baseline and follow up. A total of 30 out of 41 cases recruited had follow up data available. The levels of IL-6 (p<0.001), TNF-α (p<0.001) and TGF-β (p<0.001) at baseline were all found to be significantly elevated compared to 42 age and gender matched healthy controls. There was a significant increase in the levels of TNF-α (p=0.020) and morning levels of cortisol (p=0.009) and a significant decrease in the levels of TGF-β (p=0.004) and afternoon levels of cortisol (p=0.043) from baseline to follow up. This study showed that there was an increased level of both pro and anti-inflammatory cytokines at baseline and a prolonged pro - inflammatory compared to anti - inflammatory response which warrants larger prospective studies and comparative studies to patients with schizophrenia and bipolar disorders.
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Affiliation(s)
- Jayant Mahadevan
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
| | - Aparna Sundaresh
- Department of Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Ravi Philip Rajkumar
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - A Muthuramalingam
- Department of Psychiatry, Sri Manakula Vinayagar Medical College Hospital, Puducherry, India
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - V S Negi
- Department of Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - M G Sridhar
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Lee EE, Hong S, Martin AS, Eyler LT, Jeste DV. Inflammation in Schizophrenia: Cytokine Levels and Their Relationships to Demographic and Clinical Variables. Am J Geriatr Psychiatry 2017; 25:50-61. [PMID: 27840055 PMCID: PMC5164855 DOI: 10.1016/j.jagp.2016.09.009] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 09/26/2016] [Accepted: 09/27/2016] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Inflammation may play a role in the accelerated physical aging reported in schizophrenia, though biomarker findings and associations with demographic and clinical factors are inconsistent. METHODS In a cross-sectional, case-control design, 95 outpatients with schizophrenia (mean age ± SD: 48.1 ± 10.2 years) and 95 demographically comparable healthy comparison subjects (HCs) (mean age ± SD: 48.1 ± 12.1 years) were studied. Sociodemographic and clinical data were collected, and plasma levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interferon-γ (IFN-γ) were assayed. The authors compared cytokine levels, examined demographic and clinical associations, and adjusted for relevant variables with linear models. RESULTS Individuals with schizophrenia had higher levels of TNF-α and IL-6 but not IFN-γ than HCs. Age was not related to cytokine levels, and age relationships did not differ between diagnostic groups. Women had higher levels of IL-6. TNF-α and IL-6 levels were significantly correlated with depressive symptoms, and adjustment for depression reduced the group effect for both. Within the HCs, TNF-α levels were associated with physical comorbidity and body mass index. IL-6 levels were significantly correlated with body mass index and within schizophrenia patients, with worse mental and physical well-being. Accounting for physical morbidity and mental well-being reduced group differences in TNF-α and IL-6 levels, respectively. Worse positive symptoms were associated with higher IL-6 levels. CONCLUSION Higher TNF-α and IL-6 levels in schizophrenia patients were associated with depression, physical comorbidity, and mental well-being. Further longitudinal studies are warranted to assess inflammation as a potential treatment target for a subgroup of schizophrenia.
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Affiliation(s)
- Ellen E. Lee
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States
| | - Suzi Hong
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States,Department of Family Medicine and Public Health, University of California, San Diego
| | - Averria Sirkin Martin
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States
| | - Lisa T. Eyler
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States,Desert-Pacific Mental Illness Research Education and Clinical Center, Veterans Affairs San Diego Healthcare System, San Diego
| | - Dilip V. Jeste
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States,Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, United States,Center for Healthy Aging, University of California San Diego, La Jolla, CA, United States,Department of Neurosciences, University of California, San Diego
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A meta-analysis of blood cytokine network alterations in psychiatric patients: comparisons between schizophrenia, bipolar disorder and depression. Mol Psychiatry 2016; 21:1696-1709. [PMID: 26903267 PMCID: PMC6056174 DOI: 10.1038/mp.2016.3] [Citation(s) in RCA: 1060] [Impact Index Per Article: 132.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 12/03/2015] [Accepted: 01/11/2016] [Indexed: 12/16/2022]
Abstract
Schizophrenia, bipolar disorder and major depressive disorder (MDD) have all been associated with aberrant blood cytokine levels; however, neither the pattern of cytokine alterations nor the impact of clinical status have been compared across disorders. We performed a meta-analysis of blood cytokines in acutely and chronically ill patients with these major psychiatric disorders. Articles were identified by searching the PubMed, PsycInfo and Web of Science, and the reference lists of these studies. Sixty-eight studies met the inclusion criteria (40 schizophrenia, 10 bipolar disorder and 18 MDD) for acutely ill patients. Forty-six studies met the inclusion criteria (18 schizophrenia, 16 bipolar disorder and 12 MDD) for chronically ill patients. Levels of two cytokines (interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)), one soluble cytokine receptor (sIL-2R), and one cytokine receptor antagonist (IL-1RA) were significantly increased in acutely ill patients with schizophrenia, bipolar mania and MDD compared with controls (P<0.01). Following treatment of the acute illness, IL-6 levels significantly decreased in both schizophrenia and MDD (P<0.01); sIL-2R levels increased in schizophrenia; and IL-1RA levels in bipolar mania decreased. In chronically ill patients, the levels of IL-6 were significantly increased in schizophrenia, euthymic (but not depressed) bipolar disorder and MDD compared with controls (P<0.01). The levels of IL-1β and sIL-2R were significantly increased in both chronic schizophrenia and euthymic bipolar disorder. Overall, there were similarities in the pattern of cytokine alterations in schizophrenia, bipolar disorder and MDD during acute and chronic phases of illness, raising the possibility of common underlying pathways for immune dysfunction. Effects of treatment on cytokines were more robust for schizophrenia and MDD, but were more frequently studied than for acute mania. These findings have important implications for our understanding of the pathophysiology and treatment of major psychiatric disorders.
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Fu YY, Zhang T, Xiu MH, Tang W, Han M, Yun LT, Chen DC, Chen S, Tan SP, Soares JC, Tang WJ, Zhang XY. Altered serum levels of interleukin-3 in first-episode drug-naive and chronic medicated schizophrenia. Schizophr Res 2016; 176:196-200. [PMID: 27237600 DOI: 10.1016/j.schres.2016.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 05/09/2016] [Accepted: 05/11/2016] [Indexed: 02/09/2023]
Abstract
Elevated serum levels of Interleukin-3 (IL-3), a major component of the cytokines, have been observed in chronic and medicated patients with schizophrenia, but this elevation may reflect either or both medication and illness chronicity effects. Thus, we compared serum IL-3 levels in first-episode drug-naive (FEDN) to chronic medicated patients with schizophrenia and examined the association of IL-3 with their psychopathological symptoms. Serum IL-3 levels were assessed in 55 FEDN patients, 52 chronic medicated patients and 43 healthy controls. Schizophrenia symptomatology was assessed with the Positive and Negative Syndrome Scale (PANSS). Serum IL-3 levels were measured by sandwich enzyme-linked immunosorbent assay (ELISA). We found significantly lower IL-3 levels in FEDN patients than both chronic patients and healthy controls (both p<0.001), while IL-3 levels in chronic patients were markedly higher than in healthy controls. No significant association was observed between IL-3 and any clinical psychopathology in FEDN patients; however, we found a significant correlation between serum IL-3 levels and the PANSS general psychopathology subscore in chronic medicated patients (p<0.05). Decreased IL-3 levels in FEDN patients suggest that suppressed immune function may be associated with developing schizophrenia, but as the disease progresses IL-3 levels increase perhaps related to medication treatment or other factors that occur during chronic illness.
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Affiliation(s)
- Yin Yang Fu
- Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Tong Zhang
- Lucheng Psychiatric Hospital, Wenzhou, Zhejiang, China
| | - Mei Hong Xiu
- Wenzhou Medical University, Wenzhou, Zhejiang, China; Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Wei Tang
- Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mei Han
- School of Medicine, University of Wollongong, Australia; Illawarra Health and Medical Research Institute (IHMRI), Australia
| | - Long Tan Yun
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Da Chun Chen
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Song Chen
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Shu Ping Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Wen Jie Tang
- Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Xiang Yang Zhang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China; Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.
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Elevated peripheral cytokines characterize a subgroup of people with schizophrenia displaying poor verbal fluency and reduced Broca's area volume. Mol Psychiatry 2016; 21:1090-8. [PMID: 26194183 PMCID: PMC4960447 DOI: 10.1038/mp.2015.90] [Citation(s) in RCA: 189] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 04/11/2015] [Accepted: 05/26/2015] [Indexed: 12/12/2022]
Abstract
Previous studies on schizophrenia have detected elevated cytokines in both brain and blood, suggesting neuroinflammation may contribute to the pathophysiology in some cases. We aimed to determine the extent to which elevated peripheral cytokine messenger RNA (mRNA) expression: (1) characterizes a subgroup of people with schizophrenia and (2) shows a relationship to cognition, brain volume and/or symptoms. Forty-three outpatients with schizophrenia or schizoaffective disorder and matched healthy controls were assessed for peripheral cytokine mRNAs (interleukin (IL)-1β, IL-2, IL-6, IL-8 and IL-18), intelligence quotient, memory and verbal fluency, symptom severity and cortical brain volumes integral to language (that is, Broca's and Wernicke's areas). IL-1β mRNA levels were 28% increased in schizophrenia compared with controls (t(82)=2.64, P<0.01). Using a two-step clustering procedure, we identified a subgroup of people displaying relatively elevated cytokine mRNA levels (17/43 people with schizophrenia and 9/42 controls). Individuals with schizophrenia in the elevated cytokine subgroup performed significantly worse than the low-cytokine subgroup on verbal fluency (F(1,40)=15.7, P<0.001). There was a 17% volume reduction of the left pars opercularis (POp) (Broca's area) in patients with elevated cytokines compared with patients with lower cytokines (F(1,29)=9.41, P=0.005). Negative linear relationships between IL-1β mRNA levels and both verbal fluency and left POp volume were found in schizophrenia. This study is among the first to link blood biomarkers of inflammation with both cognitive deficits and brain volume reductions in people with schizophrenia, supporting that those with elevated cytokines represent a neurobiologically meaningful subgroup. These findings raise the possibility that targeted anti-inflammatory treatments may ameliorate cognitive and brain morphological abnormalities in some people with schizophrenia.
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Celecoxib Adjunctive Treatment to Antipsychotics in Schizophrenia: A Review of Randomized Clinical Add-On Trials. Mediators Inflamm 2016; 2016:3476240. [PMID: 27524864 PMCID: PMC4976163 DOI: 10.1155/2016/3476240] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 06/23/2016] [Accepted: 06/27/2016] [Indexed: 12/14/2022] Open
Abstract
Schizophrenia is a severe, chronic and debilitating mental disorder. Past literature has reported various hypotheses about the psychopathology of schizophrenia. Recently, a growing literature has been trying to explain the role of inflammation in the etiopathogenesis of schizophrenia. In the past, numerous immune modulation and anti-inflammatory treatment options have been proposed for schizophrenia, but sometimes the results were inconsistent. Electronic search was carried out in November 2015. PubMed and Scopus databases have been used to find studies to introduce in this review. Only randomized-placebo-controlled add-on trials were taken into account. In this way, six articles were obtained for the discussion. Celecoxib showed beneficial effects mostly in early stages of schizophrenia. In chronic schizophrenia, the data are controversial, possibly in part for methodological reasons.
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Takahashi Y, Yu Z, Sakai M, Tomita H. Linking Activation of Microglia and Peripheral Monocytic Cells to the Pathophysiology of Psychiatric Disorders. Front Cell Neurosci 2016; 10:144. [PMID: 27375431 PMCID: PMC4891983 DOI: 10.3389/fncel.2016.00144] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 05/16/2016] [Indexed: 11/17/2022] Open
Abstract
A wide variety of studies have identified microglial activation in psychiatric disorders, such as schizophrenia, bipolar disorder, and major depressive disorder. Relatively fewer, but robust, studies have detected activation of peripheral monocytic cells in psychiatric disorders. Considering the origin of microglia, as well as neuropsychoimmune interactions in the context of the pathophysiology of psychiatric disorders, it is reasonable to speculate that microglia interact with peripheral monocytic cells in relevance with the pathogenesis of psychiatric disorders; however, these interactions have drawn little attention. In this review, we summarize findings relevant to activation of microglia and monocytic cells in psychiatric disorders, discuss the potential association between these cell types and disease pathogenesis, and propose perspectives for future research on these processes.
