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You Q, Lan XB, Liu N, Du J, Ma L, Yang JM, Niu JG, Peng XD, Jin GL, Yu JQ. Neuroprotective strategies for neonatal hypoxic-ischemic brain damage: Current status and challenges. Eur J Pharmacol 2023; 957:176003. [PMID: 37640219 DOI: 10.1016/j.ejphar.2023.176003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023]
Abstract
Neonatal hypoxic-ischemic brain damage (HIBD) is a prominent contributor to both immediate mortality and long-term impairment in newborns. The elusive nature of the underlying mechanisms responsible for neonatal HIBD presents a significant obstacle in the effective clinical application of numerous pharmaceutical interventions. This comprehensive review aims to concentrate on the potential neuroprotective agents that have demonstrated efficacy in addressing various pathogenic factors associated with neonatal HIBD, encompassing oxidative stress, calcium overload, mitochondrial dysfunction, endoplasmic reticulum stress, inflammatory response, and apoptosis. In this review, we conducted an analysis of the precise molecular pathways by which these drugs elicit neuroprotective effects in animal models of neonatal hypoxic-ischemic brain injury (HIBD). Our objective was to provide a comprehensive overview of potential neuroprotective agents for the treatment of neonatal HIBD in animal experiments, with the ultimate goal of enhancing the feasibility of clinical translation and establishing a solid theoretical foundation for the clinical management of neonatal HIBD.
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Affiliation(s)
- Qing You
- Department of Pharmacology, School of Pharmacy, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750004, China.
| | - Xiao-Bing Lan
- Department of Pharmacology, School of Pharmacy, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750004, China.
| | - Ning Liu
- Department of Pharmacology, School of Pharmacy, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750004, China; Ningxia Special Traditional Medicine Modern Engineering Research Center and Collaborative Innovation Center, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750004, China.
| | - Juan Du
- Department of Pharmacology, School of Pharmacy, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750004, China.
| | - Lin Ma
- Department of Pharmacology, School of Pharmacy, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750004, China.
| | - Jia-Mei Yang
- Department of Pharmacology, School of Pharmacy, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750004, China.
| | - Jian-Guo Niu
- Ningxia Key Laboratory of Craniocerebral Diseases of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, 750004, China.
| | - Xiao-Dong Peng
- Department of Pharmacology, School of Pharmacy, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750004, China.
| | - Gui-Lin Jin
- Fujian Key Laboratory of Drug Target Discovery and Structural and Functional Research, Fuzhou, 350108, Fujian, China; Department of Pharmacology, College of Pharmacy, Fujian Medical University, Fuzhou, 350108, Fujian, China.
| | - Jian-Qiang Yu
- Department of Pharmacology, School of Pharmacy, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750004, China; Ningxia Special Traditional Medicine Modern Engineering Research Center and Collaborative Innovation Center, Ningxia Medical University, 1160 Shengli Street, Yinchuan, 750004, China.
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Gaebler AJ, Finner‐Prével M, Lammertz S, Schaffrath S, Eisner P, Stöhr F, Röcher E, