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Romeo B, Lestra V, Martelli C, Amirouche A, Benyamina A, Hamdani N. Increased markers of inflammation after cannabis cessation and their association with psychotic symptoms. Acta Neuropsychiatr 2024; 36:118-127. [PMID: 37114467 DOI: 10.1017/neu.2023.24] [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] [Indexed: 04/29/2023]
Abstract
INTRODUCTION A dysbalance of the immune system in psychotic disorders has been well investigated. However, despite a higher prevalence of cannabis (THC) consumption in patients with psychosis, few studies have investigated the impact of this use on inflammatory markers. METHODS One hundred and two inpatients were included in this retrospective study. Leukocytic formula, hsCRP, fibrinogen levels and urinary THC were measured, and comparisons were performed at baseline and after 4 weeks of cannabis cessation between cannabis users (THC+) and non-users (THC-). RESULTS After cannabis cessation, we found a greater increase in leucocyte level (p < 0.01), monocyte level (p = 0.05) and a statistical trend to a highest increase of lymphocyte level (p = 0.06) between baseline and 4 weeks in the THC+ group as compared to the THC- group. At 4 weeks, highest leucocyte (p = 0.03), lymphocyte (p = 0.04) and monocyte (p < 0.01) counts were found in the THC+ group, whereas at baseline no difference was found. A positive correlation was found between monocyte count at 4 weeks and baseline Positive and Negative Syndrome Scale (PANSS) negative subscore (p = 0.045) and between the variation of monocyte count between baseline and 4 weeks and the PANSS total score at 4 weeks (p = 0.05). CONCLUSION THC cessation is associated with an increase in inflammatory markers, including white blood cell, lymphocyte and monocyte levels, which correlates with symptomatology of patients with psychosis.
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Affiliation(s)
- Bruno Romeo
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800 Villejuif, France
- Unité de recherche UR Psychiatrie-Comorbidités-Addictions PSYCOMADD Université Paris Saclay, Paris, France
| | - Valentine Lestra
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800 Villejuif, France
| | - Catherine Martelli
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800 Villejuif, France
- Unité de recherche UR Psychiatrie-Comorbidités-Addictions PSYCOMADD Université Paris Saclay, Paris, France
- Institut National de la Santé et de la Recherche Médicale U1299, Research Unit, NeuroImaging and Psychiatry, Paris Sud University- Paris Saclay University, Paris Descartes University, Digiteo Labs, Bâtiment 660, Gif-sur-Yvette, France
| | - Ammar Amirouche
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800 Villejuif, France
- Unité de recherche UR Psychiatrie-Comorbidités-Addictions PSYCOMADD Université Paris Saclay, Paris, France
| | - Amine Benyamina
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800 Villejuif, France
- Unité de recherche UR Psychiatrie-Comorbidités-Addictions PSYCOMADD Université Paris Saclay, Paris, France
| | - Nora Hamdani
- Unité de recherche UR Psychiatrie-Comorbidités-Addictions PSYCOMADD Université Paris Saclay, Paris, France
- Cédiapsy, 87 rue d'Assas, 75006 Paris, France
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Cheng B, Bai Y, Liu L, Meng P, Cheng S, Yang X, Pan C, Wei W, Liu H, Jia Y, Wen Y, Zhang F. Mendelian randomization study of the relationship between blood and urine biomarkers and schizophrenia in the UK Biobank cohort. COMMUNICATIONS MEDICINE 2024; 4:40. [PMID: 38454150 PMCID: PMC10920902 DOI: 10.1038/s43856-024-00467-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 02/26/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND The identification of suitable biomarkers is of crucial clinical importance for the early diagnosis of treatment-resistant schizophrenia (TRS). This study aims to comprehensively analyze the association between TRS and blood and urine biomarkers. METHODS Candidate TRS-related single nucleotide polymorphisms (SNPs) were obtained from a recent genome-wide association study. The UK Biobank cohort, comprising 376,807 subjects with blood and urine biomarker testing data, was used to calculate the polygenic risk score (PRS) for TRS. Pearson correlation analyses were performed to evaluate the correlation between TRS PRS and each of the biomarkers, using calculated TRS PRS as the instrumental variables. Bidirectional two-sample Mendelian randomization (MR) was used to assess potential causal associations between candidate biomarkers with TRS. RESULTS Here we identify a significant association between TRS PRS and phosphate (r = 0.007, P = 1.96 × 10-4). Sex subgroup analyses identify seven and three candidate biomarkers associated with TRS PRS in male and female participants, respectively. For example, total protein and phosphate for males, creatinine and phosphate for females. Bidirectional two-sample MR analyses indicate that TRS is negatively associated with cholesterol (estimate = -0.363, P = 0.008). Conversely, TRS is positively associated with total protein (estimate = 0.137, P = 0.027), mean corpuscular volume (estimate = 0.032, P = 2.25 × 10-5), and mean corpuscular hemoglobin (estimate = 0.018, P = 0.007). CONCLUSIONS Our findings provide insights into the roles of blood and urine biomarkers in the early detection and treatment of TRS.
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Affiliation(s)
- Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases (Xi'an Jiaotong University), National Health and Family Planning Commission, 710061, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, 710061, Xi'an, China
- Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, China
| | - Yunfeng Bai
- School of Public Health, Shaanxi University of Chinese Medicine, 712046, Xianyang, China
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases (Xi'an Jiaotong University), National Health and Family Planning Commission, 710061, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, 710061, Xi'an, China
- Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, China
| | - Peilin Meng
- Key Laboratory of Trace Elements and Endemic Diseases (Xi'an Jiaotong University), National Health and Family Planning Commission, 710061, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, 710061, Xi'an, China
- Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, China
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases (Xi'an Jiaotong University), National Health and Family Planning Commission, 710061, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, 710061, Xi'an, China
- Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, China
| | - Xuena Yang
- Key Laboratory of Trace Elements and Endemic Diseases (Xi'an Jiaotong University), National Health and Family Planning Commission, 710061, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, 710061, Xi'an, China
- Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, China
| | - Chuyu Pan
- Key Laboratory of Trace Elements and Endemic Diseases (Xi'an Jiaotong University), National Health and Family Planning Commission, 710061, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, 710061, Xi'an, China
- Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, China
| | - Wenming Wei
- Key Laboratory of Trace Elements and Endemic Diseases (Xi'an Jiaotong University), National Health and Family Planning Commission, 710061, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, 710061, Xi'an, China
- Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, China
| | - Huan Liu
- Key Laboratory of Trace Elements and Endemic Diseases (Xi'an Jiaotong University), National Health and Family Planning Commission, 710061, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, 710061, Xi'an, China
- Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, China
| | - Yumeng Jia
- Key Laboratory of Trace Elements and Endemic Diseases (Xi'an Jiaotong University), National Health and Family Planning Commission, 710061, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, 710061, Xi'an, China
- Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases (Xi'an Jiaotong University), National Health and Family Planning Commission, 710061, Xi'an, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, 710061, Xi'an, China
- Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases (Xi'an Jiaotong University), National Health and Family Planning Commission, 710061, Xi'an, China.
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, 710061, Xi'an, China.
- Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, 710061, Xi'an, China.
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Romeo B, Lestra V, Martelli C, Amirouche A, Benyamina A, Hamdani N. The Modulated Role of Toxoplasma gondii on Eosinophils in Psychiatric Disorders after Cannabis Cessation. Pathogens 2023; 12:1333. [PMID: 38003797 PMCID: PMC10675363 DOI: 10.3390/pathogens12111333] [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: 09/05/2023] [Revised: 10/29/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
The aim of our study was to evaluate the impact of T. gondii status on eosinophils count (EOS), the eosinophil-to-lymphocyte ratio (ELR), and the eosinophil-to-neutrophil-to-lymphocytes ratio (ENLR) before and after cannabis cessation in patients with psychiatric disorders. One hundred and eighty-eight patients were included in the study. T. gondii, EOS, ELR, ENLR, and urinary cannabis were measured at baseline and after 4 weeks of cannabis cessation. Highest levels and increase of PNE (p = 0.02), ENLR levels (p = 0.031) and highest level of ELR (p = 0.03) were found in patients after cannabis cessation only in patients positive for T. gondii serology (Toxo+ group). At four weeks, significant interactions between cannabis and T. gondii status for EOS (p = 0.038), and for ENLR (p = 0.043) levels were found, as well as for the evolution between baseline and 4 weeks for ENLR level (p = 0.049). After cannabis cessation, we found a positive correlation between negative symptoms and EOS levels at 4 weeks in the Toxo+ group. This study shows that the increase of inflammation after cannabis cessation might be modulated by T. gondii seropositivity status in patients after cannabis cessation.
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Affiliation(s)
- Bruno Romeo
- Department of Psychiatry and Addictology, Paul Brousse Hospital, APHP, 94800 Villejuif, France; (V.L.); (C.M.); (A.A.); (A.B.)
- Unité de Recherche UR, Psychiatrie-Comorbidités-Addictions (PSYCOMadd), Paris Saclay University, 94800 Villejuif, France;
| | - Valentine Lestra
- Department of Psychiatry and Addictology, Paul Brousse Hospital, APHP, 94800 Villejuif, France; (V.L.); (C.M.); (A.A.); (A.B.)
| | - Catherine Martelli
- Department of Psychiatry and Addictology, Paul Brousse Hospital, APHP, 94800 Villejuif, France; (V.L.); (C.M.); (A.A.); (A.B.)
- Unité de Recherche UR, Psychiatrie-Comorbidités-Addictions (PSYCOMadd), Paris Saclay University, 94800 Villejuif, France;
- Institut National de la Santé et de la Recherche Médicale U1299, Research unit, NeuroImaging and Psychiatry, Paris Sud University-Paris Saclay University, Paris Descartes University, Digiteo Labs, 91190 Gif-sur-Yvette, France
| | - Ammar Amirouche
- Department of Psychiatry and Addictology, Paul Brousse Hospital, APHP, 94800 Villejuif, France; (V.L.); (C.M.); (A.A.); (A.B.)
- Unité de Recherche UR, Psychiatrie-Comorbidités-Addictions (PSYCOMadd), Paris Saclay University, 94800 Villejuif, France;
| | - Amine Benyamina
- Department of Psychiatry and Addictology, Paul Brousse Hospital, APHP, 94800 Villejuif, France; (V.L.); (C.M.); (A.A.); (A.B.)
- Unité de Recherche UR, Psychiatrie-Comorbidités-Addictions (PSYCOMadd), Paris Saclay University, 94800 Villejuif, France;
| | - Nora Hamdani
- Unité de Recherche UR, Psychiatrie-Comorbidités-Addictions (PSYCOMadd), Paris Saclay University, 94800 Villejuif, France;
- Cédiapsy, 75006 Paris, France
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Corsi-Zuelli F, Marques L, da Roza DL, Loureiro CM, Shuhama R, Di Forti M, Menezes PR, Louzada-Junior P, Del-Ben CM. The independent and combined effects of cannabis use and systemic inflammation during the early stages of psychosis: exploring the two-hit hypothesis. Psychol Med 2021; 52:1-11. [PMID: 33736715 DOI: 10.1017/s0033291721000726] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Cannabis consumption is a modifiable risk factor associated with psychosis, but not all cannabis users develop psychosis. Animal studies suggest that an antecedent active immune system interacts with subsequent cannabis exposure and moderates the cannabis-psychosis association, supporting the two-hit hypothesis. The clinical investigations are few, and it is unclear if the immune system is a biological candidate moderating the cannabis-psychosis association or whether cannabis increases inflammation, which in turn, augments psychosis likelihood. METHODS We explored the mediating and moderating role of blood inflammation using PROCESS macro. We used data from a cross-sectional study, including 153 first-episode psychosis patients and 256 community-based controls. Participants answered the Cannabis Experience Questionnaire (cannabis frequency, age