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Affiliation(s)
- Yuta Takahashi
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku UniversitySendai, Japan; Department of Disaster Psychiatry, Graduate School of Medicine, Tohoku UniversitySendai, Japan; Department of Psychiatry, Graduate School of Medicine, Tohoku UniversitySendai, Japan
| | - Zhiqian Yu
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku UniversitySendai, Japan; Department of Disaster Psychiatry, Graduate School of Medicine, Tohoku UniversitySendai, Japan; Group of Mental Health Promotion, Tohoku Medical Megabank Organization, Tohoku UniversitySendai, Japan
| | - Mai Sakai
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku UniversitySendai, Japan; Department of Disaster Psychiatry, Graduate School of Medicine, Tohoku UniversitySendai, Japan
| | - Hiroaki Tomita
- Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku UniversitySendai, Japan; Department of Disaster Psychiatry, Graduate School of Medicine, Tohoku UniversitySendai, Japan; Group of Mental Health Promotion, Tohoku Medical Megabank Organization, Tohoku UniversitySendai, Japan
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Buoli M, Caldiroli A, Cumerlato Melter C, Serati M, de Nijs J, Altamura AC. Biological aspects and candidate biomarkers for psychotic bipolar disorder: A systematic review. Psychiatry Clin Neurosci 2016; 70:227-44. [PMID: 26969211 DOI: 10.1111/pcn.12386] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 01/24/2016] [Accepted: 03/06/2016] [Indexed: 12/23/2022]
Abstract
AIM We carried out a systematic review of the available literature about potential biomarkers of psychotic bipolar disorder (BD-P), a specific subset presenting worse outcome and greater risk of relapse than non-psychotic bipolar disorder (BD-NP). METHODS We searched the main psychiatric databases (PubMed, ISI Web of Knowledge, PsychInfo). Only original articles with the main topic of BD-P compared to schizophrenia/BD-NP/healthy controls (HC) written in English from 1994 to 2015 were included. RESULTS BD-P patients presented higher kynurenic acid levels in the cerebrospinal fluid, elevated anti- S accharomyces cerevisiae antibodies levels, and lower serum levels of dehydroepiandrosterone sulfate and progesterone than BD-NP/HC. Event-related potentials abnormalities have been identified in BD-P with respect to BD-NP. BD-P patients also presented bigger ventricles but similar hippocampal volumes compared to BD-NP/HC. Although the results are contrasting, some cognitive deficits seemed to be related to the psychotic dimension of bipolar affective disorder, such as impairment in verbal/logical memory, working memory, verbal and semantic fluency and executive functioning. Finally, polymorphisms of genes, such as NRG1, 5HTTLPR (s), COMT, DAOA and some chromosome regions (16p12 and 13q), were positively associated with BD-P. CONCLUSION Data about the identification of specific biomarkers for BD-P are promising, but most of them have not yet been replicated. They could lead the clinicians to an early diagnosis and proper treatment, thus ameliorating outcome of BD-P and reducing the biological changes associated with a long duration of illness. Further studies with bigger samples are needed to detect more specific biological markers of the psychotic dimension of bipolar affective disorder.
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Affiliation(s)
- Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Psychiatry, University Medical Center Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
| | - Alice Caldiroli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudia Cumerlato Melter
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Jessica de Nijs
- Department of Psychiatry, University Medical Center Utrecht - Brain Centre Rudolf Magnus, Utrecht, The Netherlands
| | - A Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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Wu JQ, Chen DC, Tan YL, Tan SP, Xiu MH, Wang ZR, Yang FD, Soares JC, Zhang XY. Altered interleukin-18 levels are associated with cognitive impairment in chronic schizophrenia. J Psychiatr Res 2016; 76:9-15. [PMID: 26866662 DOI: 10.1016/j.jpsychires.2016.01.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 12/29/2015] [Accepted: 01/21/2016] [Indexed: 12/18/2022]
Abstract
The pathophysiology of cognitive deficits in schizophrenia may involve the neuroinflammation mediated by cytokines. This study examined the IL-18 levels, the cognitive function, and their association in schizophrenia. We recruited 70 chronic patients and 75 normal controls and examined the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and IL-18 levels. Positive and Negative Syndrome Scale (PANSS) was assessed in chronic patients. IL-18 levels were increased in chronic patients as compared to normal controls (p < 0.01). RBANS total score and the subscales of immediate memory and delayed memory were lower in patients than controls (all p < 0.001). In patients, IL-18 levels were positively associated with RBANS total score and the subscales of immediate and delayed memory (all p < 0.05). Multiple regression analysis further confirmed that IL-18 was an independent contributor to RBANS total score and the aforementioned two indexes (all p < 0.05). Our data demonstrate that immune responses may play an important role in cognitive deficits in schizophrenia and the abnormal levels of IL-18 reflecting the disturbed balance of proinflammatory and anti-inflammatory mechanisms may be relevant to cognitive deficits of this disorder.
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Affiliation(s)
- Jing Qin Wu
- School of Biomedical Sciences and Pharmacy, Faculty of Health, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia; Schizophrenia Research Institute, Sydney, Australia; Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Da Chun Chen
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yun Long Tan
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Shu Ping Tan
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Mei Hong Xiu
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Zhi Ren Wang
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Fu De Yang
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Xiang Yang Zhang
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China; Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA.
