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Stiernborg M, Prast-Nielsen S, Melas PA, Skott M, Millischer V, Boulund F, Forsell Y, Lavebratt C. Differences in the gut microbiome of young adults with schizophrenia spectrum disorder: using machine learning to distinguish cases from controls. Brain Behav Immun 2024; 117:298-309. [PMID: 38280535 DOI: 10.1016/j.bbi.2024.01.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/27/2023] [Accepted: 01/22/2024] [Indexed: 01/29/2024] Open
Abstract
While an association between the gut microbiome and schizophrenia spectrum disorders (SSD) has been suggested, the existing evidence is still inconclusive. To this end, we analyzed bacteria and bacterial genes in feces from 52 young adult SSD patients and 52 controls using fecal shotgun metagenomic sequencing. Compared to controls, young SSD patients were found to have significantly lower α-diversity and different β-diversity both regarding bacterial species (i.e., taxonomic diversity) and bacterial genes (i.e., functional diversity). Furthermore, the α-diversity measures 'Pielou's evenness' and 'Shannon' were significantly higher for both bacterial species, bacterial genes encoding enzymes and gut brain modules in young SSD patients on antipsychotic treatment (young SSD not on antipsychotics=9 patients, young SSD on antipsychotics=43 patients). We also applied machine learning classifiers to distinguish between young SSD patients and healthy controls based on their gut microbiome. Results showed that taxonomic and functional data classified young SSD individuals with an accuracy of ≥ 70% and with an area under the receiver operating characteristic curve (AUROC) of ≥ 0.75. Differential abundance analysis on the most important features in the classifier models revealed that most of the species with higher abundance in young SSD patients had their natural habitat in the oral cavity. In addition, many of the modules with higher abundance in young SSD patients were amino acid biosynthesis modules. Moreover, the abundances of gut-brain modules of butyrate synthesis and acetate degradation were lower in the SSD patients compared to controls. Collectively, our findings continue to support the presence of gut microbiome alterations in SSD and provide support for the use of machine learning algorithms to distinguish patients from controls based on gut microbiome profiles.
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Affiliation(s)
- Miranda Stiernborg
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Stefanie Prast-Nielsen
- Centre for Translational Microbiome Research (CTMR), Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Philippe A Melas
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
| | - Maria Skott
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
| | - Vincent Millischer
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Fredrik Boulund
- Centre for Translational Microbiome Research (CTMR), Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Yvonne Forsell
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska University Hospital Solna, Stockholm, Sweden.
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The influence of modifiable cardiovascular risk factors on cognition, functioning, and inflammatory markers in first-episode psychosis: Results from a 2-year follow-up study. Psychiatry Res 2022; 316:114760. [PMID: 35977447 DOI: 10.1016/j.psychres.2022.114760] [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: 03/05/2022] [Revised: 07/24/2022] [Accepted: 07/31/2022] [Indexed: 11/23/2022]
Abstract
To explore the influence of cardiovascular risk factors (CVRFs) on cognitive symptoms, functional impairment, and systemic inflammatory markers in first-episode psychosis (FEP) patients at baseline and 2-year follow-up. Method: In a sample of 70 FEP patients and 85 age- and sex-matched healthy controls, we assessed nine modifiable CVRFs. All participants were classified into two subgroups according to their CVRF profile: lower (0-1 CVRFs) or higher (≥2 CVRFs). The following outcomes were measured at baseline and 2-year follow-up: cognition; functional outcomes; and white blood cell (WBC) subtype. Adjusted general linear models were conducted to study the effect of diagnosis and CVRF profile on cognition, functioning, WBC, and longitudinal changes in these variables. At baseline, FEP patients with a higher CVRF profile showed a significantly slower performance on the TMT-A test for psychomotor speed and higher lymphocyte levels than patients with a lower CVRF profile. No longitudinal changes were observed in primary outcomes at 2-year follow-up. Among FEP patients with a higher CVRF profile, slower psychomotor speed performance did not correlate with increased lymphocyte levels. Our findings suggest that the cognitive effects of CVRFs manifest early in the course of psychosis, thus highlighting the importance of targeting both CVRFs and cognitive deficits in FEP.