of onset, and duration), and plasma cytokines were measured [interleukin (IL)-1β, IL-6, IL-4, IL-10, tumour necrosis factor-α (TNF-α), interferon-γ (IFN-γ), transforming growth factor-β (TGF-β); multiplex]. We computed an inflammatory composite score (ICS) to represent the systemic inflammatory state. Confounders included sex, age, ethnicity, educational level, body mass index, tobacco smoking, lifetime use of other drugs, and antipsychotic treatment. RESULTS Mediation: Cannabis consumption was not associated with increased inflammation, thus not supporting a mediating effect of inflammation. Moderation: Daily use and age of onset <17 interacted significantly with the ICS to increase the odds of psychosis beyond their individual effects and were only associated with psychosis among those scoring medium-high in the ICS. CONCLUSIONS Immune dysregulation might be part of the pathophysiology of psychosis, not explained by cannabis use or other confounders. We provide the first and initial evidence that immune dysregulation modifies the cannabis-psychosis association, in line with a two-hit hypothesis.
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Affiliation(s)
- Fabiana Corsi-Zuelli
- Department of Neuroscience and Behaviour, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- Center for Research on Inflammatory Diseases - CRID, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Leonardo Marques
- Department of Neuroscience and Behaviour, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Daiane Leite da Roza
- Department of Neuroscience and Behaviour, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Camila Marcelino Loureiro
- Center for Research on Inflammatory Diseases - CRID, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- Department of Internal Medicine, Division of Clinical Immunology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- Population Mental Health Center - NAP-SaMP, University of São Paulo, São Paulo, Brazil
| | - Rosana Shuhama
- Department of Neuroscience and Behaviour, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- Population Mental Health Center - NAP-SaMP, University of São Paulo, São Paulo, Brazil
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Paulo Rossi Menezes
- Population Mental Health Center - NAP-SaMP, University of São Paulo, São Paulo, Brazil
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Paulo Louzada-Junior
- Center for Research on Inflammatory Diseases - CRID, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- Department of Internal Medicine, Division of Clinical Immunology, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Cristina Marta Del-Ben
- Department of Neuroscience and Behaviour, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- Population Mental Health Center - NAP-SaMP, University of São Paulo, São Paulo, Brazil
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Jackson AJ, Miller BJ. Meta-analysis of total and differential white blood cell counts in schizophrenia. Acta Psychiatr Scand 2020; 142:18-26. [PMID: 31850530 DOI: 10.1111/acps.13140] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/08/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Schizophrenia is associated with alterations in blood inflammatory markers, including cytokines. Total white blood cell (WBC) count is a marker of low-grade inflammation. We conducted a meta-analysis of total and differential WBC counts in patients with schizophrenia. METHOD Articles were identified through a systematic search of PsycINFO, Pub Med, Web of Science, and the associated references. Data were analyzed using a random effects approach. RESULTS Twenty-four studies met the inclusion criteria. Blood total WBC, monocytes, and neutrophils were significantly higher in schizophrenia vs. controls with small-to-medium effect sizes (standardized mean difference [SMD] = 0.39-0.53, P < 0.01 for each). In first-episode psychosis compared with controls, neutrophils and monocytes were significantly increased with similar effect sizes (SMD = 0.40-0.41, P ≤ 0.01 for each), and there was a trend for higher total WBC (SMD = 0.46, P = 0.05). CONCLUSIONS Consistent with studies of other inflammatory markers, we found evidence for increased total and differential WBC counts in schizophrenia. Our results complement other studies of WBC counts in schizophrenia. These findings are relevant to the pathophysiology and potentially the treatment of schizophrenia.
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Affiliation(s)
| | - Brian J Miller
- Department of Psychiatry, Augusta University, Augusta, GA, USA
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