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Lai CY, Scarr E, Udawela M, Everall I, Chen WJ, Dean B. Biomarkers in schizophrenia: A focus on blood based diagnostics and theranostics. World J Psychiatry 2016; 6:102-17. [PMID: 27014601 PMCID: PMC4804259 DOI: 10.5498/wjp.v6.i1.102] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 10/20/2015] [Accepted: 12/17/2015] [Indexed: 02/05/2023] Open
Abstract
Identifying biomarkers that can be used as diagnostics or predictors of treatment response (theranostics) in people with schizophrenia (Sz) will be an important step towards being able to provide personalized treatment. Findings from the studies in brain tissue have not yet been translated into biomarkers that are practical in clinical use because brain biopsies are not acceptable and neuroimaging techniques are expensive and the results are inconclusive. Thus, in recent years, there has been search for blood-based biomarkers for Sz as a valid alternative. Although there are some encouraging preliminary data to support the notion of peripheral biomarkers for Sz, it must be acknowledged that Sz is a complex and heterogeneous disorder which needs to be further dissected into subtype using biological based and clinical markers. The scope of this review is to critically examine published blood-based biomarker of Sz, focusing on possible uses for diagnosis, treatment response, or their relationship with schizophrenia-associated phenotype. We sorted the studies into six categories which include: (1) brain-derived neurotrophic factor; (2) inflammation and immune function; (3) neurochemistry; (4) oxidative stress response and metabolism; (5) epigenetics and microRNA; and (6) transcriptome and proteome studies. This review also summarized the molecules which have been conclusively reported as potential blood-based biomarkers for Sz in different blood cell types. Finally, we further discusses the pitfall of current blood-based studies and suggest that a prediction model-based, Sz specific, blood oriented study design as well as standardize blood collection conditions would be useful for Sz biomarker development.
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Abstract
Although there is a cumulative evidence for the inflammation pathophysiology in schizophrenia, it has not been conclusively proven yet. One reason for this is the lack of studies that have controlled for major confounding factors such as obesity, smoking, antipsychotic use, and stress. The studies in which the major confounding factors were controlled were done in subjects in acute relapse and in treatment-resistant schizophrenia. To date, no studies have been done in stable outpatients with schizophrenia controlling for major confounding factors. Data on cerebrospinal fluid cytokines in large sample independent of confounding factors are also lacking. The efficacy signal from anti-inflammatory medications in schizophrenia has been modest. In this study, the inconsistent and nonvalidated cytokine findings independent of the confounding factors are discussed.
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Affiliation(s)
- Maju Mathew Koola
- Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Watanabe K, Miura I, Kanno-Nozaki K, Horikoshi S, Mashiko H, Niwa SI, Yabe H. Associations between five-factor model of the Positive and Negative Syndrome Scale and plasma levels of monoamine metabolite in patients with schizophrenia. Psychiatry Res 2015; 230:419-23. [PMID: 26416588 DOI: 10.1016/j.psychres.2015.09.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 09/01/2015] [Accepted: 09/18/2015] [Indexed: 11/19/2022]
Abstract
The five-factor model of the Positive and Negative Syndrome Scale (PANSS) for schizophrenia symptoms is the most common multiple-factor model used in analyses; its use may improve evaluation of symptoms in schizophrenia patients. Plasma monoamine metabolite levels are possible indicators of clinical symptoms or response to antipsychotics in schizophrenia. We investigated the association between five-factor model components and plasma monoamine metabolites levels to explore the model's biological basis. Plasma levels of homovanillic acid (HVA), 3-methoxy-4-hydroxyphenylglycol (MHPG), and 5-hydroxyindoleacetic acid (5-HIAA) were measured using high-performance liquid chromatography in 65 Japanese patients with schizophrenia. Significant negative correlation between plasma 5-HIAA levels and the depression/anxiety component was found. Furthermore, significant positive correlation was found between plasma MHPG levels and the excitement component. Plasma HVA levels were not correlated with any five-factor model component. These results suggest that the five-factor model of the PANSS may have a biological basis, and may be useful for elucidating the psychopathology of schizophrenia. Assessment using the five-factor model may enable understanding of monoaminergic dysfunction, possibly allowing more appropriate medication selection. Further studies of a larger number of first-episode schizophrenia patients are needed to confirm and extend these results.
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Affiliation(s)
- Kenya Watanabe
- Department of Pharmacy, Fukushima Medical University Hospital, Fukushima, Japan
| | - Itaru Miura
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan.
| | - Keiko Kanno-Nozaki
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan
| | - Sho Horikoshi
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan
| | - Hirobumi Mashiko
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan
| | - Shin-Ichi Niwa
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan; Department of Neuropsychiatry, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan
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Increased interleukin-2 serum levels were associated with psychopathological symptoms and cognitive deficits in treatment-resistant schizophrenia. Schizophr Res 2015; 169:16-21. [PMID: 26549630 DOI: 10.1016/j.schres.2015.10.038] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 10/22/2015] [Accepted: 10/26/2015] [Indexed: 12/29/2022]
Abstract
Accumulating evidence showed that interleukin-2 (IL-2) may be involved in the pathophysiology of schizophrenia. Increased IL-2 levels have been found in the serum of schizophrenia patients with mixed results. In the present study, we assessed serum IL-2 levels in a large group of 160 schizophrenia patients compared to 60 healthy control subjects matched for age and gender. The schizophrenia symptomatology was assessed by the Positive and Negative Syndrome Scale (PANSS), and serum IL-2 levels were measured by sandwich ELISA. The results showed that IL-2 levels were significantly higher in chronic patients with schizophrenia than in healthy control subjects (p<0.001). Correlation analysis revealed a significantly negative association between IL-2 levels and the PANSS cognitive and positive subscales (both p<0.01). Stepwise multiple regression analyses confirmed IL-2 as the influencing factor for the cognitive and positive subscales of the PANSS. Our findings suggested that increased IL-2 may be involved in the cognitive impairments and psychopathology of chronic schizophrenia.
