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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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Dines M, Kes M, Ailán D, Cetkovich-Bakmas M, Born C, Grunze H. Bipolar disorders and schizophrenia: discrete disorders? Front Psychiatry 2024; 15:1352250. [PMID: 38745778 PMCID: PMC11091416 DOI: 10.3389/fpsyt.2024.1352250] [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: 12/07/2023] [Accepted: 04/16/2024] [Indexed: 05/16/2024] Open
Abstract
Background With similarities in heritability, neurobiology and symptomatology, the question has been raised whether schizophrenia and bipolar disorder are truly distinctive disorders or belong to a continuum. This narrative review summarizes common and distinctive findings from genetics, neuroimaging, cognition and clinical course that may help to solve this ethiopathogenetic puzzle. Methods The authors conducted a literature search for papers listed in PubMed and Google Scholar, using the search terms "schizophrenia" and "bipolar disorder" combined with different terms such as "genes", "neuroimaging studies", "phenomenology differences", "cognition", "epidemiology". Articles were considered for inclusion if they were written in English or Spanish, published as full articles, if they compared subjects with schizophrenia and bipolar disorder, or subjects with either disorder with healthy controls, addressing differences between groups. Results Several findings support the hypothesis that schizophrenia and bipolar disorder are discrete disorders, yet some overlapping of findings exists. The evidence for heritability of both SZ and BD is obvious, as well as the environmental impact on individual manifestations of both disorders. Neuroimaging studies support subtle differences between disorders, it appears to be rather a pattern of irregularities than an unequivocally unique finding distinguishing schizophrenia from bipolar disorder. The cognitive profile displays differences between disorders in certain domains, such as premorbid intellectual functioning and executive functions. Finally, the timing and trajectory of cognitive impairment in both disorders also differs. Conclusion The question whether SZ and BD belong to a continuum or are separate disorders remains a challenge for further research. Currently, our research tools may be not precise enough to carve out distinctive, unique and undisputable differences between SZ and BD, but current evidence favors separate disorders. Given that differences are subtle, a way to overcome diagnostic uncertainties in the future could be the application of artificial intelligence based on BigData. Limitations Despite the detailed search, this article is not a full and complete review of all available studies on the topic. The search and selection of papers was also limited to articles in English and Spanish. Selection of papers and conclusions may be biased by the personal view and clinical experience of the authors.
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Affiliation(s)
- Micaela Dines
- Department of Psychiatry, Instituto de Neurología Cognitiva (INECO), Buenos Aires, Argentina
- Department of Psychiatry, Instituto de Neurociencia Cognitiva y Traslacional (Consejo Nacional de Investigaciones Científicas y Técnicas - Fundación INECO - Universidad Favaloro), Buenos Aires, Argentina
| | - Mariana Kes
- Department of Psychiatry, Instituto de Neurología Cognitiva (INECO), Buenos Aires, Argentina
- Department of Psychiatry, Instituto de Neurociencia Cognitiva y Traslacional (Consejo Nacional de Investigaciones Científicas y Técnicas - Fundación INECO - Universidad Favaloro), Buenos Aires, Argentina
| | - Delfina Ailán
- Department of Psychiatry, Instituto de Neurología Cognitiva (INECO), Buenos Aires, Argentina
- Department of Psychiatry, Instituto de Neurociencia Cognitiva y Traslacional (Consejo Nacional de Investigaciones Científicas y Técnicas - Fundación INECO - Universidad Favaloro), Buenos Aires, Argentina
| | - Marcelo Cetkovich-Bakmas
- Department of Psychiatry, Instituto de Neurología Cognitiva (INECO), Buenos Aires, Argentina
- Department of Psychiatry, Instituto de Neurociencia Cognitiva y Traslacional (Consejo Nacional de Investigaciones Científicas y Técnicas - Fundación INECO - Universidad Favaloro), Buenos Aires, Argentina
| | - Christoph Born
- Department of Psychiatry, Psychiatrie Schwäbisch Hall, Ringstraße, Germany
- Department of Psychiatry, Paracelsus Medical University, Nuremberg, Germany
| | - Heinz Grunze
- Department of Psychiatry, Psychiatrie Schwäbisch Hall, Ringstraße, Germany
- Department of Psychiatry, Paracelsus Medical University, Nuremberg, Germany
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Rodríguez J, De Santis Arévalo J, Dennis VA, Rodríguez AM, Giambartolomei GH. Bystander activation of microglia by Brucella abortus-infected astrocytes induces neuronal death via IL-6 trans-signaling. Front Immunol 2024; 14:1343503. [PMID: 38322014 PMCID: PMC10844513 DOI: 10.3389/fimmu.2023.1343503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/29/2023] [Indexed: 02/08/2024] Open
Abstract
Inflammation plays a key role in the pathogenesis of neurobrucellosis where glial cell interactions are at the root of this pathological condition. In this study, we present evidence indicating that soluble factors secreted by Brucella abortus-infected astrocytes activate microglia to induce neuronal death. Culture supernatants (SN) from B. abortus-infected astrocytes induce the release of pro-inflammatory mediators and the increase of the microglial phagocytic capacity, which are two key features in the execution of live neurons by primary phagocytosis, a recently described mechanism whereby B. abortus-activated microglia kills neurons by phagocytosing them. IL-6 neutralization completely abrogates neuronal loss. IL-6 is solely involved in increasing the phagocytic capacity of activated microglia as induced by SN from B. abortus-infected astrocytes and does not participate in their inflammatory activation. Both autocrine microglia-derived and paracrine astrocyte-secreted IL-6 endow microglial cells with up-regulated phagocytic capacity that allows them to phagocytose neurons. Blocking of IL-6 signaling by soluble gp130 abrogates microglial phagocytosis and concomitant neuronal death, indicating that IL-6 activates microglia via trans-signaling. Altogether, these results demonstrate that soluble factors secreted by B. abortus-infected astrocytes activate microglia to induce, via IL-6 trans-signaling, the death of neurons. IL-6 signaling inhibition may thus be considered a strategy to control inflammation and CNS damage in neurobrucellosis.
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Affiliation(s)
- Julia Rodríguez
- Instituto de Inmunología, Genética y Metabolismo (INIGEM), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Julia De Santis Arévalo
- Instituto de Inmunología, Genética y Metabolismo (INIGEM), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Vida A Dennis
- Center for NanoBiotechnology Research and Department of Biological Sciences, Alabama State University, Montgomery, AL, United States
| | - Ana M Rodríguez
- Instituto de Inmunología, Genética y Metabolismo (INIGEM), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Guillermo H Giambartolomei
- Instituto de Inmunología, Genética y Metabolismo (INIGEM), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
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4
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Wu D, Wu Q, Li F, Wang Y, Zeng J, Tang B, Bishop JR, Xiao L, Lui S. Free water alterations in different inflammatory subgroups in schizophrenia. Brain Behav Immun 2024; 115:557-564. [PMID: 37972880 DOI: 10.1016/j.bbi.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 09/09/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Accumulating evidence suggests that inflammatory dysregulation both in blood and the brain is implicated in the pathogenesis of schizophrenia. Alterations in peripheral cytokines are not evident in all patients and there may be discrete altered inflammatory subgroups in schizophrenia. Recent studies using a novel and in vivo free-water imaging to detect inflammatory processes, have shown increased free water in white matter in schizophrenia. However, no studies to date have investigated the free water alterations in different inflammatory subgroups in schizophrenia. METHODS Forty-four patients with schizophrenia and 49 controls were recruited. The serum levels of interleukin-1 beta (IL-1β), IL-6, IL-10, and IL-12p70 were measured and used for cluster analysis with K-means and hierarchical algorithms. Diffusion tensor imaging (DTI) images were collected for all participants and voxel-wise free water and fractional anisotropy of tissue (FA-t) were compared between groups with Randomise running in FSL. Partial correlation analysis was employed to explore the association of the peripheral cytokine levels with free water. RESULTS We identified two statistically quantifiable discrete subgroups of patients based on the cluster analysis of cytokine measures. The peripheral levels of IL-1β (P < 0.001), IL-10 (P = 0.041), and IL-12p70 (P < 0.001) showed significant differences between the two different inflammatory subgroups. In the inflammatory subgroup with a predominantly higher IL-1β level, increased free water values in white matter were found mainly in the left posterior limb of the internal capsule, posterior corona radiata, and partly in the left sagittal stratum. These affected areas did not overlap with the regions that showed significant free water differences between patients and healthy controls. In the inflammatory subgroup with lower IL-1β levels, peripheral IL-1β was significantly associated with free water values in white matter while no such association was detected in the patient group. CONCLUSIONS Localized free water differences were demonstrated between the two identified inflammatory subgroups in our data, and free water appears to be a feasible in vivo neuroimaging biomarker guiding the target of inflammatory intervention and development of new therapeutic strategies in an individualized manner in schizophrenia.
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Affiliation(s)
- Dongsheng Wu
- Department of Radiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China; West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China.
| | - Qi Wu
- Key Lab of Intelligent Information Processing of Chinese Academy of Sciences, Institute of Computing Technology, Chinese Academy of Sciences, Beijing, China.
| | - Fei Li
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China.
| | - Yaxuan Wang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Jiaxin Zeng
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Biqiu Tang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Jeffrey R Bishop
- Department of Experimental and Clinical Pharmacology and Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States.
| | - Li Xiao
- Key Lab of Intelligent Information Processing of Chinese Academy of Sciences, Institute of Computing Technology, Chinese Academy of Sciences, Beijing, China; School of Artificial Intelligence, Beijing University of Posts and Telecommunications, Beijing, China.
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China.
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5
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Corley E, Patlola SR, Laighneach A, Corvin A, McManus R, Kenyon M, Kelly JP, Mckernan DP, King S, Hallahan B, Mcdonald C, Morris DW, Donohoe G. Genetic and inflammatory effects on childhood trauma and cognitive functioning in patients with schizophrenia and healthy participants. Brain Behav Immun 2024; 115:26-37. [PMID: 37748567 DOI: 10.1016/j.bbi.2023.09.013] [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: 02/08/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/27/2023] Open
Abstract
Recent studies have reported a negative association between exposure to childhood trauma, including physical neglect, and cognitive functioning in patients with schizophrenia. Childhood trauma has been found to influence immune functioning, which may contribute to the risk of schizophrenia and cognitive symptoms of the disorder. In this study, we aimed to test the hypothesis that physical neglect is associated with cognitive ability, and that this association is mediated by a combined latent measure of inflammatory response, and moderated by higher genetic risk for schizophrenia. The study included 279 Irish participants, comprising 102 patients and 177 healthy participants. Structural equation modelling was used to perform mediation and moderation analyses. Inflammatory response was measured via basal plasma levels of IL-6, TNF-α, and CRP, and cognitive performance was assessed across three domains: full-scale IQ, logical memory, and the emotion recognition task. Genetic variation for schizophrenia was estimated using a genome-wide polygenic score based on genome-wide association study summary statistics. The results showed that inflammatory response mediated the association between physical neglect and all measures of cognitive functioning, and explained considerably more variance than any of the inflammatory markers alone. Furthermore, genetic risk for schizophrenia was observed to moderate the direct pathway between physical neglect and measures of non-social cognitive functioning in both patient and healthy participants. However, genetic risk did not moderate the mediated pathway associated with inflammatory response. Therefore, we conclude that the mediating role of inflammatory response and the moderating role of higher genetic risk may independently influence the association between adverse early life experiences and cognitive function in patients and healthy participants.
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Affiliation(s)
- Emma Corley
- School of Psychology, University of Galway, Ireland; Centre for Neuroimaging, Cognition, and Genomics (NICOG), University of Galway, Ireland
| | - Saahithh Redddi Patlola
- Centre for Neuroimaging, Cognition, and Genomics (NICOG), University of Galway, Ireland; Pharmacology & Therapeutics and Galway Neuroscience Centre, University of Galway, Ireland
| | - Aodán Laighneach
- Centre for Neuroimaging, Cognition, and Genomics (NICOG), University of Galway, Ireland; School of Biological and Chemical Sciences, University of Galway, Ireland
| | - Aiden Corvin
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Institute of Molecular Medicine, Trinity College Dublin, Ireland
| | - Ross McManus
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Institute of Molecular Medicine, Trinity College Dublin, Ireland
| | - Marcus Kenyon
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Institute of Molecular Medicine, Trinity College Dublin, Ireland
| | - John P Kelly
- Pharmacology & Therapeutics and Galway Neuroscience Centre, University of Galway, Ireland
| | - Declan P Mckernan
- Pharmacology & Therapeutics and Galway Neuroscience Centre, University of Galway, Ireland
| | - Sinead King
- School of Psychology, University of Galway, Ireland; Centre for Neuroimaging, Cognition, and Genomics (NICOG), University of Galway, Ireland
| | - Brian Hallahan
- Department of Psychiatry, Clinical Science Institute, University of Galway, Ireland
| | - Colm Mcdonald
- Department of Psychiatry, Clinical Science Institute, University of Galway, Ireland
| | - Derek W Morris
- Centre for Neuroimaging, Cognition, and Genomics (NICOG), University of Galway, Ireland; School of Biological and Chemical Sciences, University of Galway, Ireland
| | - Gary Donohoe
- School of Psychology, University of Galway, Ireland; Centre for Neuroimaging, Cognition, and Genomics (NICOG), University of Galway, Ireland.
