Association between elevated serum matrix metalloproteinase-2 and tumor necrosis factor-α, and clinical symptoms in male patients with treatment-resistant and chronic medicated schizophrenia

NGF-β and BDNF levels are altered in male patients with chronic schizophrenia: effects on clinical symptoms

BACKGROUND

Schizophrenia, a severe mental disorder with complex pathophysiology, involves neurotrophic factors, which play crucial roles in neurodevelopment and neuroplasticity. This study investigated NGF-β and BDNF levels in chronic schizophrenia and their association with clinical symptoms, cognitive function, and 1,25(OH)₂D levels.

METHODS

In this cross-sectional study, 72 male patients with chronic schizophrenia and 70 matched healthy controls were enrolled. Psychopathological symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS), and cognitive function was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The serum levels of NGF-β, BDNF, and 1,25(OH)₂D were measured.

RESULTS

Serum levels of NGF-β (F = 35.239, P < 0.001) and BDNF (F = 12.669, P < 0.001) were significantly decreased in patients with chronic schizophrenia compared to healthy controls. NGF-β levels were negatively correlated with PANSS negative symptoms (beta = -0.205, t = -2.098, P = 0.040) and positively correlated with 1,25(OH)₂D levels (r = 0.324, P = 0.006). Decreased serum BDNF concentrations were negatively correlated with language deficits (beta = -0.301, t = -2.762, P = 0.007). Significant associations were observed between chronic schizophrenia and reduced levels of NGF-β (B = 1.040, P < 0.001, RR = 2.829, 95% CI: 2.101-3.811) and BDNF (B = 0.526, P = 0.001, RR = 1.692, 95% CI: 1.241-2.306).

CONCLUSIONS

Our findings indicated that NGF-β and BDNF levels were altered in chronic schizophrenia and were associated with clinical symptoms and vitamin D metabolism. These results provided new insight into the etiology of schizophrenia.

Variations in inflammatory regulators in male patients with chronic schizophrenia associated with psychopathology and cognitive deficits

BACKGROUND

Immune dysregulation has been identified as a contributing factor in the pathophysiology of schizophrenia. This study aimed to investigate variations in specific immune regulators and their correlation with psychopathology and cognitive functions in male patients with chronic schizophrenia.

METHODS

Employing a cross-sectional design, this study included 72 male patients with chronic schizophrenia. The Positive and Negative Syndrome Scale (PANSS) and the Repeatable Battery for the Assessment of Neuropsychological Status were utilized to assess psychopathology and cognitive functions, respectively.

RESULTS

Serum levels of interleukin (IL)-4, IL-10, IL-12p40, IL-13, and monocyte chemoattractant protein-1 (MCP-1) were measured. There were significantly increased levels of IL-4, IL-13, and MCP-1, alongside decreased levels of IL-10 in patients compared to controls (all P < 0.05). IL-4 levels showed a significant negative association with PANSS positive symptoms (beta=-0.222, P = 0.042). After controlling for antipsychotic medication, BMI, and smoking, this correlation was no longer significant (r=-0.232, P = 0.055). Additionally, positive correlations of IL-4 (beta = 0.297, P = 0.008), IL-13 (beta = 0.371, P = 0.001), and MCP-1 (beta = 0.280, P = 0.013) with language scores were observed. Increased levels of IL-4 (P = 0.044, OR = 1.994), IL-13 (P = 0.019, OR = 2.245), as well as IL-4 and MCP-1 interactions (P = 0.043, OR = 2.000) were positively associated with the risk of chronic schizophrenia, while lower levels of IL-10 (P = 0.003, OR = 0.2.867) were also linked to an increased risk.

CONCLUSION

The identified associations between specific immune markers and the clinical and cognitive features of chronic schizophrenia in males underscored the potential immune-mediated mechanisms underlying schizophrenia.

Impact of second-generation antipsychotics monotherapy or combined therapy in cytokine, lymphocyte subtype, and thyroid antibodies for schizophrenia: a retrospective study

BACKGROUND

Schizophrenia (SCZ) shares high clinical relevance with the immune system, and the potential interactions of psychopharmacological drugs with the immune system are still an overlooked area. Here, we aimed to identify whether the second-generation antipsychotics (SGA) monotherapy or combined therapy of SGA with other psychiatric medications influence the routine blood immunity biomarkers of patients with SCZ.

METHODS

Medical records of inpatients with SCZ from January 2019 to June 2023 were retrospectively screened from June 2023 to August 2023. The demographic data and peripheral levels of cytokines (IL-2, IL-4, IL-6, TNF-α, INF-γ, and IL-17 A), lymphocyte subtype proportions (CD3+, CD4+, CD8 + T-cell, and natural killer (NK) cells), and thyroid autoimmune antibodies (thyroid peroxidase antibody (TPOAb), and antithyroglobulin antibody (TGAb)) were collected and analyzed.

RESULTS

30 drug-naïve patients, 64 SGA monotherapy (20 for first-episode SCZ, 44 for recurrent SCZ) for at least one week, 39 combined therapies for recurrent SCZ (18 with antidepressant, 10 with benzodiazepine, and 11 with mood stabilizer) for at least two weeks, and 23 used to receive SGA monotherapy (had withdrawn for at least two weeks) were included despite specific medication. No difference in cytokines was found between the SGA monotherapy sub-groups (p > 0.05). Of note, SGA monotherapy appeared to induce a down-regulation of IFN-γ in both first (mean [95% confidence interval]: 1.08 [0.14-2.01] vs. 4.60 [2.11-7.08], p = 0.020) and recurrent (1.88 [0.71-3.05] vs. 4.60 [2.11-7.08], p = 0.027) episodes compared to drug-naïve patients. However, the lymphocyte proportions and thyroid autoimmune antibodies remained unchanged after at least two weeks of SGA monotherapy (p > 0.05). In combined therapy groups, results mainly resembled the SGA monotherapy for recurrent SCZ (p > 0.05).

CONCLUSION

The study demonstrated that SGA monotherapy possibly achieved its comfort role via modulating IFN-γ, and SGA combined therapy showed an overall resemblance to monotherapy.