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Westhoff D, Witlox J, van Aalst C, Scholtens RM, de Rooij SE, van Munster BC, de Jonghe JFM, Houdijk APJ, Eikelenboom P, van Westerloo DJ, van de Beek D, van Gool WA, Koenderman L. Preoperative protein profiles in cerebrospinal fluid in elderly hip fracture patients at risk for delirium: A proteomics and validation study. BBA CLINICAL 2015; 4:115-22. [PMID: 26675981 PMCID: PMC4661734 DOI: 10.1016/j.bbacli.2015.10.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 10/12/2015] [Accepted: 10/26/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND A neuroinflammatory response is suggested to play an important role in delirium, a common complication in older hospitalized patients. We examined whether hip fracture patients who develop postoperative delirium have a different proteome in cerebrospinal fluid (CSF) prior to surgery. METHODS Patients (≥ 75 years) were admitted for hip fracture surgery. CSF was collected during spinal anaesthesia; proteins were separated using gel electrophoresis and identified with mass spectrometry. We compared the proteome of patients with and without postoperative delirium. Findings were validated in an independent, comparable cohort using immuno-assays. RESULTS In the derivation cohort 53 patients were included, 35.8% developed postoperative delirium. We identified differences in levels of eight CSF proteins between patients with and without subsequent delirium: complement factor C3, contactin-1, fibulin-1 and I-beta-1,3-N-acetylglucosaminyltransferase were significantly lower in patients with postoperative delirium, while neural cell adhesion molecule-2, fibrinogen, zinc-α-2-glycoprotein and haptoglobin levels were significantly higher. In the validation cohort 21.2% of 52 patients developed postoperative delirium. Immuno-assays confirmed contactin-1 results although not statistically significant. Complement factor C3 was significantly higher in patients with postoperative delirium. CONCLUSION Our results show the complexity of pathophysiological mechanisms involved in delirium and emphasizes the need of independent validation of findings. GENERAL SIGNIFICANCE This study highlights the challenges and inconsistent findings in studies of delirium, a serious complication in older patients. We analysed proteins in CSF, the most proximal fluid to the brain. All patients were free from delirium at the time of sampling.
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Affiliation(s)
- Dunja Westhoff
- Department of Neurology, Academic Medical Center, PO box 22660, 1100 DD Amsterdam, The Netherlands
| | - Joost Witlox
- Department of Geriatrics, Medical Center Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands
| | - Corneli van Aalst
- Department of Respiratory Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Rikie M Scholtens
- Department of Geriatrics, Academic Medical Center, PO box 22660, 1100 DD Amsterdam, The Netherlands
| | - Sophia E de Rooij
- Department of Geriatrics, Academic Medical Center, PO box 22660, 1100 DD Amsterdam, The Netherlands ; Department of Geriatrics, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Barbara C van Munster
- Department of Geriatrics, Academic Medical Center, PO box 22660, 1100 DD Amsterdam, The Netherlands ; Department of Geriatrics, Gelre hospitals, Albert Schweitzerlaan 31, 7334 DZ Apeldoorn, The Netherlands
| | - Jos F M de Jonghe
- Department of Geriatrics, Medical Center Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands
| | - Alexander P J Houdijk
- Department of Surgery, Medical Center Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands ; Trial Center Holland Health, Alkmaar, The Netherlands
| | | | - David J van Westerloo
- Department of Intensive Care Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Diederik van de Beek
- Department of Neurology, Academic Medical Center, PO box 22660, 1100 DD Amsterdam, The Netherlands
| | - Willem A van Gool
- Department of Neurology, Academic Medical Center, PO box 22660, 1100 DD Amsterdam, The Netherlands
| | - Leo Koenderman
- Department of Respiratory Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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Petrikis P, Voulgari PV, Tzallas AT, Archimandriti DT, Skapinakis P, Mavreas V. Cytokine profile in drug-naïve, first episode patients with psychosis. J Psychosom Res 2015. [PMID: 26213351 DOI: 10.1016/j.jpsychores.2015.06.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE An increasing body of evidence suggests that immunological changes may play a role in schizophrenia but the results of the studies are controversial and little is known about the presence of those changes at the onset of the disease. Our aim is to compare the levels of interleukin (IL) IL-2, IL-6, IL-10, IL-17 and transforming growth factor -β2 (TGF-β2) between drug-naïve-first episode patients with psychosis and healthy controls matched for age, sex, BMI and smoking. METHODS Thirty-nine drug-naïve-first episode patients with psychosis and 39 healthy individuals (control group) were enrolled in the study. Serum levels of IL-2, IL-6, IL-10, IL-17 and TGF-β2 were measured by enzyme linked immunosorbent assay (ELISA). RESULTS Serum IL-2 and IL-6 levels were significantly higher in the drug-naïve patients with psychosis group (p<0.022 and p<0.002 respectively) compared to healthy controls. No differences were found between the two groups in the levels of IL-10, IL-17. The levels of TGF-β2 did not differ significantly between the two groups. CONCLUSION The serum levels of IL-2 and IL-6 are increased in first episode drug-naïve patients with psychosis compared to healthy controls. An inflammatory response mediated by IL-2 and IL-6 may play a role in schizophrenia.
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Affiliation(s)
- Petros Petrikis
- Psychiatric Clinic, Medical School, University of Ioannina (UOI), P.O. Box 1186, 45110 Ioannina, Greece.
| | - Paraskevi V Voulgari
- Rheumatology Clinic, Department of Internal Medicine, Medical School, 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
| | - Dimitra T Archimandriti
- Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina (UOI), P.O. Box 1186, 45110 Ioannina, Greece
| | - Petros Skapinakis
- Psychiatric Clinic, Medical School, University of Ioannina (UOI), P.O. Box 1186, 45110 Ioannina, Greece
| | - Venetsanos Mavreas
- Psychiatric Clinic, Medical School, University of Ioannina (UOI), P.O. Box 1186, 45110 Ioannina, Greece
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Noto C, Maes M, Ota VK, Teixeira AL, Bressan RA, Gadelha A, Brietzke E. High predictive value of immune-inflammatory biomarkers for schizophrenia diagnosis and association with treatment resistance. World J Biol Psychiatry 2015. [PMID: 26212792 DOI: 10.3109/15622975.2015.1062552] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Recent schizophrenia (SCZ) research aims to establish biomarkers with high predictive value for the diagnosis, severity of illness or treatment resistance. SCZ is accompanied by activated immune-inflammatory pathways, including increased levels of cytokines and chemokines, but few studies tried to identify predictive properties of such measures. METHODS We included 54 medicated SCZ patients and 118 healthy controls and examined 15 cytokines and chemokines. Possible associations between these immune-inflammatory biomarkers and the diagnosis of SCZ, severity of illness and treatment resistance were investigated. RESULTS SCZ is associated with a specific cytokine - chemokine profile, i.e., increased CCL11, MIP-1α, sTNF-R1 and sTNF-R2 levels, and decreased levels of IP-10, TNF-α, IL-2 and IL-4. The combination of five biomarkers (sTNF-R1, sTNF-R2, CCL11, IP-10, IL-4) may predict the diagnosis of SCZ with a sensitivity of 70.0% and a specificity of 89.4%. There was a weak association between the negative symptoms and biomarkers, i.e., IL-2 (inversely) and CCL11 (positively). Patients with treatment resistance showed increased levels of sTNF-R1, sTNF-R2 and MCP-1. CONCLUSIONS The findings of this study reinforce that SCZ is associated with a pro-inflammatory profile and suggest that some immune mediators may be used as reliable biomarkers for the diagnosis of SCZ and treatment resistance.