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Fenn-Moltu S, Deakin B, Drake R, Howes OD, Lawrie SM, Lewis S, Nikkheslat N, Walters JTR, MacCabe JH, Mondelli V, Egerton A. The association between peripheral inflammation, brain glutamate and antipsychotic response in Schizophrenia: Data from the STRATA collaboration. Brain Behav Immun 2023; 111:343-351. [PMID: 37182555 PMCID: PMC7615624 DOI: 10.1016/j.bbi.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/10/2023] [Accepted: 05/08/2023] [Indexed: 05/16/2023] Open
Abstract
Glutamate and increased inflammation have been separately implicated in the pathophysiology of schizophrenia and the extent of clinical response to antipsychotic treatment. Despite the mechanistic links between pro-inflammatory and glutamatergic pathways, the relationships between peripheral inflammatory markers and brain glutamate in schizophrenia have not yet been investigated. In this study, we tested the hypothesis that peripheral levels of pro-inflammatory cytokines would be positively associated with brain glutamate levels in schizophrenia. Secondary analyses determined whether this relationship differed according to antipsychotic treatment response. The sample consisted of 79 patients with schizophrenia, of whom 40 were rated as antipsychotic responders and 39 as antipsychotic non-responders. Brain glutamate levels were assessed in the anterior cingulate cortex (ACC) and caudate using proton magnetic resonance spectroscopy (1H-MRS) and blood samples were collected for cytokine assay on the same study visit (IL-6, IL-8, IL-10, TNF- α and IFN-γ). Across the whole patient sample, there was a positive relationship between interferon-gamma (IFN-γ) and caudate glutamate levels (r = 0.31, p = 0.02). In the antipsychotic non-responsive group only, there was a positive relationship between interleukin-8 (IL-8) and caudate glutamate (r = 0.46, p = 0.01). These findings provide evidence to link specific peripheral inflammatory markers and caudate glutamate in schizophrenia and may suggest that this relationship is most marked in patients who show a poor response to antipsychotic treatment.
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Affiliation(s)
- Sunniva Fenn-Moltu
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK.
| | - Bill Deakin
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Richard Drake
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Oliver D Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, UK; Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, London, UK
| | | | - Shôn Lewis
- Division of Psychology and Mental Health, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Naghmeh Nikkheslat
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - James T R Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - James H MacCabe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, UK
| | - Valeria Mondelli
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, UK; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alice Egerton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, UK
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7
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Li Q, Gong Y, Cui Y, Cheng C, Wang Y, Huang G, Gu W, Meng B, Wang M, Wu D, Zhao S, Yang X, Qin W, Sun J, Guo T. Efficacy of transcutaneous electrical acupoint stimulation for patients with first-episode schizophrenia: An 8-week, preliminary, randomized controlled trial. Psychiatry Res 2023; 325:115255. [PMID: 37245485 DOI: 10.1016/j.psychres.2023.115255] [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: 01/27/2023] [Revised: 05/09/2023] [Accepted: 05/15/2023] [Indexed: 05/30/2023]
Abstract
Combination therapy with antipsychotics has been investigated for treating schizophrenia, and has shown clear advantages among non-invasive therapies. Transcutaneous electrical acupoint stimulation (TEAS) is a novel non-invasive treatment with definite efficacy in treating mental disorders. The current study aimed to investigate the efficacy of TEAS in further improving the psychotic symptoms in patients with first-episode schizophrenia (FES) being treated with pharmacological drugs. This 8-week, preliminary, sham-controlled, randomized clinical trial was conducted in patients with FES to compare the efficacy of TEAS and sham TEAS in combination with aripiprazole treatment. The primary outcome was a change in the Positive and Negative Syndrome Scale (PANSS) score after ending the intervention (Week 8). A total of 49 participants completed the whole treatment cycle. The linear mixed-effects regression for PANSS indicated a significant time × group interaction (F(2, 116)=9.79, p <0.001). The PANSS score differed by 8.77 points (95% CI, -2.07 to -15.47 points; p=.01) between the TEAS group and the sham TEAS group after 8 weeks of treatment; this difference was significant. This study indicates that 8 weeks of TEAS combined with aripiprazole treatment can effectively treat FES. Thus, TEAS is an effective combination therapy to improve the psychiatric symptoms of FES.
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Affiliation(s)
- Qifu Li
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming 650500, China
| | - Yi Gong
- Yunnan University of Chinese Medicine Teaching Hospital/Kunming Psychiatry Hospital, Kunming, 650000, China
| | - Yapeng Cui
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xian, 710126, China
| | - Chen Cheng
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xian, 710126, China
| | - Yin Wang
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xian, 710126, China
| | - Gaoyangzi Huang
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming 650500, China
| | - Weiqiang Gu
- Yunnan University of Chinese Medicine Teaching Hospital/Kunming Psychiatry Hospital, Kunming, 650000, China
| | - Bin Meng
- Yunnan University of Chinese Medicine Teaching Hospital/Kunming Psychiatry Hospital, Kunming, 650000, China
| | - Mian Wang
- Yunnan University of Chinese Medicine Teaching Hospital/Kunming Psychiatry Hospital, Kunming, 650000, China
| | - Dongniya Wu
- Yunnan University of Chinese Medicine Teaching Hospital/Kunming Psychiatry Hospital, Kunming, 650000, China
| | - Siwen Zhao
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming 650500, China
| | - Xuejuan Yang
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xian, 710126, China
| | - Wei Qin
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xian, 710126, China
| | - Jinbo Sun
- Engineering Research Center of Molecular and Neuro Imaging of the Ministry of Education, School of Life Science and Technology, Xidian University, Xian, 710126, China.
| | - Taipin Guo
- School of Second Clinical Medicine/The Second Affiliated Hospital, Yunnan University of Chinese Medicine, Kunming 650500, China; Key Laboratory for Acupuncture, Moxibustion and Tuina Prevention and Treatment of Brain Diseases in Yunnan Universities, Kunming, China.
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8
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Heseltine-Carp W, Dale V, van Eck van der Sluijs J, van der Feltz-Cornelis C. Are serum hsCRP and IL-6 prognostic markers in somatic symptom disorder and related disorders? An exploratory analysis in a prospective cohort study. J Psychiatr Res 2023; 157:88-95. [PMID: 36455378 DOI: 10.1016/j.jpsychires.2022.11.026] [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: 07/18/2022] [Revised: 10/31/2022] [Accepted: 11/19/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the roles of hsCRP and IL-6 as prognostic markers for treatment outcome in SSRD. METHODS In this prospective cohort study, 237 consecutive outpatients diagnosed with SSRD at the Clinical Centre of Excellence for Body Mind and Health, the Netherlands were assessed. At intake, venepuncture was performed for serum hsCRP and IL-6. Baseline scores for PHQ-9, GAD7, physical symptom score (PSQ-51) and BPI questionnaires were obtained. Patients were followed up at the end of their usual treatment programme, which lasted approximately 12 months. RESULTS Higher baseline hsCRP was associated with high physical symptom scores (PSQ-51), but not BPI, GAD-7 and PHQ-9 questionnaire scores at end of treatment. No association was identified between baseline IL-6 and follow-up symptom questionnaire scores after treatment. Adjustment for age, gender and somatic comorbidity showed no significant change in the association. CONCLUSION This exploratory analysis provides some evidence that in patients with SSRD, high baseline serum hsCRP may predict poorer treatment outcomes in physical symptoms but not depression, anxiety or pain symptoms. Baseline serum hsCRP may therefore be a useful factor in identifying SSRD patients who are at risk of a persistent high physical symptom burden.
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Affiliation(s)
- William Heseltine-Carp
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK.
| | - Veronica Dale
- Department of Health Sciences, University of York, UK.
| | - Jonna van Eck van der Sluijs
- Altrecht, Psychosomatiek Eikenboom, the Netherlands; Clinical Centre of Excellence for Body Mind and Health, GGz Breburg, Tilburg, the Netherlands.
| | - Christina van der Feltz-Cornelis
- Clinical Centre of Excellence for Body Mind and Health, GGz Breburg, Tilburg, the Netherlands; Department of Health Sciences, Hull York Medical School (HYMS), University of York, UK.
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9
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Abstract
BACKGROUND Treatment with antipsychotics is associated with an increased risk of type 2 diabetes mellitus (T2D), and increased levels of inflammatory biomarkers are present in patients with T2D. We previously demonstrated that the glucagon-like peptide-1 receptor agonist liraglutide significantly reduced glucometabolic disturbances and body weight in prediabetic, overweight/obese schizophrenia-spectrum disorder patients treated with clozapine or olanzapine. This study aims to assess the involvement of cytokines in the therapeutic effects of liraglutide. METHODS Serum concentrations of 10 cytokines (interferon-γ [IFN-γ], tumor necrosis factor-α, interleukin 1β [IL-1β], IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, and IL-13) from fasting prediabetic and normal glucose-tolerant (NGT) patients with schizophrenia-spectrum disorders were measured using multiplexed immunoassays. Prediabetic patients were randomized to 16 weeks of treatment with liraglutide or placebo, and cytokines were measured again at the end of the treatment. RESULTS IFN-γ (1.98 vs 1.17 pg/ml, P = .001), IL-4 (0.02 vs 0.01 pg/ml, P < .001), and IL-6 (0.73 vs 0.46 pg/ml, P < .001) were significantly higher in prediabetic (n = 77) vs NGT patients (n = 31). No significant changes in cytokine levels following treatment with liraglutide (n = 37) vs placebo (n = 40) were found. CONCLUSION Prediabetic vs NGT patients with schizophrenia treated with clozapine or olanzapine had increased serum levels of several proinflammatory cytokines, further substantiating the link between inflammation and T2D. Treatment with liraglutide did not affect the investigated cytokines. Further testing of these findings in larger numbers of individuals is needed.
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10
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García-Juárez M, Camacho-Morales A. Defining the role of anti- and pro-inflammatory outcomes of Interleukin-6 in mental health. Neuroscience 2022; 492:32-46. [DOI: 10.1016/j.neuroscience.2022.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/03/2022] [Accepted: 03/16/2022] [Indexed: 01/03/2023]
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11
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Beeraka NM, Avila-Rodriguez MF, Aliev G. Recent Reports on Redox Stress-Induced Mitochondrial DNA Variations, Neuroglial Interactions, and NMDA Receptor System in Pathophysiology of Schizophrenia. Mol Neurobiol 2022; 59:2472-2496. [PMID: 35083660 DOI: 10.1007/s12035-021-02703-4] [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: 10/05/2021] [Accepted: 12/14/2021] [Indexed: 10/19/2022]
Abstract
Schizophrenia (SZ) is a chronic psychiatric disorder affecting several people worldwide. Mitochondrial DNA (mtDNA) variations could invoke changes in the OXPHOS system, calcium buffering, and ROS production, which have significant implications for glial cell survival during SZ. Oxidative stress has been implicated in glial cells-mediated pathogenesis of SZ; the brain comparatively more prone to oxidative damage through NMDAR. A confluence of scientific evidence points to mtDNA alterations, Nrf2 signaling, dynamic alterations in dorsolateral prefrontal cortex (DLPFC), and provocation of oxidative stress that enhance pathophysiology of SZ. Furthermore, the alterations in excitatory signaling related to NMDAR signaling were particularly reported for SZ pathophysiology. Current review reported the recent evidence for the role of mtDNA variations and oxidative stress in relation to pathophysiology of SZ, NMDAR hypofunction, and glutathione deficiency. NMDAR system is influenced by redox dysregulation in oxidative stress, inflammation, and antioxidant mediators. Several studies have demonstrated the relationship of these variables on severity of pathophysiology in SZ. An extensive literature search was conducted using Medline, PubMed, PsycINFO, CINAHL PLUS, BIOSIS Preview, Google scholar, and Cochrane databases. We summarize consistent evidence pointing out a plausible model that may elucidate the crosstalk between mtDNA alterations in glial cells and redox dysregulation during oxidative stress and the perturbation of NMDA neurotransmitter system during current therapeutic modalities for the SZ treatment. This review can be beneficial for the development of promising novel diagnostics, and therapeutic modalities by ascertaining the mtDNA variations, redox state, and efficacy of pharmacological agents to mitigate redox dysregulation and augment NMDAR function to treat cognitive and behavioral symptoms in SZ.