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Dias ICS, de Campos-Carli SM, Vieira ELM, Mota APL, Azevedo PS, Anício VTDS, Guimarães FC, Mantovani LM, Cruz BF, Teixeira AL, Salgado JV. Adiponectin and Stnfr2 peripheral levels are associated with cardiovascular risk in patients with schizophrenia. J Psychiatr Res 2022; 149:331-338. [PMID: 34785039 DOI: 10.1016/j.jpsychires.2021.11.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/17/2021] [Accepted: 11/06/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To investigate the association between cytokine peripheral levels and the risk of cardiovascular disease in patients with schizophrenia and controls. METHODS A sample of 40 patients and 40 control subjects participated in the study. Psychiatric diagnosis was established following structured clinical assessment. The Framingham Score was used to assess cardiovascular risk (CVR). Serum levels of the cytokines IL-1β, IL-6, IL-8, IL-10, IL-12p70 and TNF-α were determined by cytometric bead array (CBA) technique, and the serum levels of IL-33, sST2, sTNFR1, sTNFR2, Leptin and Adiponectin by Enzyme-Linked Immunosorbent assay (ELISA). RESULTS Patients with schizophrenia showed greater frequency of moderate CVR when compared with controls (p = 0.14). In addition, patients showed higher levels of sTNFR2 and Adiponectin compared to controls (p = 0.007 and p < 0.001, respectively). Adiponectin and sTNFR2 were associated with CVR only in patients (p = 0.0002 and p = 0.033, respectively). In multivariate analysis controlling for socio-demographic and clinical confounders, illness duration (r = 0.492; p < 0.002) and sTNFR2 (r = 0.665; p < 0.004) were independent predictors of CVR. CONCLUSION Our results reinforce the concept that patients with schizophrenia are at greater risk to develop cardiovascular diseases, and suggest that the associated chronic low-grade inflammation might play a role in this process.
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Affiliation(s)
- Ingrid Caroline Silva Dias
- Neuroscience Program, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil; Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), MG, Brazil
| | - Salvina Maria de Campos-Carli
- Neuroscience Program, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil; Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), MG, Brazil
| | - Erica Leandro Marciano Vieira
- Neuroscience Program, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil; Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), MG, Brazil
| | - Ana Paula Lucas Mota
- Department of de Clinical Analyses, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Pâmela Santos Azevedo
- Department of de Clinical Analyses, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Lucas Machado Mantovani
- Neuroscience Program, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil; Instituto Raul Soares - FHEMIG, Belo Horizonte, Brazil
| | - Breno Fiúza Cruz
- Mental Health Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Antonio Lúcio Teixeira
- Neuroscience Program, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil; Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, USA; Instituto de Ensino e Pesquisa, Faculdade Santa Casa BH, Belo Horizonte, Brazil
| | - João Vinícius Salgado
- Neuroscience Program, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil; Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil.
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Physical exercise is associated with a reduction in inflammatory biomarkers in first-episode psychosis: A pilot study of CRP, SAA, sICAM-1 and sVCAM-1. Schizophr Res 2021; 228:316-318. [PMID: 33497905 DOI: 10.1016/j.schres.2020.12.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 10/01/2020] [Accepted: 12/31/2020] [Indexed: 11/21/2022]
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Reduced levels of circulating adhesion molecules in adolescents with early-onset psychosis. NPJ SCHIZOPHRENIA 2020; 6:20. [PMID: 32811840 PMCID: PMC7434772 DOI: 10.1038/s41537-020-00112-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/07/2020] [Indexed: 12/12/2022]
Abstract
It is suggested that neurodevelopmental abnormalities are involved in the disease mechanisms of psychotic disorders. Although cellular adhesion molecules (CAMs) participate in neurodevelopment, modulate blood–brain barrier permeability, and facilitate leukocyte migration, findings concerning their systemic levels in adults with psychosis are inconsistent. We examined plasma levels and mRNA expression in peripheral blood mononuclear cells (PBMCs) of selected CAMs in adolescents with early-onset psychosis (EOP) aged 12–18 years (n = 37) and age-matched healthy controls (HC) (n = 68). EOP patients exhibited significantly lower circulating levels of soluble platelet selectin (~−22%) and soluble vascular cell adhesion molecule-1 (~−14%) than HC. We found no significant associations with symptom severity. PSEL mRNA expression was increased in PBMCs of patients and significantly negatively correlated to duration of illness. These findings suggest a role for CAMs in the pathophysiology of psychotic disorders.