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Affiliation(s)
- Cristiano Noto
- a LiNC-Interdisciplinary Laboratory of Clinical Neuroscience, Universidade Federal de São Paulo (UNIFESP) , Brazil.,b First Episode Psychosis Program, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP) , São Paulo , Brazil.,c Programa de Esquizofrenia (PROESQ), Universidade Federal de São Paulo (UNIFESP) , Brazil
| | - Michael Maes
- d Department of Psychiatry , Chulalongkorn University , Bangkok , Thailand.,e Health Sciences Graduate Program, Health Sciences Center, State University of Londrina (UEL) , Brazil
| | - Vanessa Kiyomi Ota
- a LiNC-Interdisciplinary Laboratory of Clinical Neuroscience, Universidade Federal de São Paulo (UNIFESP) , Brazil
| | - Antônio Lúcio Teixeira
- f Translational Psychoneuroimmunology Group, Universidade Federal de Minas Gerais , Belo Horizonte , Brazil
| | - Rodrigo Affonseca Bressan
- a LiNC-Interdisciplinary Laboratory of Clinical Neuroscience, Universidade Federal de São Paulo (UNIFESP) , Brazil.,c Programa de Esquizofrenia (PROESQ), Universidade Federal de São Paulo (UNIFESP) , Brazil
| | - Ary Gadelha
- a LiNC-Interdisciplinary Laboratory of Clinical Neuroscience, Universidade Federal de São Paulo (UNIFESP) , Brazil.,c Programa de Esquizofrenia (PROESQ), Universidade Federal de São Paulo (UNIFESP) , Brazil
| | - Elisa Brietzke
- a LiNC-Interdisciplinary Laboratory of Clinical Neuroscience, Universidade Federal de São Paulo (UNIFESP) , Brazil
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Liu H, Cai H, Ren Z, Zhong J, Li J. Clozapine Regulates Cytokines, T-cell Subsets and Immunoglobulins Serum Levels in MK-801-Evoked Schizophrenia Rat. INT J PHARMACOL 2015. [DOI: 10.3923/ijp.2015.596.603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Leza JC, García-Bueno B, Bioque M, Arango C, Parellada M, Do K, O'Donnell P, Bernardo M. Inflammation in schizophrenia: A question of balance. Neurosci Biobehav Rev 2015; 55:612-26. [PMID: 26092265 DOI: 10.1016/j.neubiorev.2015.05.014] [Citation(s) in RCA: 142] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 04/22/2015] [Accepted: 05/18/2015] [Indexed: 02/08/2023]
Abstract
In the past decade, there has been renewed interest in immune/inflammatory changes and their associated oxidative/nitrosative consequences as key pathophysiological mechanisms in schizophrenia and related disorders. Both brain cell components (microglia, astrocytes, and neurons) and peripheral immune cells have been implicated in inflammation and the resulting oxidative/nitrosative stress (O&NS) in schizophrenia. Furthermore, down-regulation of endogenous antioxidant and anti-inflammatory mechanisms has been identified in biological samples from patients, although the degree and progression of the inflammatory process and the nature of its self-regulatory mechanisms vary from early onset to full-blown disease. This review focuses on the interactions between inflammation and O&NS, their damaging consequences for brain cells in schizophrenia, the possible origins of inflammation and increased O&NS in the disorder, and current pharmacological strategies to deal with these processes (mainly treatments with anti-inflammatory or antioxidant drugs as add-ons to antipsychotics).
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Affiliation(s)
- Juan C 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.
| | - Borja García-Bueno
- 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
| | - Miquel Bioque
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Complutense University, Madrid, Spain; Barcelona Clínic Schizophrenia Unit, Hospital Clínic Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Celso Arango
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Complutense University, Madrid, Spain; Department of Psychiatry, Faculty of Medicine, Complutense University, Madrid, Spain; Child and Adolescent Psychiatry Department, IIS Hospital Gregorio Marañón (IISGM), Madrid, Spain
| | - Mara Parellada
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Complutense University, Madrid, Spain; Department of Psychiatry, Faculty of Medicine, Complutense University, Madrid, Spain; Child and Adolescent Psychiatry Department, IIS Hospital Gregorio Marañón (IISGM), Madrid, Spain
| | - Kim Do
- Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Miguel Bernardo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Complutense University, Madrid, Spain; Barcelona Clínic Schizophrenia Unit, Hospital Clínic Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
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An HM, Tan YL, Shi J, Wang ZR, Soars JC, Wu JQ, Yang FD, Huang XF, Zhang XY. Altered IL-2, IL-6 and IL-8 serum levels in schizophrenia patients with tardive dyskinesia. Schizophr Res 2015; 162:261-8. [PMID: 25600548 DOI: 10.1016/j.schres.2014.12.037] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 11/29/2014] [Accepted: 12/29/2014] [Indexed: 11/27/2022]
Abstract
Immune deregulation has been postulated to be one of the mechanisms underlying the pathogenesis of tardive dyskinesia (TD). We hypothesized that interleukins would have a link with TD in schizophrenia patients. In this study, the serum IL-2, IL-6 and IL-8 levels were examined by enzyme-linked immunosorbent assay (ELISA) in schizophrenia patients with TD (n=48) and without TD (n=45), and healthy controls (n=44). The psychopathological symptoms of schizophrenia were assessed by the Positive and Negative Syndrome Scale (PANSS). The severity of TD was evaluated using Abnormal Involuntary Movement Scale (AIMS). The results showed that serum IL-2, IL-6 and IL-8 levels were significantly different among schizophrenia patients with TD and without TD and normal controls. Moreover, IL-2 level was significantly correlated with PANSS positive subscale and general subscale in patients with TD and without TD. In addition, IL-2 level was positively correlated with AIMS score in TD patients. The results supported that immune disturbance is related to the schizophrenia patients, especially to the patients with TD and ILs might play an important role in the pathophysiology of schizophrenia patients with TD.