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Affiliation(s)
- Narasimha M Beeraka
- Department of Human Anatomy, I M Sechenov First Moscow State Medical University (Sechenov University), St. Trubetskaya, 8, bld. 2, Moscow, 119991, Russia.
| | - Marco F Avila-Rodriguez
- Faculty of Health Sciences, Department of Clinical Sciences, Barrio Santa Helena, University of Tolima, 730006, Ibagué, Colombia
| | - Gjumrakch Aliev
- Department of Human Anatomy, I M Sechenov First Moscow State Medical University (Sechenov University), St. Trubetskaya, 8, bld. 2, Moscow, 119991, Russia.,Institute of Physiologically Active Compounds, Russian Academy of Sciences, Chernogolovka, Moscow Region, 142432, Russia.,Research Institute of Human Morphology, 3 Tsyurupy Street, Moscow, 117418, Russia.,GALLY International Research Institute, 7733 Louis Pasteur Drive, #330, San Antonio, TX, 78229, USA
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12
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Murphy CE, Walker AK, O'Donnell M, Galletly C, Lloyd AR, Liu D, Weickert CS, Weickert TW. Peripheral NF-κB dysregulation in people with schizophrenia drives inflammation: putative anti-inflammatory functions of NF-κB kinases. Transl Psychiatry 2022; 12:21. [PMID: 35027554 PMCID: PMC8758779 DOI: 10.1038/s41398-021-01764-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/23/2021] [Accepted: 11/30/2021] [Indexed: 12/18/2022] Open
Abstract
Elevations in plasma levels of pro-inflammatory cytokines and C-reactive protein (CRP) in patient blood have been associated with impairments in cognitive abilities and more severe psychiatric symptoms in people with schizophrenia. The transcription factor nuclear factor kappa B (NF-κB) regulates the gene expression of pro-inflammatory factors whose protein products trigger CRP release. NF-κB activation pathway mRNAs are increased in the brain in schizophrenia and are strongly related to neuroinflammation. Thus, it is likely that this central immune regulator is also dysregulated in the blood and associated with cytokine and CRP levels. We measured levels of six pro-inflammatory cytokine mRNAs and 18 mRNAs encoding NF-κB pathway members in peripheral blood leukocytes from 87 people with schizophrenia and 83 healthy control subjects. We then assessed the relationships between the alterations in NF-κB pathway genes, pro-inflammatory cytokine and CRP levels, psychiatric symptoms and cognition in people with schizophrenia. IL-1β and IFN-γ mRNAs were increased in patients compared to controls (both p < 0.001), while IL-6, IL-8, IL-18, and TNF-α mRNAs did not differ. Recursive two-step cluster analysis revealed that high levels of IL-1β mRNA and high levels of plasma CRP defined 'high inflammation' individuals in our cohort, and a higher proportion of people with schizophrenia were identified as displaying 'high inflammation' compared to controls using this method (p = 0.03). Overall, leukocyte expression of the NF-κB-activating receptors, TLR4 and TNFR2, and the NF-κB subunit, RelB, was increased in people with schizophrenia compared to healthy control subjects (all p < 0.01), while NF-κB-inducing kinase mRNAs IKKβ and NIK were downregulated in patients (all p < 0.05). We found that elevations in TLR4 and RelB appear more related to inflammatory status than to a diagnosis of schizophrenia, but changes in TNFR2 occur in both the high and low inflammation patients (but were exaggerated in high inflammation patients). Further, decreased leukocyte expression of IKKβ and NIK mRNAs was unique to high inflammation patients, which may represent schizophrenia-specific dysregulation of NF-κB that gives rise to peripheral inflammation in a subset of patients.
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Affiliation(s)
- Caitlin E Murphy
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Adam K Walker
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Drug Discovery Biology Theme, Monash University, Parkville, Australia
| | | | - Cherrie Galletly
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
- Ramsay Health Care (SA) Mental Health, Adelaide, South Australia, Australia
| | - Andrew R Lloyd
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Dennis Liu
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Cynthia Shannon Weickert
- Neuroscience Research Australia, Sydney, New South Wales, Australia.
- School of Psychiatry, University of New South Wales, Sydney, Australia.
- Department of Neuroscience & Physiology, Upstate Medical University, Syracuse, New York, NY, USA.
| | - Thomas W Weickert
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Department of Neuroscience & Physiology, Upstate Medical University, Syracuse, New York, NY, USA
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13
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Ansari Z, Pawar S, Seetharaman R. Neuroinflammation and oxidative stress in schizophrenia: are these opportunities for repurposing? Postgrad Med 2021; 134:187-199. [PMID: 34766870 DOI: 10.1080/00325481.2021.2006514] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Purpose: To summarize the main findings on the subject of neuroinflammation and oxidative stress in patients with Schizophrenia (SCZ).Methods: A narrative review of all the relevant papers known to the authors was conducted.Results: SCZ is a chronic, debilitating, neuropsychiatric disorder associated with an immense and adverse impact on both the patient and the caregiver, and impairs the overall quality of life. The current modality of treatment involves the use of antipsychotics to balance the disturbances in the neurotransmitters in the dopaminergic and serotonin pathways in the brain, which have a role to play in SCZ. Contemporary management of SCZ focuses mainly on symptomatic control due to the lack of effective curative treatments.Despite the optimum use of antipsychotics, there is a considerable proportion of the patient population who are poor responders. This has necessitated the exploration of new etiopathologies in order to evolve new modalities of treatment. This narrative review, conducted over a period of 3 months, throws light on the large-scale evidence pointing toward neuroinflammation and oxidative stress as key etiopathological markers that merit further consideration in SCZ, and may even be the basis for devising novel pharmacotherapies for SCZ.Conclusions: This review discusses the various plausible hypotheses, viz., cytokine hypothesis of peripheral inflammation, acute-phase reactants in SCZ, microglial hypothesis of central inflammation, neurogenesis in relation to neuroinflammation, and oxidative stress in SCZ. It also highlights the many opportunities available for repurposing already marketed drugs with anti-inflammatory and antioxidant properties with a view to devising more effective and comprehensive therapies to manage SCZ.
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Affiliation(s)
- Zarrin Ansari
- Department of Pharmacology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India
| | - Sudhir Pawar
- Department of Pharmacology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India
| | - Rajmohan Seetharaman
- Department of Pharmacology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India
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14
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Hime GR, Stonehouse SLA, Pang TY. Alternative models for transgenerational epigenetic inheritance: Molecular psychiatry beyond mice and man. World J Psychiatry 2021; 11:711-735. [PMID: 34733638 PMCID: PMC8546770 DOI: 10.5498/wjp.v11.i10.711] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 07/19/2021] [Accepted: 08/25/2021] [Indexed: 02/06/2023] Open
Abstract
Mental illness remains the greatest chronic health burden globally with few in-roads having been made despite significant advances in genomic knowledge in recent decades. The field of psychiatry is constantly challenged to bring new approaches and tools to address and treat the needs of vulnerable individuals and subpopulations, and that has to be supported by a continuous growth in knowledge. The majority of neuropsychiatric symptoms reflect complex gene-environment interactions, with epigenetics bridging the gap between genetic susceptibility and environmental stressors that trigger disease onset and drive the advancement of symptoms. It has more recently been demonstrated in preclinical models that epigenetics underpins the transgenerational inheritance of stress-related behavioural phenotypes in both paternal and maternal lineages, providing further supporting evidence for heritability in humans. However, unbiased prospective studies of this nature are practically impossible to conduct in humans so preclinical models remain our best option for researching the molecular pathophysiologies underlying many neuropsychiatric conditions. While rodents will remain the dominant model system for preclinical studies (especially for addressing complex behavioural phenotypes), there is scope to expand current research of the molecular and epigenetic pathologies by using invertebrate models. Here, we will discuss the utility and advantages of two alternative model organisms–Caenorhabditis elegans and Drosophila melanogaster–and summarise the compelling insights of the epigenetic regulation of transgenerational inheritance that are potentially relevant to human psychiatry.
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Affiliation(s)
- Gary R Hime
- Department of Anatomy and Physiology, The University of Melbourne, Parkville 3010, VIC, Australia
| | - Sophie LA Stonehouse
- Mental Health Theme, The Florey Institute of Neuroscience and Mental Health, Parkville 3052, VIC, Australia
| | - Terence Y Pang
- Department of Anatomy and Physiology, The University of Melbourne, Parkville 3010, VIC, Australia
- Mental Health Theme, The Florey Institute of Neuroscience and Mental Health, Parkville 3052, VIC, Australia
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15
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Murphy CE, Walker AK, Weickert CS. Neuroinflammation in schizophrenia: the role of nuclear factor kappa B. Transl Psychiatry 2021; 11:528. [PMID: 34650030 PMCID: PMC8516884 DOI: 10.1038/s41398-021-01607-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/22/2021] [Accepted: 09/03/2021] [Indexed: 12/12/2022] Open
Abstract
Neuroinflammation, particularly in the dorsolateral prefrontal cortex, is well-established in a subset of people with schizophrenia, with significant increases in inflammatory markers including several cytokines. Yet the cause(s) of cortical inflammation in schizophrenia remains unknown. Clues as to potential microenvironmental triggers and/or intracellular deficits in immunoregulation may be gleaned from looking further upstream of effector immune molecules to transcription factors that control inflammatory gene expression. Here, we focus on the 'master immune regulator' nuclear factor kappa B (NF-κB) and review evidence in support of NF-κB dysregulation causing or contributing to neuroinflammation in patients. We discuss the utility of 'immune biotyping' as a tool to analyse immune-related transcripts and proteins in patient tissue, and the insights into cortical NF-κB in schizophrenia revealed by immune biotyping compared to studies treating patients as a single, homogenous group. Though the ubiquitous nature of NF-κB presents several hurdles for drug development, targeting this key immunoregulator with novel or repurposed therapeutics in schizophrenia is a relatively underexplored area that could aid in reducing symptoms of patients with active neuroinflammation.
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Affiliation(s)
- Caitlin E. Murphy
- grid.250407.40000 0000 8900 8842Neuroscience Research Australia, Randwick, NSW 2031 Australia
| | - Adam K. Walker
- grid.250407.40000 0000 8900 8842Neuroscience Research Australia, Randwick, NSW 2031 Australia ,grid.1005.40000 0004 4902 0432School of Psychiatry, University of New South Wales, Randwick, NSW 2031 Australia ,grid.1002.30000 0004 1936 7857Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052 Australia
| | - Cynthia Shannon Weickert
- Neuroscience Research Australia, Randwick, NSW, 2031, Australia. .,School of Psychiatry, University of New South Wales, Randwick, NSW, 2031, Australia. .,Department of Neuroscience and Physiology, Upstate Medical University, Syracuse, NY, 13210, USA.
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16
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Miller BJ, Herzig KH, Jokelainen J, Karhu T, Keinänen-Kiukaanniemi S, Järvelin MR, Veijola J, Viinamäki H, Päivikki Tanskanen, Jääskeläinen E, Isohanni M, Timonen M. Inflammation, hippocampal volume, and cognition in schizophrenia: results from the Northern Finland Birth Cohort 1966. Eur Arch Psychiatry Clin Neurosci 2021; 271:609-622. [PMID: 32382794 DOI: 10.1007/s00406-020-01134-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/27/2020] [Indexed: 02/08/2023]
Abstract
Increased blood interleukin-6 (IL-6) levels are a replicated abnormality in schizophrenia, and may be associated with smaller hippocampal volumes and greater cognitive impairment. These findings have not been investigated in a population-based birth cohort. The general population Northern Finland Birth Cohort 1966 was followed until age 43. Subjects with schizophrenia were identified through the national Finnish Care Register. Blood IL-6 levels were measured in n = 82 subjects with schizophrenia and n = 5373 controls at age 31. Additionally, 31 patients with schizophrenia and 63 healthy controls underwent brain structural MRI at age 34, and cognitive testing at ages 34 and 43. Patients with schizophrenia had significantly higher median (interquartile range) blood IL-6 levels than controls (5.31, 0.85-17.20, versus 2.42, 0.54-9.36, p = 0.02) after controlling for potential confounding factors. In both schizophrenia and controls, higher blood IL-6 levels were predictors of smaller hippocampal volumes, but not cognitive performance at age 34. We found evidence for increased IL-6 levels in patients with midlife schizophrenia from a population-based birth cohort, and replicated associations between IL-6 levels and hippocampal volumes. Our results complement and extend the previous findings, providing additional evidence that IL-6 may play a role in the pathophysiology of schizophrenia and associated brain alterations.