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Moreno C, Parellada M, MacDowell KS, García-Bueno B, Cabrera B, González-Pinto A, Saiz P, Lobo A, Rodriguez-Jimenez R, Berrocoso E, Bernardo M, Leza JC. Differences in the regulation of inflammatory pathways in adolescent- and adult-onset first-episode psychosis. Eur Child Adolesc Psychiatry 2019; 28:1395-1405. [PMID: 30843122 DOI: 10.1007/s00787-019-01295-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 02/09/2019] [Indexed: 12/16/2022]
Abstract
A precise description of the inflammatory response in first-episode psychosis (FEP) by age of onset does not exist. We explored baseline and 6-month follow-up differences in the pro/anti-inflammatory balance in plasma and peripheral blood mononuclear cells in adolescent-onset FEP (≤ 18 y.o., N = 27) and adult-onset FEP (≥ 25 y.o., N = 43) using non-parametric 1-category ANCOVA, with age group as an independent variable and values of pro- and anti-inflammatory markers at baseline and at follow-up as dependent variables. We used a non-parametric repeated-measures mixed-effects model to explore the baseline/6-month change in pro- and anti-inflammatory markers within adolescent- and adult-onset groups, exploring differential trajectories of change by means of the interaction of time by age-of-onset group. Levels of the nuclear transcription factor (NFκB), a master regulator of the inflammatory and oxido/nitrosative status of cells, were higher in adolescent-onset FEP both at baseline and after 6 months. During follow-up, we found further increases in levels of soluble inflammatory markers (PGE2 and NO2-) only in adolescent-onset FEP. In contrast, in adult-onset FEP, the expression of inducible NO synthase (iNOS), which is also pro-inflammatory, tended to decrease, with no further increase in other pro-inflammatory markers. Significant differences in the direction of change by age-of-onset cohort exist only for NFκB (F = 4.165, df = 2, 70.95, p = 0.019). Our results support the existence of changes in the pro/anti-inflammatory balance in FEP depending on the neurodevelopmental stage at illness onset. These results also suggest that inflammation may be a potential therapeutic target in adolescent-onset FEP.
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Affiliation(s)
- C Moreno
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense (UCM), IiSGM, Madrid, Spain.
| | - M Parellada
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense (UCM), IiSGM, Madrid, Spain
| | - K S MacDowell
- Department of Pharmacology and Toxicology, Faculty of Medicine, UCM, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), IUINQ, Madrid, Spain
| | - B García-Bueno
- Department of Pharmacology and Toxicology, Faculty of Medicine, UCM, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), IUINQ, Madrid, Spain
| | - B Cabrera
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain
| | - A González-Pinto
- Hospital Universitario, Alava, EHU/UPV, BIOARABA, Vitoria, Spain
| | - P Saiz
- Department of Psychiatry, Faculty of Medicine, University of Oviedo, Oviedo, Spain
| | - A Lobo
- Department of Psychiatry, Instituto de Investigación Sanitaria Aragón, University of Zaragoza, Zaragoza, Spain
| | - R Rodriguez-Jimenez
- Department of Psychiatry, Instituto de Investigación Hospital, 12 de Octubre (i+12), Madrid, Spain.,CogPsy-Group, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - E Berrocoso
- Neuropsychopharmacology and Psychobiology Research Group, Department of Psychology, Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, University of Cádiz, Cádiz, Spain
| | - M Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Barcelona, Spain.,Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - J C Leza
- Department of Pharmacology and Toxicology, Faculty of Medicine, UCM, Instituto de Investigación Sanitaria Hospital 12 de Octubre (i+12), IUINQ, Madrid, Spain
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Una década del proyecto de primeros episodios psicóticos (PEPs): avanzando hacia una psiquiatría de precisión. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2019; 12:135-140. [DOI: 10.1016/j.rpsm.2019.03.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 03/22/2019] [Indexed: 12/24/2022]
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