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Affiliation(s)
- Hui-Mei An
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yun-Long Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Jing Shi
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Zhi-Ren Wang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Jair C Soars
- Department of Psychiatry and Behavioral Sciences, Harris County Psychiatric Center, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jing Qin Wu
- School of Biomedical Sciences and Pharmacy, Faculty of Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Fu-De Yang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Xu-Feng Huang
- Centre for Translational Neuroscience, School of Medicine, Illawarra Health and Medical Research Institute, University of Wollongong, NSW, Australia
| | - 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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El Kissi Y, Samoud S, Mtiraoui A, Letaief L, Hannachi N, Ayachi M, Ali BBH, Boukadida J. Increased Interleukin-17 and decreased BAFF serum levels in drug-free acute schizophrenia. Psychiatry Res 2015; 225:58-63. [PMID: 25453636 DOI: 10.1016/j.psychres.2014.10.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 09/22/2014] [Accepted: 10/03/2014] [Indexed: 10/24/2022]
Abstract
Hypotheses regarding an immune-cytokine basis of schizophrenia have been postulated with controversial findings and a lack of data related to many cytokines. The aim of this study was to assess serum levels of Interferon-γ (IFN-γ), Interleukin-4 (IL-4), Transforming Growth Factor-β (TGF-β), Interleukin-17 (IL-17) and B-cell Activating Factor (BAFF) in schizophrenic patients and to determine correlations between cytokine levels and clinical parameters. Serum cytokine levels were measured with ELISA techniques in 60 neuroleptic-free patients on acute phase of the disease (BPRS≥40) and 28 healthy controls matched for age and sex. Current symptoms were assessed with Brief Psychiatric Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS). No significant difference was found between patients and controls regarding IFN-γ serum levels. IL-4 was not detected in both groups. Patients exhibited significantly higher IL-17 and lower BAFF serum levels. IL-17 and BAFF levels were negatively correlated in schizophrenic patients. SANS global score was negatively correlated with IL-17 and positively correlated with IFN-γ serum levels. These results argue against the involvement of Th1 or Th2 population cells in schizophrenia. IL-17 and BAFF could be valuable markers for schizophrenia.
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Affiliation(s)
- Yousri El Kissi
- Department of Psychiatry, Farhat Hached University Hospital, Ibn El Jazzar Street, Sousse 4000, Tunisia.
| | - Samar Samoud
- Department of Microbiology and Immunology, Farhat Hached University Hospital, Ibn El Jazzar Street, Sousse 4000, Tunisia; Research Unit (UR02SP13), Farhat Hached University Hospital, Ibn El Jazzar Street, Sousse 4000, Tunisia
| | - Ahlem Mtiraoui
- Department of Psychiatry, Farhat Hached University Hospital, Ibn El Jazzar Street, Sousse 4000, Tunisia
| | - Leila Letaief
- Department of Psychiatry, Farhat Hached University Hospital, Ibn El Jazzar Street, Sousse 4000, Tunisia
| | - Neila Hannachi
- Department of Microbiology and Immunology, Farhat Hached University Hospital, Ibn El Jazzar Street, Sousse 4000, Tunisia; Research Unit (UR02SP13), Farhat Hached University Hospital, Ibn El Jazzar Street, Sousse 4000, Tunisia
| | - Mouna Ayachi
- Department of Psychiatry, Farhat Hached University Hospital, Ibn El Jazzar Street, Sousse 4000, Tunisia
| | - Bechir Ben Hadj Ali
- Department of Psychiatry, Farhat Hached University Hospital, Ibn El Jazzar Street, Sousse 4000, Tunisia
| | - Jalel Boukadida
- Department of Microbiology and Immunology, Farhat Hached University Hospital, Ibn El Jazzar Street, Sousse 4000, Tunisia; Research Unit (UR02SP13), Farhat Hached University Hospital, Ibn El Jazzar Street, Sousse 4000, Tunisia
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Interleukin-6: the missing element of the neurocognitive deterioration in schizophrenia? The focus on genetic underpinnings, cognitive impairment and clinical manifestation. Eur Arch Psychiatry Clin Neurosci 2015; 265:449-59. [PMID: 25214388 PMCID: PMC4540774 DOI: 10.1007/s00406-014-0533-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 09/02/2014] [Indexed: 12/21/2022]
Abstract
The influence of the immune system deregulation on the risk of schizophrenia is increasingly recognized. The aim of this study was to assess the influence of serum interleukin-6 (IL-6) level together with the polymorphism in its gene (IL6 -174G/C) and high sensitivity C-reactive protein (hsCRP) levels on clinical manifestation and cognition in schizophrenia patients. We recruited 151 patients with schizophrenia and 194 healthy control subjects. Psychopathology was evaluated using Operational Criteria for Psychotic Illness checklist, Positive and Negative Syndrome Scale (PANSS) and Scales for Assessment of Positive and Negative Symptoms. Cognitive performance in schizophrenia patients was assessed using following tests: Rey Auditory Verbal Learning Test, Trail Making Test, Verbal Fluency Tests, Stroop and subscales from Wechsler Adults Intelligence Scale-R-Pl (Similarities, Digit Symbol Coding, Digit Span Forward and Backward). Serum IL-6 and hsCRP levels were significantly higher in schizophrenia patients in comparison with healthy controls. Both hsCRP and IL-6 levels were associated with insidious psychosis onset, duration of illness and chronic schizophrenia course with deterioration. After adjustment for age, education level, number of years of completed education, illness duration, total PANSS score, depression severity and chlorpromazine equivalent, there was still a positive association between IL-6 and hsCRP levels and worse cognitive performance. The IL6 -174G/C polymorphism did not influence IL-6 level, but it was associated with the severity of positive symptoms. Our results suggest that elevated IL-6 levels may play the role in cognitive impairment and serve as potential inflammatory biomarker of deterioration in schizophrenia.