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Affiliation(s)
- Brian J Miller
- Department of Psychiatry and Health Behavior, Augusta University, 997 Saint Sebastian Way, Augusta, GA, 30912, USA.
| | - Karl-Heinz Herzig
- Research Unit of Biomedicine, University of Oulu, Oulu, Finland.,Medical Research Center (MRC) and Oulu University Hospital, Oulu, Finland.,Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland
| | - Jari Jokelainen
- Medical Research Center (MRC) and Oulu University Hospital, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Toni Karhu
- Research Unit of Biomedicine, University of Oulu, Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Medical Research Center (MRC) and Oulu University Hospital, Oulu, Finland.,Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Marjo-Riitta Järvelin
- Medical Research Center (MRC) and Oulu University Hospital, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Juha Veijola
- Medical Research Center (MRC) and Oulu University Hospital, Oulu, Finland.,Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Heimo Viinamäki
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.,Psychiatry, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | | | - Erika Jääskeläinen
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Matti Isohanni
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Markku Timonen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
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17
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The Potential Use of Peripheral Blood Mononuclear Cells as Biomarkers for Treatment Response and Outcome Prediction in Psychiatry: A Systematic Review. Mol Diagn Ther 2021; 25:283-299. [PMID: 33978935 DOI: 10.1007/s40291-021-00516-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Psychiatric disorders have a major impact on the global burden of disease while therapeutic interventions remain insufficient to adequately treat a large number of patients. Regrettably, the efficacy of several psychopharmacological treatment regimens becomes apparent only after 4-6 weeks, and at this point, a significant number of patients present as non-responsive. As such, many patients go weeks/months without appropriate treatment or symptom management. Adequate biomarkers for treatment success and outcome prediction are thus urgently needed. OBJECTIVE With this systematic review, we provide an overview of the use of peripheral blood mononuclear cells (PBMCs) and their signaling pathways in evaluating and/or predicting the effectiveness of different treatment regimens in the course of psychiatric illnesses. We highlight PBMC characteristics that (i) reflect treatment presence, (ii) allow differentiation of responders from non-responders, and (iii) prove predictive at baseline with regard to treatment outcome for a broad range of psychiatric intervention strategies. REVIEW METHODS A PubMed database search was performed to extract papers investigating the relation between any type of PBMC characteristic and treatment presence and/or outcome in patients suffering from severe mental illness. Criteria for eligibility were: written in English; psychiatric diagnosis based on DSM-III-R or newer; PBMC isolation via gradient centrifugation; comparison between treated and untreated patients via PBMC features; sample size ≥ n = 5 per experimental group. Papers not researching in vivo treatment effects between patients and healthy controls, non-clinical trials, and non-hypothesis-/data-driven (e.g., -omics designs) approaches were excluded. DATA SYNTHESIS Twenty-nine original articles were included and qualitatively summarized. Antidepressant and antipsychotic treatments were mostly reflected by intracellular inflammatory markers while intervention with mood stabilizers was evidenced through cell maturation pathways. Lastly, cell viability parameters mirrored predominantly non-pharmacological therapeutic strategies. As for response prediction, PBMC (subtype) counts and telomerase activity seemed most promising for antidepressant treatment outcome determination; full length brain-derived neurotrophic factor (BDNF)/truncated BDNF were shown to be most apt to prognosticate antipsychotic treatment. CONCLUSIONS We conclude that, although inherent limitations to and heterogeneity in study designs in combination with the scarce number of original studies hamper unambiguous identification, several PBMC characteristics-mostly related to inflammatory pathways and cell viability-indeed show promise towards establishment as clinically relevant treatment biomarkers.
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18
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Hughes HK, Mills-Ko E, Yang H, Lesh TA, Carter CS, Ashwood P. Differential Macrophage Responses in Affective Versus Non-Affective First-Episode Psychosis Patients. Front Cell Neurosci 2021; 15:583351. [PMID: 33716670 PMCID: PMC7943877 DOI: 10.3389/fncel.2021.583351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 02/02/2021] [Indexed: 11/13/2022] Open
Abstract
Increased innate immune activation and inflammation are common findings in psychotic and affective (mood) disorders such as schizophrenia (SCZ), bipolar disorder (BD), and major depressive disorder (MDD), including increased numbers and activation of monocytes and macrophages. These findings often differ depending on the disorder, for example, we previously found increases in circulating inflammatory cytokines associated with monocytes and macrophages in SCZ, while BD had increases in anti-inflammatory cytokines. Despite these differences, few studies have specifically compared immune dysfunction in affective versus non-affective psychotic disorders and none have compared functional monocyte responses across these disorders. To address this, we recruited 25 first episode psychosis (FEP) patients and 23 healthy controls (HC). FEP patients were further grouped based on the presence (AFF) or absence (NON) of mood disorder. We isolated peripheral blood mononuclear cells and cultured them for 1 week with M-CSF to obtain monocyte-derived macrophages. These cells were then stimulated for 24 h to skew them to inflammatory and alternative phenotypes, in order to identify differences in these responses. Following stimulation with LPS and LPS plus IFNγ, we found that macrophages from the NON-group had diminished inflammatory responses compared to both HC and AFF groups. Interestingly, when skewing macrophages to an alternative phenotype using LPS plus IL-4, the AFF macrophages increased production of inflammatory cytokines. Receiver operating curve analysis showed predictive power of inflammatory cytokine concentrations after LPS stimulation in the AFF group versus NON-group. Our results suggest dysfunctional monocyte responses in both affective and non-affective psychotic disorder, with varying types of immune dysfunction depending on the presence or absence of a mood component.
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Affiliation(s)
- Heather K. Hughes
- Department of Medical Microbiology and Immunology, University of California at Davis, Davis, CA, United States
- MIND Institute, University of California at Davis, Sacramento, CA, United States
| | - Emily Mills-Ko
- Department of Medical Microbiology and Immunology, University of California at Davis, Davis, CA, United States
- MIND Institute, University of California at Davis, Sacramento, CA, United States
| | - Houa Yang
- Department of Medical Microbiology and Immunology, University of California at Davis, Davis, CA, United States
- MIND Institute, University of California at Davis, Sacramento, CA, United States
| | - Tyler A. Lesh
- Department of Psychiatry and Behavioral Sciences, University of California at Davis, Sacramento, CA, United States
| | - Cameron S. Carter
- Department of Psychiatry and Behavioral Sciences, University of California at Davis, Sacramento, CA, United States
| | - Paul Ashwood
- Department of Medical Microbiology and Immunology, University of California at Davis, Davis, CA, United States
- MIND Institute, University of California at Davis, Sacramento, CA, United States
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19
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Rahman MR, Islam T, Nicoletti F, Petralia MC, Ciurleo R, Fisicaro F, Pennisi M, Bramanti A, Demirtas TY, Gov E, Islam MR, Mussa BM, Moni MA, Fagone P. Identification of Common Pathogenetic Processes between Schizophrenia and Diabetes Mellitus by Systems Biology Analysis. Genes (Basel) 2021; 12:genes12020237. [PMID: 33562405 PMCID: PMC7916024 DOI: 10.3390/genes12020237] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 02/07/2023] Open
Abstract
Schizophrenia (SCZ) is a psychiatric disorder characterized by both positive symptoms (i.e., psychosis) and negative symptoms (such as apathy, anhedonia, and poverty of speech). Epidemiological data show a high likelihood of early onset of type 2 diabetes mellitus (T2DM) in SCZ patients. However, the molecular processes that could explain the epidemiological association between SCZ and T2DM have not yet been characterized. Therefore, in the present study, we aimed to identify underlying common molecular pathogenetic processes and pathways between SCZ and T2DM. To this aim, we analyzed peripheral blood mononuclear cell (PBMC) transcriptomic data from SCZ and T2DM patients, and we detected 28 differentially expressed genes (DEGs) commonly modulated between SCZ and T2DM. Inflammatory-associated processes and membrane trafficking pathways as common biological processes were found to be in common between SCZ and T2DM. Analysis of the putative transcription factors involved in the regulation of the DEGs revealed that STAT1 (Signal Transducer and Activator of Transcription 1), RELA (v-rel reticuloendotheliosis viral oncogene homolog A (avian)), NFKB1 (Nuclear Factor Kappa B Subunit 1), and ERG (ETS-related gene) are involved in the expression of common DEGs in SCZ and T2DM. In conclusion, we provide core molecular signatures and pathways that are shared between SCZ and T2DM, which may contribute to the epidemiological association between them.
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Affiliation(s)
- Md Rezanur Rahman
- Department of Biotechnology and Genetic Engineering, Faculty of Biological Sciences, Islamic University, Kushtia 7003, Bangladesh;
- Department of Biochemistry and Biotechnology, Khwaja Yunus Ali University, Enayetpur, Sirajganj 6751, Bangladesh;
| | - Tania Islam
- Department of Biochemistry and Biotechnology, Khwaja Yunus Ali University, Enayetpur, Sirajganj 6751, Bangladesh;
| | - Ferdinando Nicoletti
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95124 Catania, Italy; (F.F.); (M.P.); (P.F.)
- Correspondence:
| | - Maria Cristina Petralia
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy; (M.C.P.); (R.C.); (A.B.)
| | - Rosella Ciurleo
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy; (M.C.P.); (R.C.); (A.B.)
| | - Francesco Fisicaro
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95124 Catania, Italy; (F.F.); (M.P.); (P.F.)
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95124 Catania, Italy; (F.F.); (M.P.); (P.F.)
| | - Alessia Bramanti
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy; (M.C.P.); (R.C.); (A.B.)
| | - Talip Yasir Demirtas
- Department of Bioengineering, Faculty of Engineering, Adana Alparslan Turkes Science and Technology University, Adana 01250, Turkey; (T.Y.D.); (E.G.)
| | - Esra Gov
- Department of Bioengineering, Faculty of Engineering, Adana Alparslan Turkes Science and Technology University, Adana 01250, Turkey; (T.Y.D.); (E.G.)
| | - Md Rafiqul Islam
- School of Biomedical Sciences, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, QLD 4059, Australia;
- Department of Pharmacy, Faculty of Biological Science and Technology, Jashore University of Science and Technology, Jashore 7408, Bangladesh
| | - Bashair M. Mussa
- Basic Medical Sciences Department, College of Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates;
| | - Mohammad Ali Moni
- WHO Collaborating Centre on eHealth, UNSW Digital Health, School of Public Health and Community Medicine, Faculty of Medicine, Sydney, NSW 2052, Australia;
| | - Paolo Fagone
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95124 Catania, Italy; (F.F.); (M.P.); (P.F.)
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20
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Melbourne JK, Rosen C, Chase KA, Feiner B, Sharma RP. Monocyte Transcriptional Profiling Highlights a Shift in Immune Signatures Over the Course of Illness in Schizophrenia. Front Psychiatry 2021; 12:649494. [PMID: 34054608 PMCID: PMC8160367 DOI: 10.3389/fpsyt.2021.649494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/19/2021] [Indexed: 02/05/2023] Open
Abstract
With advanced understanding of the intricate interplay between the immune and central nervous systems in neurological and neuropsychiatric illness, there is renewed interest in the potential contribution of immune dysregulation to the development and progression of schizophrenia. To inform this line of inquiry requires a more nuanced understanding of specific immune changes throughout the course of illness. Here, we utilized a genome-wide sequencing approach to transcriptionally profile circulating monocytes in participants with chronic schizophrenia. These myeloid cells, isolated from whole blood samples, are highly plastic with potentially important disease-modifying functions. Differential gene expression and gene set enrichment analyses, focusing on established monocyte phenotypic signatures, including those related to proinflammatory ("M1-like") and protective or tissue remodeling ("M2-like") functions, were carried out. We demonstrate an overall enrichment of both "M1-like" (interferon-alpha, interferon-gamma, lipopolysaccharide acute) and "M2-like" (endotoxin tolerance, glucocorticoid acute) monocyte signatures in the participants with schizophrenia compared to non-psychiatric controls. There was no enrichment of the "M1-like" chronic stress signature or the "M2-like" interleukin-4 signature. Using the Molecular Signatures Database Hallmark gene sets list, the "interferon response" was most strongly enriched in schizophrenia compared to controls. Additionally, an exploratory subgroup analysis based on illness duration suggests a shift in monocyte phenotype with illness progression. Specifically, the "M1-like" interferon-gamma signature shows decreased enrichment accompanied by increased enrichment of opposing "M2-like" signatures in participants with a medium illness duration shifting to a strong enrichment of interferon response signatures only in participants with a long illness duration. These findings related to circulating immune cell phenotype have potentially important implications for understanding the role of immune dysregulation in schizophrenia and are a critical consideration for future study design and immune-targeting treatment strategies.
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Affiliation(s)
- Jennifer K Melbourne
- Department of Psychiatry, The Psychiatric Institute, University of Illinois at Chicago, Chicago, IL, United States
| | - Cherise Rosen
- Department of Psychiatry, The Psychiatric Institute, University of Illinois at Chicago, Chicago, IL, United States
| | - Kayla A Chase
- Department of Psychiatry, The Psychiatric Institute, University of Illinois at Chicago, Chicago, IL, United States
| | - Benjamin Feiner
- Department of Psychiatry, The Psychiatric Institute, University of Illinois at Chicago, Chicago, IL, United States
| | - Rajiv P Sharma
- Department of Psychiatry, The Psychiatric Institute, University of Illinois at Chicago, Chicago, IL, United States
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21
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Reale M, Costantini E, Greig NH. Cytokine Imbalance in Schizophrenia. From Research to Clinic: Potential Implications for Treatment. Front Psychiatry 2021; 12:536257. [PMID: 33746786 PMCID: PMC7973221 DOI: 10.3389/fpsyt.2021.536257] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 01/18/2021] [Indexed: 12/13/2022] Open
Abstract
Cytokines are one of the most important components of the immune system. They orchestrate the brain's response to infectious and other exogenous insults and are crucial mediators of the cross-talk between the nervous and immune systems. Epidemiological studies have demonstrated that severe infections and autoimmune disorders, in addition to genetic predisposition, are risk factors for schizophrenia. Furthermore, maternal infection during pregnancy appears to increase the risk of schizophrenia, and proinflammatory cytokines may be negatively involved in the neurodevelopmental process. A cytokine imbalance has been described in the blood and cerebrospinal fluid of schizophrenia patients, particularly in the T helper type 1 [Th1] and type 2 [Th2] cytokines, albeit the results of such studies appear to be contradictory. Chronic stress, likewise, appears to contribute to a lasting proinflammatory state and likely also promotes the disorder. The aim of this mini-review is to investigate the roles of different cytokines in the pathophysiology of schizophrenia and define how cytokines may represent key molecular targets to regulate for the prevention and treatment of schizophrenia. How current antipsychotic drugs impact cytokine networks is also evaluated. In this context, we propose to change the focus of schizophrenia from a traditionally defined brain disorder, to one that is substantially impacted by the periphery and immune system.
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Affiliation(s)
- Marcella Reale
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Erica Costantini
- Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Nigel H Greig
- Drug Design and Development Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, United States
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22
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Zhu L, Wu X, Xu B, Zhao Z, Yang J, Long J, Su L. The machine learning algorithm for the diagnosis of schizophrenia on the basis of gene expression in peripheral blood. Neurosci Lett 2020; 745:135596. [PMID: 33359735 DOI: 10.1016/j.neulet.2020.135596] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 12/10/2020] [Accepted: 12/20/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Schizophrenia (SCZ) is a highly heritable mental disorder with a substantial disease burden. Machine learning (ML) method can be used to identify individuals with SCZ on the basis of blood gene expression data with high accuracy. METHODS This study aimed to differentiate patients with SCZ from healthy individuals by using the messenger RNA expression level in peripheral blood of 48 patients with SCZ and 50 controls via ML algorithms, namely, artificial neural networks, extreme gradient boosting, support vector machine (SVM), decision tree, and random forest. The expression of six mRNAs was detected using quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS The relative expression levels of GNAI1 (P < 0.001), PRKCA (P < 0.001), and PRKCB (P = 0.021) increased in the SCZ group, whereas those of FYN (P < 0.001), LYN (P = 0.022), and YWHAZ (P < 0.001) decreased in the SCZ group. We generated models with various combinations of genes based on five ML algorithms. The SVM model with six factors (GNAI1, FYN, PRKCA, YWHAZ, PRKCB, and LYN genes) was the best model for distinguishing patients with SCZ from healthy individuals (AUC = 0.993, sensitivity = 1.000, specificity = 0.895, and Youden index = 0.895). CONCLUSIONS This study suggested that the combination of genes using the ML method is better than the use of a single gene to discriminate patients with SCZ from healthy individuals. The combination of GNAI1, FYN, PRKCA, YWHAZ, PRKCB, and LYN under the SVM model can be used as a diagnostic biomarker for SCZ.
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Affiliation(s)
- Lulu Zhu
- School of Public Health of Guangxi Medical University, Nanning, Guangxi, China
| | - Xulong Wu
- School of Public Health of Guangxi Medical University, Nanning, Guangxi, China
| | - Bingyi Xu
- School of Public Health of Guangxi Medical University, Nanning, Guangxi, China
| | - Zhi Zhao
- School of Public Health of Guangxi Medical University, Nanning, Guangxi, China
| | - Jialei Yang
- School of Public Health of Guangxi Medical University, Nanning, Guangxi, China
| | - Jianxiong Long
- School of Public Health of Guangxi Medical University, Nanning, Guangxi, China.
| | - Li Su
- School of Public Health of Guangxi Medical University, Nanning, Guangxi, China.
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23
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Zafar T. Potential biomarkers of emotional stress induced neurodegeneration. eNeurologicalSci 2020; 21:100292. [PMID: 33294647 PMCID: PMC7695868 DOI: 10.1016/j.ensci.2020.100292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 01/14/2023] Open
Abstract
Mental health is a matter of great significance and interest both socially and scientifically. The present review aims to provide an informative platform about the classical biomarkers available to identify and diagnose the neurodegeneration induced by emotional stress and depression. Present article provides an expert comprehensive overview of the universally accepted markers and their mechanism of action involved in emotional stress assessment and its management. This envisioned piece of work emphasize on the incorporation of clinical markers in classical psychiatry experiments will make the information more significant, reliable and universally accepted. The information summaries in the article will facilitates the researchers of clinical psychiatry, neuropharmacology and neuropsychiatry in management of depressive disorders along with the identification of possible neurodegenerative association. Health is an overall outcome of emotional, physiological, endocrinological and neurological factors. Emotional stress and depression are silent causes of neurodegeneration. Clinical markers play a vital role in the management of neurological health. Endocrine secretions play a vital role in mediation of various neurotransmission, nerves excitability and neurodegeneration.
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Affiliation(s)
- Tabassum Zafar
- Department of Bioscience, Faculty of Life Sciences, Barkatullah University, Bhopal 462026, Madhya Pradesh, India
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24
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Gibson CL, Nia AB, Spriggs SA, DeFrancisco D, Swift A, Perkel C, Zhong X, Mazumdar M, Fernandez N, Patel M, Kim-Schulze S, Hurd YL. Cannabinoid use in psychotic patients impacts inflammatory levels and their association with psychosis severity. Psychiatry Res 2020; 293:113380. [PMID: 32818918 PMCID: PMC8292796 DOI: 10.1016/j.psychres.2020.113380] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 08/06/2020] [Accepted: 08/09/2020] [Indexed: 12/21/2022]
Abstract
Inflammatory abnormalities are well-documented in individuals with chronic psychotic disorders. Particular attention has focused on interleukin-6 (IL-6) and its correlation with psychotic symptom severity. Cannabis use is associated with an increased risk of psychosis and also has immunomodulating properties. It has been hypothesized that inflammatory disturbances are a common underlying pathology between cannabis use and psychosis. We measured inflammatory markers in individuals admitted to a psychiatric unit with acute psychosis who had toxicology positive for natural and/or synthetic cannabinoids (n = 59) compared to patients with negative cannabinoid toxicology (n = 60). Psychosis severity was assessed using the Positive and Negative Syndrome Scale (PANSS). While PANSS scores were similar between groups, cannabinoid-positive participants were more likely to receive pro re nata (PRN or as-needed) medications for agitation in the psychiatric emergency room, particularly synthetic cannabinoid-positive participants. In unadjusted models, cannabinoid-positive participants had lower interferon-γ (IFN-γ) levels (p = 0.046), but this finding was not significant after adjusting for covariates and multiple comparisons. Among cannabinoid-positive participants, IL-6 levels negatively correlated with PANSS total score (p = 0.040), as well as positive (p = 0.035) and negative (p = 0.024) subscales. Results suggest inflammatory alterations among psychotic individuals with comorbid cannabinoid use.
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Affiliation(s)
- Claire L. Gibson
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Anahita Bassir Nia
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Sharron A. Spriggs
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Daniel DeFrancisco
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Amy Swift
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Charles Perkel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Xiaobo Zhong
- Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Madhu Mazumdar
- Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Nicolas Fernandez
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Manishkumar Patel
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Seunghee Kim-Schulze
- Human Immune Monitoring Center, Icahn School of Medicine at Mount Sinai, New York City, NY, USA,Department of Oncological Science, Icahn School of Medicine at Mount Sinai, New York City, NY, USA,Precision Immunology Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Yasmin L. Hurd
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA,Addiction Institute at Mount Sinai, New York City, NY, USA,Corresponding Author: Dr. Yasmin L. Hurd, 1470 Madison Avenue, Hess building for Science and Medicine, 10-105, New York, NY 10029, Phone: (212)824-9314; Fax: (646)-537-9598,
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25
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Balcioglu YH, Kirlioglu SS. C-Reactive Protein/Albumin and Neutrophil/Albumin Ratios as Novel Inflammatory Markers in Patients with Schizophrenia. Psychiatry Investig 2020; 17:902-910. [PMID: 32894927 PMCID: PMC7538240 DOI: 10.30773/pi.2020.0185] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 07/07/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Peripheral biomarker studies in schizophrenia are insufficient to correspond to whether inflammatory markers are trait- or state-related. The main objective of this study was to compare novel biomarkers C-reactive protein/albumin ratio (CAR), neutrophil/albumin ratio (NAR), and complete blood count-derived inflammatory markers; neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), red-cell distribution width (RDW), and mean platelet volume (MPV) between patients with acutely exacerbated and remitted schizophrenia and healthy controls. METHODS Anonymous data of a total of 618 patients with schizophrenia (179 in remission, 439 with acute exacerbation) and 445 psychiatrically and medically healthy subjects admitted to outpatient units were included. One-way ANOVA with Tukey's HSD post-hoc test, Pearson's correlation test, receiver operating characteristic analysis, and binomial logistic regression analysis were performed. RESULTS CAR, NAR, NLR, PLR, MLR, RDW, MPV values were found higher in patients with schizophrenia than in healthy subjects. Except for NAR (p=0.007), none of the markers differed between acute exacerbation and remission. As a cut-off value of CAR, 0.388 differentiated patients with schizophrenia from controls (sensitivity 81%, specificity 81%). CAR, NAR, and MPV significantly predicted the diagnosis of schizophrenia. CONCLUSION CAR and NAR are reliable biomarkers of inflammation and a combination of inflammatory markers including CAR and NAR could be used to reflect the increased inflammatory status in schizophrenia, regardless of relapse or remission.
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Affiliation(s)
- Yasin Hasan Balcioglu
- Department of Psychiatry, Bakirkoy Prof Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey.,Department of Medical Sciences, Institute of Forensic Sciences and Legal Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Simge Seren Kirlioglu
- Department of Psychiatry, Bakirkoy Prof Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
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26
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Abstract
The definition of FIRS requires systemic inflammation and elevated levels of IL-6 in fetal plasma. That definition does not specify how systemic inflammation is to be recognized, and perinatal measurement of IL-6 is not a standard procedure. FIRS has not been examined in a population-based study that included post-neonatal outcome so its incidence and natural history are not known. The overlap, and similarities and differences, of FIRS as compared with other causes of neonatal encephalopathy, and how these relate to findings in the placenta, have not been jointly examined in a generalizable sample. FIRS has chiefly been discussed in the obstetric literature because of the need for decisions about management of delivery and antibiotic use. If the term "FIRS" is to be employed in other contexts, consensus should be sought as to which clinical, placental, and laboratory findings are most appropriate for identification of perinatal inflammatory processes, infectious or sterile.
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Affiliation(s)
- Karin B Nelson
- Scientist emerita, NINDS, NIH. Retired, Children's Hospital Medical Center, Depart. Neurology, DC. Address: 5524 Charles St, Bethesda, MD, 20814, USA.
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27
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Hughes H, Ashwood P. Overlapping evidence of innate immune dysfunction in psychotic and affective disorders. Brain Behav Immun Health 2020; 2:100038. [PMID: 34589829 PMCID: PMC8474635 DOI: 10.1016/j.bbih.2020.100038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/17/2020] [Accepted: 01/24/2020] [Indexed: 12/17/2022] Open
Abstract
Disturbances of the immune system and immune responses after activation are a common finding in neuropsychiatric disorders. Psychotic and affective disorders such as major depressive disorder (MDD), schizophrenia (SCZ) and bipolar disorder (BD) also share high rates of comorbidity with inflammatory and metabolic disorders. Evidence of elevated circulating inflammatory cytokines, altered numbers and function of immune cells, and evidence of neuroinflammation including activation of microglia in the brain have been found in patients with SCZ, BD and MDD. Often these findings correlate to psychological state at the time of measurement. However, significant variation exists across these studies in many aspects, creating challenges in identifying a specific signature of immune dysfunction in these disorders. Innate immune dysfunction, and alterations in monocytes, the critical sentinel cells of the innate immune system, have been seen repeatedly in all three of these disorders, with frequent overlap in findings. In this review, dysfunction specific to the innate arm of the immune system is compared for overlapping evidence across three major psychotic and affective disorders.
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Affiliation(s)
- H.K. Hughes
- Department of Medical Microbiology and Immunology, University of California Davis, Davis, CA, USA
- MIND Institute, University of California Davis, Davis, CA, USA
| | - P. Ashwood
- Department of Medical Microbiology and Immunology, University of California Davis, Davis, CA, USA
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28
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Shivakumar V, Sreeraj VS, Subbanna M, Kalmady SV, Amaresha AC, Narayanaswamy JC, Debnath M, Venkatasubramanian G. Differential impact of interleukin-6 promoter gene polymorphism on hippocampal volume in antipsychotic-naïve schizophrenia patients. Indian J Psychiatry 2020; 62:36-42. [PMID: 32001929 PMCID: PMC6964441 DOI: 10.4103/psychiatry.indianjpsychiatry_486_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 10/02/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Differential susceptibility model hypothesizes that a genotype need not be unfavorable all the time as postulated in stress-diathesis model but can be beneficial in a supportive context. Single-nucleotide polymorphism (SNP) (rs18000795) within the promoter region of interleukin-6 (IL-6) gene was earlier noted to have a differential susceptibility on hippocampal volume in schizophrenia (SCZ). MATERIALS AND METHODS We examined antipsychotic-naïve/free SCZ patients (n = 35) in comparison with healthy controls (n = 68). Hippocampus volumes were assessed in 3 Tesla magnetic resonance imaging using voxel-based morphometry. Region of interest analysis was done using hippocampus mask. IL-6 SNP (rs1800795) was genotyped using TaqMan allelic discrimination assay. RESULTS A significantly deficient right (T = 3.03; K E= 392; P SVC-FWE= 0.04) and left (T = 3.03; K E= 47; P uncorr= 0.03) hippocampal gray matter volumes were noted in SCZ patients after controlling for the potential confounding effects of age, sex, and total brain volume. There was a significant diagnosis x rs1800795 genotype interaction involving both left (T = 2.17, K E= 95, P uncorr= 0.02) and right (T = 1.82, K E= 29, P uncorr= 0.04) hippocampal volumes. Patients with GG (left: F =5.78; P = 0.02; right: F =6.21; P = 0.01) but not GC/CC genotype (left: F =0.89; P = 0.34; right: F <0.01; P = 0.95) had volume depletion. CONCLUSION A paradoxical smaller hippocampal volume with GG genotype was noted in SCZ. Further elucidation of its mechanistic basis might have translational implications.