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Dietrich-Muszalska A. Oxidative Stress in Schizophrenia. OXIDATIVE STRESS IN APPLIED BASIC RESEARCH AND CLINICAL PRACTICE 2015. [DOI: 10.1007/978-1-4939-0440-2_2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Vakalopoulos C. The effect of deficient muscarinic signaling on commonly reported biochemical effects in schizophrenia and convergence with genetic susceptibility loci in explaining symptom dimensions of psychosis. Front Pharmacol 2014; 5:277. [PMID: 25566074 PMCID: PMC4266038 DOI: 10.3389/fphar.2014.00277] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 11/27/2014] [Indexed: 11/13/2022] Open
Abstract
With the advent of DSM 5 criticism has generally centered on a lack of biological validity of the diagnostic criteria. Part of the problem in describing a nosology of psychosis is the tacit assumption of multiple genetic causes each with an incremental loading on the clinical picture that fails to differentiate a clear underlying pathophysiology of high impact. The aim of this paper is to consolidate a primary theory of deficient muscarinic signaling underlying key clinical features of schizophrenia and its regulation by several important genetic associations including neuregulin, DISC and dysbindin. Secondary reductions in markers for GABAergic function and changes in the levels of interneuron calcium binding proteins parvalbumin and calbindin can be attributed to dysfunctional muscarinic transduction. A parallel association exists for cytokine production. The convergent pathway hypothesis is likewise used to model dopaminergic and glutamatergic theories of schizophrenia. The negative symptom dimension is correlated with dysfunction of Akt and ERK transduction, a major point of convergence. The present paradigm predicts the importance of a recent finding of a deletion in a copy number variant of PLCB1 and its potential use if replicated, as one of the first testable biological markers differentiating schizophrenia from bipolar disorder and further subtyping of schizophrenia into deficit and non-deficit. Potential limitations of PLCB1 as a prospective marker are also discussed.
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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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The SHP-1 expression is associated with cytokines and psychopathological status in unmedicated first episode schizophrenia patients. Brain Behav Immun 2014; 41:251-60. [PMID: 24793756 DOI: 10.1016/j.bbi.2014.04.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 03/25/2014] [Accepted: 04/21/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Recent lines of research have boosted awareness of the immunological facets of schizophrenia. However, associations with protein tyrosine phosphatase regulators have never been reported. The aim of our study was to investigate the expression and promoter status methylation of phosphatase SHP-1, a key negative regulator of the inflammatory process, in Peripheral blood mononuclear cells (PBMCs) of Schizophrenic patients. METHODS We enrolled fifty-four (28 men and 26 women) unmedicated first episode subjects (SC) who met DSM-IV and thirty-eight (22 men and 16 women) healthy controls (HC). The SC psychopathological status was assessed using the Positive and Negative Syndrome Scale. We evaluated SHP-1 expression by Quantitative Real-time PCR (qPCR) and Western blotting (WB) methods and promoter status methylation through PCR bisulfate. IKK/NFkB signaling was detected by WB, and medium and plasma levels of pro-inflammatory cytokines (IL-1β, IL-2, and TNF-α) by the ELISA method. SHP-1 was silenced by treating cells with specific siRNA. RESULTS We found a significantly lower level of SHP-1 gene expression in PBMCs from SC vs. HC, consistently with which the promoter region analyzed presented significant hypermethylation. Silencing of SHP-1 expression induced higher activation of IKK/NF-kB signaling and pro-inflammatory cytokine production in ex vivo PBMCs from both SC and HC. Linear regression among patients generated a model in which SHP-1 expression explained 30% of the clinical negative symptom variance (adjusted R(2)=0.30, ANOVA p<0.001). CONCLUSIONS Our findings are the first to suggest that impairment of SHP-1 expression is involved in the physiopathology of schizophrenia, opening fruitful new avenues for ameliorating treatment at least of negative symptoms.
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Can BDNF and IL-2 be indicators for the diagnosis in schizophrenic patients with depressive symptoms? Acta Neuropsychiatr 2014; 26:291-7. [PMID: 25241757 DOI: 10.1017/neu.2014.13] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of the current study is to determine whether serum levels of brain-derived neurotrophic factor (BDNF) and interleukin-2 (IL-2) can be biological indicators for the diagnosis of schizophrenia in patients with depressive symptoms. METHOD Forty-seven patients (11 patients diagnosed with schizophrenia, 16 patients diagnosed with schizophrenia and comorbid depression and 20 patients diagnosed with major depressive disorder) and 20 healthy subjects were enrolled. The Positive and Negative Symptoms Scale, the Calgary Depression Scale for Schizophrenia and the Hamilton Depression Rating Scale were used for assessment. The serum BDNF and IL-2 levels of all the subjects were studied. RESULTS Decreased levels of serum BDNF and increased levels of serum IL-2 were found in the patients diagnosed with either schizophrenia, schizophrenia with depression, or major depressive disorder (p = 0.049, p = 0.010; p = 0.001 and p = 0.044; p = 0.027, p = 0.003; respectively) compared with control group. There were no significant differences between the patient groups in their serum BDNF and IL-2 levels. CONCLUSIONS The present study suggests that neurotrophic factors and immune system changes are involved in the pathogenesis of schizophrenia with or without depressive symptomatology. However, the data do not clarify whether depressive symptoms in schizophrenia occur as a dimension of schizophrenia or as symptoms of major depression that is comorbid with schizophrenia.
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Fatty liver-induced changes in stereotypic behavior in rats and effects of glucagon-like peptide-1 analog on stereotypy. Kaohsiung J Med Sci 2014; 30:447-52. [DOI: 10.1016/j.kjms.2014.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 04/26/2014] [Accepted: 02/25/2014] [Indexed: 02/06/2023] Open
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