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Affiliation(s)
- Venkataram Shivakumar
- Translational Psychiatry Lab, Neurobiology Research Center, Bengaluru, Karnataka, India.,InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, Bengaluru, Karnataka, India
| | - Vanteemar S Sreeraj
- Translational Psychiatry Lab, Neurobiology Research Center, Bengaluru, Karnataka, India.,InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, Bengaluru, Karnataka, India
| | - Manjula Subbanna
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, Bengaluru, Karnataka, India.,Department of Human Genetics, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Sunil V Kalmady
- Translational Psychiatry Lab, Neurobiology Research Center, Bengaluru, Karnataka, India.,InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, Bengaluru, Karnataka, India
| | - Anekal C Amaresha
- Translational Psychiatry Lab, Neurobiology Research Center, Bengaluru, Karnataka, India.,InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, Bengaluru, Karnataka, India
| | - Janardhanan C Narayanaswamy
- Translational Psychiatry Lab, Neurobiology Research Center, Bengaluru, Karnataka, India.,InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, Bengaluru, Karnataka, India
| | - Monojit Debnath
- InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, Bengaluru, Karnataka, India.,Department of Human Genetics, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ganesan Venkatasubramanian
- Translational Psychiatry Lab, Neurobiology Research Center, Bengaluru, Karnataka, India.,InSTAR Program, Schizophrenia Clinic, Department of Psychiatry, Bengaluru, Karnataka, India
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29
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Th17 and MAIT cell mediated inflammation in antipsychotic free schizophrenia patients. Schizophr Res 2019; 212:47-53. [PMID: 31439420 DOI: 10.1016/j.schres.2019.08.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 07/29/2019] [Accepted: 08/05/2019] [Indexed: 12/11/2022]
Abstract
The immune hypothesis of schizophrenia has gained significant popularity in recent years in schizophrenia research. Evidence suggests that the peripheral immune system communicates with central nervous system and the effect propagates through microglial and lymphocyte crosstalk, especially during neuro-inflammation. Although, there is previous literature indicating changes in lymphocyte population in schizophrenia, detailed studies with respect to T and B cells are scarce. Mucosal associated invariant T (MAIT) cells are functionally associated with the gut microbiome. The gut microbiome has been implicated in the pathogenesis of schizophrenia. However, there is no information on the frequency of MAIT cells in schizophrenia. Hence, we investigated changes in proportions of T cells, B cells and MAIT cells in peripheral blood mononuclear cells derived from antipsychotic-free patients with schizophrenia in comparison to healthy controls. In line with earlier reports, we noted perturbations in Th17 cells. This study for the first time reports changes in frequencies of MAIT cells in a homogenous population of antipsychotic-free patients with schizophrenia. These changes, though not common across all patients nevertheless point to the fact that inflammation is prevalent in a significant subset of schizophrenia cases.
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Chase KA, Feiner B, Ramaker MJ, Hu E, Rosen C, Sharma RP. Examining the effects of the histone methyltransferase inhibitor BIX-01294 on histone modifications and gene expression in both a clinical population and mouse models. PLoS One 2019; 14:e0216463. [PMID: 31185023 PMCID: PMC6559633 DOI: 10.1371/journal.pone.0216463] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 04/08/2019] [Indexed: 01/03/2023] Open
Abstract
Schizophrenia has been consistently characterized by abnormal patterns of gene down-regulation, increased restrictive chromatin assemblies, and reduced transcriptional activity. Histone methyltransferase (HMT) mRNA and H3K9me2 levels are elevated in postmortem brain and peripheral blood cells of persons with schizophrenia. Moreover, this epigenomic state likely contributes to the disease, as HMT levels correlate with clinical symptomatology. This manuscript sought to establish the potential therapeutic value of the HMT inhibitor BIX-01294 (BIX). Human peripheral mononuclear cells (PBMC) from 24 individuals with schizophrenia and 24 healthy individuals were cultured in the presence of BIX (5uM or 10uM). Mice were given once daily intraperitoneal injections of BIX (0.5 or 1mg/kg) for one week. Cultured cells, mouse cortex, or striatum was harvested, RNA extracted and RT-PCR conducted for several schizophrenia candidate genes: IL-6, Gad1, Nanog, KLF4, Reln, and Bdnf9a. Total H3K9me2 levels were measured using western blot while H3K9me2 binding to selected genes of interest was conducted using chromatin immunoprecipitation (ChIP). Neuronal subtype-specific BDNF conditional knockdown was conducted using the cre/lox system of mutant animals. Treatment with BIX decreased H3K9me2 and increased selected mRNA levels in cultured PBMCs from both normal controls and participants with schizophrenia. In mice, peripheral administration of BIX decreased cortical H3K9me2 levels and increased schizophrenia candidate gene expression. In BDNF conditional knockdown animals, BIX administration was able to significantly rescue Bdnf9a mRNA levels in ChAT and D1 Bdnf conditional knockdown mice. The results presented in this manuscript demonstrate a potential for further research into the clinical effectiveness of histone modifying pharmacology in the treatment of schizophrenia.
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Affiliation(s)
- Kayla A. Chase
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States of America
- Jesse Brown Veterans Affairs Medical Center, Chicago, IL, United States of America
| | - Benjamin Feiner
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Marcia J. Ramaker
- Department of Psychiatry, University of California, La Jolla, CA, United States of America
| | - Edward Hu
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Cherise Rosen
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Rajiv P. Sharma
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States of America
- Jesse Brown Veterans Affairs Medical Center, Chicago, IL, United States of America
- * E-mail:
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The JAK-STAT1 transcriptional signature in peripheral immune cells reveals alterations related to illness duration and acuity in psychosis. Brain Behav Immun 2019; 77:37-45. [PMID: 30503835 PMCID: PMC8521437 DOI: 10.1016/j.bbi.2018.11.317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/18/2018] [Accepted: 11/28/2018] [Indexed: 11/22/2022] Open
Abstract
Multiple lines of inquiry demonstrate alterations to immune function in psychosis. Clinically, this is reflected by elevated proinflammatory cytokines in serum, indicating activation of circulating immune cells. Data from isolated cells in clinical populations support the presence of altered activity of pertinent intracellular signaling pathways. Here, we focus on the well-characterized IFN-γ mediated JAK-STAT1 signaling pathway, which is involved in multiple aspects of immunity, including activation of circulating immune cells to a proinflammatory phenotype. By measuring a transcriptional signature characteristic of activation of this pathway, we demonstrate that JAK-STAT1 signature gene expression is suppressed in participants with psychosis who are early in illness and in participants who are hospitalized with an acute exacerbation of psychosis. Furthermore, we find that this expression signature normalizes in participants who have a longer illness duration and chronic, but not acute, psychopathology. This relationship of JAK-STAT1 signature gene expression with clinical characteristics highlights the temporal and contextual complexity of alterations to immune activity in psychosis and provides important insight into the functional state of circulating immune cells. These findings are of particular interest given recent research illustrating the importance of peripherally derived immune cells and the effectors they secrete in mediating neurophysiological processes of relevance for psychiatric illness.
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Chase KA, Melbourne JK, Rosen C, McCarthy-Jones S, Jones N, Feiner BM, Sharma RP. Traumagenics: At the intersect of childhood trauma, immunity and psychosis. Psychiatry Res 2019; 273:369-377. [PMID: 30682559 DOI: 10.1016/j.psychres.2018.12.097] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 12/06/2018] [Accepted: 12/18/2018] [Indexed: 01/26/2023]
Abstract
Early childhood trauma, including physical, sexual or emotional abuse, neglect, harm or threat of harm, is associated with adulthood dysregulation of the immune system. Trauma can induce chronic immune system activation. Associations between a chronic pro-inflammatory state and schizophrenia are an enduring finding of psychiatry, with elevated cytokine concentrations correlated with psychotic symptom severity. Most importantly, persons with schizophrenia and a history of childhood trauma demonstrate increased cytokine levels. Specific types of childhood trauma can also differentially impact the expression of unique immune markers. This study tested the hypotheses that levels of adverse childhood experiences (ACEs) would be associated with levels of peripheral immune activity assessed by IL6, IFNG, CXCL10, IRF1, STAT1 and TLR4 mRNA expression, and that there would be an association between ACEs and psychosis along a continuum from non-clinical controls (NCC) to psychotic disorders such as schizophrenia. These hypotheses were tested in 20 schizophrenia, 20 NCC. We found correlations between ACEs scores and immune markers, specifically IL6. We also found a positive association between ACEs and positive symptoms. Childhood trauma, through its effects on IL6, may be a risk factor for schizophrenia.
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Affiliation(s)
- Kayla A Chase
- Department of Psychiatry, University of Illinois at Chicago, 900 S. Ashland Ave, Suite 3268, Chicago, IL 60612, USA.
| | - Jennifer K Melbourne
- Department of Psychiatry, University of Illinois at Chicago, 900 S. Ashland Ave, Suite 3268, Chicago, IL 60612, USA
| | - Cherise Rosen
- Department of Psychiatry, University of Illinois at Chicago, 900 S. Ashland Ave, Suite 3268, Chicago, IL 60612, USA
| | | | - Nev Jones
- Department of Mental Health Law & Policy, Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa, FL, USA
| | - Benjamin M Feiner
- Department of Psychiatry, University of Illinois at Chicago, 900 S. Ashland Ave, Suite 3268, Chicago, IL 60612, USA
| | - Rajiv P Sharma
- Department of Psychiatry, University of Illinois at Chicago, 900 S. Ashland Ave, Suite 3268, Chicago, IL 60612, USA
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Subbanna M, Shivakumar V, Talukdar PM, Narayanaswamy JC, Venugopal D, Berk M, Varambally S, Venkatasubramanian G, Debnath M. Role of IL-6/RORC/IL-22 axis in driving Th17 pathway mediated immunopathogenesis of schizophrenia. Cytokine 2018; 111:112-118. [PMID: 30138899 DOI: 10.1016/j.cyto.2018.08.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/01/2018] [Accepted: 08/13/2018] [Indexed: 02/07/2023]
Abstract
The immuno-inflammatory origin of schizophrenia in a subset of patients is viewed as a key element of an overarching etiological construct. Despite substantial research, the immune components exerting major effect are yet to be fully clarified. Disrupted T cell networks have consistently been linked to the pathogenesis of schizophrenia. Amongst the Th cell subsets, the Th17 cells have emerged as a paradigmatic lineage with significant functional implications in a vast number of immune mediated diseases including brain disorders such as schizophrenia. The present study was aimed at examining the functional role of the Th17 pathway in schizophrenia. To address this, genotyping of IL17A (rs2275913; G197A) Single Nucleotide Polymorphism was carried out by the PCR-RFLP method in 221 schizophrenia patients and 223 healthy control subjects. Gene expression of two transcription factors STAT3 and RORC was quantified in a subset of drug naïve schizophrenia patients (n = 56) and healthy controls (n = 52) by TaqMan assay. The plasma levels of fifteen cytokines belonging to Th17 pathway were estimated in a subset of drug naïve schizophrenia patients (n = 61) and healthy controls (n = 50) by using Bio-Plex Pro Human Th17 cytokine assays. The AA genotype was associated with higher total score of bizarre behaviour and apathy in female schizophrenia patients. A high gene expression level of RORC was observed in drug naïve schizophrenia patients. In addition, significantly elevated plasma levels of IL-6 and IL-22, and reduced levels of IL-1β and IL-17F were noted in schizophrenia patients. Taken together, these findings indicate a dysregulated Th17 pathway in schizophrenia patients.
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Affiliation(s)
- Manjula Subbanna
- Department of Human Genetics, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Venkataram Shivakumar
- Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India; Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Pinku Mani Talukdar
- Department of Human Genetics, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Janardhanan C Narayanaswamy
- Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India; Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Deepthi Venugopal
- Department of Human Genetics, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Michael Berk
- Deakin University, School of Medicine, IMPACT Strategic Research Centre, Geelong, Victoria, Australia; Orygen, The Centre of Excellence in Youth Mental Health, The Department of Psychiatry and the Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Australia
| | - Shivarama Varambally
- Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India; Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Ganesan Venkatasubramanian
- Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India; Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Monojit Debnath
- Department of Human Genetics, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
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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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Melbourne JK, Rosen C, Feiner B, Sharma RP. C4A mRNA expression in PBMCs predicts the presence and severity of delusions in schizophrenia and bipolar disorder with psychosis. Schizophr Res 2018; 197:321-327. [PMID: 29449061 PMCID: PMC6087677 DOI: 10.1016/j.schres.2018.01.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 09/28/2017] [Accepted: 01/17/2018] [Indexed: 01/06/2023]
Abstract
Altered immune function is an established finding in psychotic disorders such as schizophrenia and bipolar disorder with psychosis, though its role in their development and progression remains to be understood. Evidence suggests altered JAK-STAT1 pathway activity in peripheral blood cells from participants with schizophrenia compared to controls. Activation of this pathway leads to increased expression of complement component 4A (C4A), which has recently been implicated in schizophrenia. Here, we examine mRNA expression of C4A in peripheral blood cells from participants with schizophrenia, bipolar disorder and controls. STAT1 and IRF-1 mRNA expression are included as measures of JAK-STAT1 pathway activation in the same participants. Further, we examine the association of each genes mRNA expression with clinical symptom measures using the Positive and Negative Syndrome Scale (PANSS) and the Psychotic Symptom Rating Scale (PSYRATS). We demonstrate that C4A, STAT1 and IRF-1 mRNA expression levels are correlated across the entire sample, indicating shared transcriptional regulatory mechanisms. Further, we show that C4A mRNA expression alone is positively associated with psychotic symptomatology, specifically the presence and severity of delusions. These findings are noteworthy given recent findings that demonstrate a critical role for complement proteins in synaptic pruning, alterations of which are proposed to contribute to psychopathology in psychosis.
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Affiliation(s)
- Jennifer K Melbourne
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St., Chicago, IL, USA, 60612.
| | - Cherise Rosen
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St., Chicago, IL, USA, 60612.
| | - Benjamin Feiner
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St., Chicago, IL, USA, 60612.
| | - Rajiv P Sharma
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St., Chicago, IL, USA, 60612; Jesse Brown Veterans Affairs Medical Center, 820 South Damen Avenue (M/C 151), Chicago, IL, USA, 60612.
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36
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Rodrigues-Amorim D, Rivera-Baltanás T, Spuch C, Caruncho HJ, González-Fernandez Á, Olivares JM, Agís-Balboa RC. Cytokines dysregulation in schizophrenia: A systematic review of psychoneuroimmune relationship. Schizophr Res 2018; 197:19-33. [PMID: 29239785 DOI: 10.1016/j.schres.2017.11.023] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/15/2017] [Accepted: 11/18/2017] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Schizophrenia is a multifactorial psychiatric disease with complex interactions among the brain and the immune system. A psycho-immune relationship underling schizophrenia is supported by several studies and integrates a specific area of knowledge - psychoneuroimmunology. METHODS A systematic review was performed by 2009 Preferred Reporting Items (PRISMA) recommendations. Based on the inclusion/exclusion criteria, publications with relevant information (evaluated by the Joanna Briggs Institute Critical Appraisals tools to quality assessment) were included. RESULTS In this review, we considered the inflammatory activity promoted by cytokine alterations in schizophrenia aetiology, which reflects the systemic comprehension of this disease in opposition to the traditional approach focused solely on the brain. We focus on the analysis of several specific outcomes, such as proinflammatory cytokines, sample sort, laboratory techniques, diagnosis scales and results of each publication. CONCLUSION This systematic review confirms the existence of cytokines abnormalities in schizophrenia disease. Immune imbalances such as increased levels of some cytokines (either at protein level or at mRNA expression), cytokine mRNAs, as well as cytokine gene polymorphisms have been reported with a large support in schizophrenia. These findings provide a strong evidence of a concomitant process of inflammatory activity in schizophrenia illness course.
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Affiliation(s)
- Daniela Rodrigues-Amorim
- Psychiatric Diseases Research Group, Galicia Sur Health Research Institute (IISGS), Complexo Hospitalario Universitario de Vigo (CHUVI), SERGAS, CIBERSAM, Spain
| | - Tania Rivera-Baltanás
- Psychiatric Diseases Research Group, Galicia Sur Health Research Institute (IISGS), Complexo Hospitalario Universitario de Vigo (CHUVI), SERGAS, CIBERSAM, Spain
| | - Carlos Spuch
- Neurology Research Group, Galicia Sur Health Research Institute (IISGS), Complexo Hospitalario Universitario de Vigo (CHUVI), SERGAS, CIBERSAM, Spain
| | - Hector J Caruncho
- Division of Medical Sciences, University of Victoria, Victoria, BC V8P 5C2, Canada
| | - África González-Fernandez
- Immunology, Biomedical Research Center (CINBIO) (Centro Singular de Investigación de Galicia), Galicia-Sur Health Research Institute (IISGS), University Campus, University of Vigo, Vigo, Spain
| | - Jose M Olivares
- Psychiatric Diseases Research Group, Galicia Sur Health Research Institute (IISGS), Complexo Hospitalario Universitario de Vigo (CHUVI), SERGAS, CIBERSAM, Spain
| | - Roberto C Agís-Balboa
- Psychiatric Diseases Research Group, Galicia Sur Health Research Institute (IISGS), Complexo Hospitalario Universitario de Vigo (CHUVI), SERGAS, CIBERSAM, Spain.
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37
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Miller BJ, Buckley PF, McEvoy JP. Inflammation, substance use, psychopathology, and cognition in phase 1 of the clinical antipsychotic trials of intervention effectiveness study. Schizophr Res 2018; 195:275-282. [PMID: 28843438 DOI: 10.1016/j.schres.2017.08.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 08/11/2017] [Accepted: 08/16/2017] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Schizophrenia has been associated with aberrant blood levels of inflammatory markers. However, patients with comorbid illicit drug use have been inadequately studied with respect to immune function. Furthermore, associations between inflammatory markers, psychopathology, and cognition have been inconsistently considered. We investigated relationships between inflammatory markers, comorbid marijuana and cocaine use, and psychopathology and cognition in patients with schizophrenia. METHOD For subjects with available fasting data from the baseline visit of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial, inflammatory markers were investigated as predictors of psychopathology and cognition in patients with and without comorbid marijuana or cocaine use, using linear regression models controlling for potential confounding factors. RESULTS Compared to subjects with a negative urine drug screen (UDS), marijuana use was a predictor of higher lymphocytes and E-selectin, and lower leptin (p≤0.04 for each); cocaine use was a predictor of higher adiponectin (p=0.04). In subjects with marijuana use, lower WBC and higher IL-6 were predictors of higher PANSS total score (p<0.05 for each). In subjects with cocaine use, lower total and differential WBC were predictors of higher PANSS total score (p<0.04 for each). In younger, non-obese subjects with a negative UDS, higher monocytes and IL-6 were predictors of PANSS total score (p<0.04 for each). CONCLUSIONS Our findings provide additional evidence that inflammation may be associated with psychopathology and cognition in some patients with schizophrenia. Furthermore, there is preliminary evidence for differential effects of comorbid marijuana and cocaine use on these relationships.
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Affiliation(s)
- Brian J Miller
- Department of Psychiatry and Health Behavior, Augusta University, Augusta, GA, United States.
| | - Peter F Buckley
- School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Joseph P McEvoy
- Department of Psychiatry and Health Behavior, Augusta University, Augusta, GA, United States
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Pozzi D, Menna E, Canzi A, Desiato G, Mantovani C, Matteoli M. The Communication Between the Immune and Nervous Systems: The Role of IL-1β in Synaptopathies. Front Mol Neurosci 2018; 11:111. [PMID: 29674955 PMCID: PMC5895746 DOI: 10.3389/fnmol.2018.00111] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 03/20/2018] [Indexed: 12/14/2022] Open
Abstract
In the last 15 years, groundbreaking genetic progress has underlined a convergence onto coherent synaptic pathways for most psychiatric and neurodevelopmental disorders, which are now collectively called “synaptopathies.” However, the modest size of inheritance detected so far indicates a multifactorial etiology for these disorders, underlining the key contribution of environmental effects to them. Inflammation is known to influence the risk and/or severity of a variety of synaptopathies. In particular, pro-inflammatory cytokines, produced and released in the brain by activated astrocytes and microglia, may play a pivotal role in these pathologies. Although the link between immune system activation and defects in cognitive processes is nowadays clearly established, the knowledge of the molecular mechanisms by which inflammatory mediators specifically hit synaptic components implicated in synaptopathies is still in its infancy. This review summarizes recent evidence showing that the pro-inflammatory cytokine interleukin-1β (IL-1β) specifically targets synaptopathy molecular substrate, leading to memory defects and pathological processes. In particular, we describe three specific pathways through which IL-1β affects (1) synaptic maintenance/dendritic complexity, (2) spine morphology, and (3) the excitatory/inhibitory balance. We coin the term immune synaptopathies to identify this class of diseases.
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Affiliation(s)
- Davide Pozzi
- Department of Biomedical Sciences, Humanitas University, Rozzano, Italy.,Humanitas Clinical and Research Center, Rozzano, Italy
| | - Elisabetta Menna
- Humanitas Clinical and Research Center, Rozzano, Italy.,Istituto di Neuroscienze, Consiglio Nazionale delle Ricerche, Milan, Italy
| | - Alice Canzi
- Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Genni Desiato
- Humanitas Clinical and Research Center, Rozzano, Italy.,School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | | | - Michela Matteoli
- Humanitas Clinical and Research Center, Rozzano, Italy.,Istituto di Neuroscienze, Consiglio Nazionale delle Ricerche, Milan, Italy
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Melbourne JK, Chase KA, Feiner B, Rosen C, Sharma RP. Long non-coding and endogenous retroviral RNA levels are associated with proinflammatory cytokine mRNA expression in peripheral blood cells: Implications for schizophrenia. Psychiatry Res 2018; 262:465-468. [PMID: 28942956 PMCID: PMC5851803 DOI: 10.1016/j.psychres.2017.09.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 09/08/2017] [Accepted: 09/11/2017] [Indexed: 11/17/2022]
Abstract
Recent research indicates that the expression of long non-coding and endogenous retroviral RNAs is coordinated with the activity of immune molecules often dysregulated in schizophrenia. We measured the expression of TMEVPG1, NRON, HERV-W env and HERV-W gag in blood cells from participants with schizophrenia and controls. We report that a) expression levels of these non-coding RNAs are correlated with proinflammatory cytokine mRNA expression in all participants, b) HERV-W transcripts are negatively correlated with atypical antipsychotic use in participants with schizophrenia, and c) that these RNAs are transcribed in response to proinflammatory stimuli in a THP-1 monocyte cell line.
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Affiliation(s)
- Jennifer K Melbourne
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St., Chicago, IL 60612, USA
| | - Kayla A Chase
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St., Chicago, IL 60612, USA; University of California, Department of Psychiatry, 9500 Gilman Drive, MC 8505, La Jolla, San Diego, CA 92037, USA
| | - Benjamin Feiner
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St., Chicago, IL 60612, USA
| | - Cherise Rosen
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St., Chicago, IL 60612, USA
| | - Rajiv P Sharma
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St., Chicago, IL 60612, USA; Jesse Brown Veterans Affairs Medical Center, 820 South Damen Avenue (M/C 151), Chicago, IL 60612, USA.
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40
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Kroken RA, Sommer IE, Steen VM, Dieset I, Johnsen E. Constructing the Immune Signature of Schizophrenia for Clinical Use and Research; An Integrative Review Translating Descriptives Into Diagnostics. Front Psychiatry 2018; 9:753. [PMID: 30766494 PMCID: PMC6365449 DOI: 10.3389/fpsyt.2018.00753] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 12/19/2018] [Indexed: 12/11/2022] Open
Abstract
Schizophrenia is considered a syndrome comprised by several disease phenotypes, covering a range of underlying pathologies. One of these disease mechanisms seems to involve immune dysregulation and neuroinflammation. While the current dopamine receptor-blocking antipsychotic drugs decrease psychotic symptoms and prevent relapse in the majority of patients with schizophrenia, there is a huge need to explore new treatment options that target other pathophysiological pathways. Such studies should aim at identifying robust biomarkers in order to diagnose and monitor the immune biophenotype in schizophrenia and develop better selection procedures for clinical trials with anti-inflammatory and immune-modulating drugs. In this focused review, we describe available methods to assess inflammatory status and immune disturbances in vivo. We also outline findings of immune disturbances and signs of inflammation at cellular, protein, and brain imaging levels in patients with schizophrenia. Furthermore, we summarize the results from studies with anti-inflammatory or other immune-modulating drugs, highlighting how such studies have dealt with participant selection. Finally, we propose a strategy to construct an immune signature that may be helpful in selecting and monitoring participants in studies with immune modulating drugs and also applicable in regular clinical work.
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Affiliation(s)
- Rune A Kroken
- Psychiatric Division, Haukeland University Hospital, Bergen, Norway.,Norwegian Centre for Mental Disorders Research, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Iris E Sommer
- Department of Neuroscience and Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Vidar M Steen
- Department of Clinical Science, Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, University of Bergen, Bergen, Norway.,Dr. E. Martens Research Group of Biological Psychiatry, Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
| | - Ingrid Dieset
- Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Acute Psychiatric Department, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Erik Johnsen
- Psychiatric Division, Haukeland University Hospital, Bergen, Norway.,Norwegian Centre for Mental Disorders Research, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
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41
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van de Sandt CE, Bárcena M, Koster AJ, Kasper J, Kirkpatrick CJ, Scott DP, de Vries RD, Herold S, Rimmelzwaan GF, Kuiken T, Short KR. Human CD8 + T Cells Damage Noninfected Epithelial Cells during Influenza Virus Infection In Vitro. Am J Respir Cell Mol Biol 2017; 57:536-546. [PMID: 28613916 DOI: 10.1165/rcmb.2016-0377oc] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
During severe influenza A virus (IAV) infections, a large amount of damage to the pulmonary epithelium is the result of the antiviral immune response. Specifically, whilst CD8+ T cells are important for killing IAV-infected cells, during a severe IAV infection, they can damage uninfected epithelial cells. At present, the mechanisms by which this occurs are unclear. Here, we used a novel in vitro coculture model of human NCl-H441 cells and CD8+ T cells to provide a new insight into how CD8+ T cells may affect uninfected epithelial cells during severe IAV infections. Using this model, we show that human IAV-specific CD8+ T cells produce soluble factors that reduce the barrier integrity of noninfected epithelial cells (referred to as "bystander damage"). We show that this bystander damage is the result of a combination of TNF-α and IFN-γ. This bystander damage occurred in the absence of widespread epithelial cell death and was instead associated with decreased expression of epithelial cell ion channels and pumps. Together, these data suggest that ameliorating the function of epithelial cell ion channels and pumps may help reduce immunopathology during severe IAV infections.
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Affiliation(s)
| | - Montserrat Bárcena
- 2 Department of Molecular Cell Biology, Section of Electron Microscopy, Leiden University Medical Centre, Leiden, the Netherlands
| | - Abraham J Koster
- 2 Department of Molecular Cell Biology, Section of Electron Microscopy, Leiden University Medical Centre, Leiden, the Netherlands
| | - Jennifer Kasper
- 3 Institute of Pathology, University Medical Centre, Johannes Gutenberg University, Mainz, Germany
| | - Charles J Kirkpatrick
- 3 Institute of Pathology, University Medical Centre, Johannes Gutenberg University, Mainz, Germany
| | - Dana P Scott
- 4 Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | - Rory D de Vries
- 1 Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Susanne Herold
- 5 University of Giessen and Marburg Lung Centre, Justus-Liebig-University of Giessen, Member of the German Centre for Lung Research, Giessen, Germany
| | - Guus F Rimmelzwaan
- 1 Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Thijs Kuiken
- 1 Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Kirsty R Short
- 1 Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands.,6 School of Biomedical Sciences, The University of Queensland, Brisbane, Queensland, Australia; and.,7 Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, Queensland, Australia
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42
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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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43
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Nikolić T, Petronijević M, Sopta J, Velimirović M, Stojković T, Jevtić Dožudić G, Aksić M, Radonjić NV, Petronijević N. Haloperidol affects bones while clozapine alters metabolic parameters - sex specific effects in rats perinatally treated with phencyclidine. BMC Pharmacol Toxicol 2017; 18:65. [PMID: 29020988 PMCID: PMC5637335 DOI: 10.1186/s40360-017-0171-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 10/03/2017] [Indexed: 01/26/2023] Open
Abstract
Background The presentation of schizophrenia (SCH) symptoms differs between the sexes. Long-term treatment with antipsychotics is frequently associated with decreased bone mineral density, increased fracture risk and metabolic side effects. Perinatal phencyclidine (PCP) administration to rodents represents an animal model of SCH. The aim of this study was to assess the effects of chronic haloperidol and clozapine treatment on bone mass, body composition, corticosterone, IL-6 and TNF-α concentrations and metabolic parameters in male and female rats perinatally treated with PCP. Methods Six groups of male and six groups of female rats (n = 6-12 per group) were subcutaneously treated on 2nd, 6th, 9th and 12th postnatal day (PN), with either PCP (10 mg/kg) or saline. At PN35, one NaCl and PCP group (NaCl-H and PCP-H) started receiving haloperidol (1 mg/kg/day) and one NaCl and PCP group (NaCl-C and PCP-C) started receiving clozapine (20 mg/kg/day) dissolved in drinking water. The remaining NaCl and PCP groups received water. Dual X-ray absorptiometry measurements were performed on PN60 and PN98. Animals were sacrificed on PN100. Femur was analysed by light microscopy. Concentrations of corticosterone, TNF-α and IL-6 were measured in serum samples using enzyme-linked immunosorbent assay (ELISA) commercially available kits. Glucose, cholesterol and triacylglycerol concentrations were measured in serum spectrophotometrically. Results Our results showed that perinatal PCP administration causes a significant decrease in bone mass and deterioration in bone quality in male and female rats. Haloperidol had deleterious, while clozapine had protective effect on bones. The effects of haloperidol on bones were more pronounced in male rats. It seems that the observed changes are not the consequence of the alterations of corticosterone, IL-6 and TNF-α concentration since no change of these factors was observed. Clozapine induced increase of body weight and retroperitoneal fat in male rats regardless of perinatal treatment. Furthermore, clozapine treatment caused sex specific increase in pro-inflammatory cytokines. Conclusion Taken together our findings confirm that antipsychotics have complex influence on bone and metabolism. Evaluation of potential markers for individual risk of antipsychotics induced adverse effects could be valuable for improvement of therapy of this life-long lasting disease. Electronic supplementary material The online version of this article (10.1186/s40360-017-0171-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tatjana Nikolić
- Institute of Medical and Clinical Biochemistry, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milan Petronijević
- Military Medical Academy, Clinic of Rheumatology, University of Defence, Belgrade, Serbia
| | - Jelena Sopta
- Institute of Pathology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milica Velimirović
- Institute of Medical and Clinical Biochemistry, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Tihomir Stojković
- Institute of Medical and Clinical Biochemistry, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Gordana Jevtić Dožudić
- Institute of Medical and Clinical Biochemistry, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milan Aksić
- Institute of Anatomy "Niko Miljanic", School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nevena V Radonjić
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Nataša Petronijević
- Institute of Medical and Clinical Biochemistry, School of Medicine, University of Belgrade, Belgrade, Serbia.
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44
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Mitra S, Natarajan R, Ziedonis D, Fan X. Antioxidant and anti-inflammatory nutrient status, supplementation, and mechanisms in patients with schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2017; 78:1-11. [PMID: 28499901 DOI: 10.1016/j.pnpbp.2017.05.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 05/06/2017] [Accepted: 05/08/2017] [Indexed: 10/19/2022]
Abstract
Over 50 million people around the world suffer from schizophrenia, a severe mental illness characterized by misinterpretation of reality. Although the exact causes of schizophrenia are still unknown, studies have indicated that inflammation and oxidative stress may play an important role in the etiology of the disease. Pro-inflammatory cytokines are crucial for normal central nervous development and proper functioning of neural networks and neurotransmitters. Patients with schizophrenia tend to have abnormal immune activation resulting in elevated pro-inflammatory cytokine levels, ultimately leading to functional brain impairments. Patients with schizophrenia have also been found to suffer from oxidative stress, a result of an imbalance between the production of free radicals and the ability to detoxify their harmful effects. Furthermore, inflammation and oxidative stress are implicated to be related to the severity of psychotic symptoms. Several nutrients are known to have anti-inflammatory and antioxidant functions through various mechanisms in our body. The present review evaluates studies and literature that address the status and supplementation of omega-3 polyunsaturated fatty acids, vitamin D, B vitamins (B6, folate, B12), vitamin E, and carotenoids in different stages of schizophrenia. The possible anti-inflammatory and antioxidant mechanisms of action of each nutrient are discussed.
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Affiliation(s)
- Sumedha Mitra
- Department of Psychiatry, UMass Memorial Medical Center/University of Massachusetts Medical School, One Biotech, 365 Plantation Street, Worcester, MA 01605, USA
| | - Radhika Natarajan
- Department of Psychiatry, UMass Memorial Medical Center/University of Massachusetts Medical School, One Biotech, 365 Plantation Street, Worcester, MA 01605, USA
| | - Douglas Ziedonis
- Department of Psychiatry, UMass Memorial Medical Center/University of Massachusetts Medical School, One Biotech, 365 Plantation Street, Worcester, MA 01605, USA
| | - Xiaoduo Fan
- Department of Psychiatry, UMass Memorial Medical Center/University of Massachusetts Medical School, One Biotech, 365 Plantation Street, Worcester, MA 01605, USA.
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45
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Melbourne JK, Feiner B, Rosen C, Sharma RP. Targeting the Immune System with Pharmacotherapy in Schizophrenia. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2017; 4:139-151. [PMID: 28674674 PMCID: PMC5493152 DOI: 10.1007/s40501-017-0114-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Jennifer K. Melbourne
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St., Chicago, IL, USA, 60612
| | - Benjamin Feiner
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St., Chicago, IL, USA, 60612
| | - Cherise Rosen
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St., Chicago, IL, USA, 60612
| | - Rajiv P. Sharma
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St., Chicago, IL, USA, 60612
- Jesse Brown Veterans Affairs Medical Center, 820 South Damen Avenue (M/C 151), Chicago, IL, USA, 60612
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46
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Zadka Ł, Dzięgiel P, Kulus M, Olajossy M. Clinical Phenotype of Depression Affects Interleukin-6 Synthesis. J Interferon Cytokine Res 2017; 37:231-245. [PMID: 28418766 DOI: 10.1089/jir.2016.0074] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Major depressive disorder (MDD) is not a single disease, but a number of various ailments that form one entity. Psychomotor retardation, anhedonia, sleep disorders, an increased suicide risk, and anxiety are the main symptoms that often define the clinical diagnosis of depression. Interleukin-6 (IL-6), as one of the proinflammatory cytokines, seems to be overexpressed during certain mental disorders, including MDD. Overexpression of IL-6 in depression is thought to be a factor associated with bad prognosis and worse disease course. IL-6 may directly affect brain functioning and production of neurotransmitters; moreover, its concentration is correlated with certain clinical symptoms within the wide range of depressive symptomatology. Furthermore, there is a strong correlation between IL-6 synthesis and psychosomatic functioning of the patient. This article discusses potential sources and significance of IL-6 in the pathogenesis of depression.
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Affiliation(s)
- Łukasz Zadka
- 1 Department of Histology and Embryology, Wroclaw Medical University , Wrocław, Poland .,2 II Department of Psychiatry and Psychiatric Rehabilitation, Independent Public Teaching Hospital No 1 in Lublin, Medical University of Lublin , Lublin, Poland
| | - Piotr Dzięgiel
- 1 Department of Histology and Embryology, Wroclaw Medical University , Wrocław, Poland
| | - Michał Kulus
- 1 Department of Histology and Embryology, Wroclaw Medical University , Wrocław, Poland
| | - Marcin Olajossy
- 2 II Department of Psychiatry and Psychiatric Rehabilitation, Independent Public Teaching Hospital No 1 in Lublin, Medical University of Lublin , Lublin, Poland
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47
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Rosen C, Jones N, Chase KA, Melbourne JK, Grossman LS, Sharma RP. Immersion in altered experience: An investigation of the relationship between absorption and psychopathology. Conscious Cogn 2017; 49:215-226. [PMID: 28219788 DOI: 10.1016/j.concog.2017.01.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 10/10/2016] [Accepted: 01/13/2017] [Indexed: 12/20/2022]
Abstract
Understanding alterations in perceptual experiences as a component of the basic symptom structure of psychosis may improve early detection and the identification of subtle shifts that can precede symptom onset or exacerbation. We explored the phenomenological construct of absorption and psychotic experiences in both clinical (bipolar psychosis and schizophrenia spectrum) and non-clinical participants. Participants with psychosis endorsed significantly higher absorption compared to the non-clinical group. Absorption was positively correlated with all types of hallucinations and multiple types of delusions. The analysis yielded two distinct cluster groups that demarcated a distinction along the continuum of self-disturbance: on characterized by attenuated ego boundaries and the other stable ego boundaries. The study suggests that absorption is a potentially important but under-researched component of psychosis that overlaps with, but is not identical to the more heavily theorized constructs of aberrant salience and hyperreflexivity.
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Affiliation(s)
- Cherise Rosen
- University of Illinois at Chicago, Department of Psychiatry, 1601 W. Taylor St., Chicago, IL 60612, United States.
| | - Nev Jones
- Felton Institute, 1500 Franklin Street, San Francisco, CA 94109, United States
| | - Kayla A Chase
- University of California, Department of Psychiatry, 9500 Gilman Drive, MC 8505, La Jolla, CA 92037, United States
| | - Jennifer K Melbourne
- University of Illinois at Chicago, Department of Psychiatry, 1601 W. Taylor St., Chicago, IL 60612, United States
| | - Linda S Grossman
- University of Illinois at Chicago, Department of Psychiatry, 1601 W. Taylor St., Chicago, IL 60612, United States
| | - Rajiv P Sharma
- University of Illinois at Chicago, Department of Psychiatry, 1601 W. Taylor St., Chicago, IL 60612, United States; Jesse Brown Veterans Affairs Medical Center, 820 South Damen Avenue, Chicago, IL 60612, United States
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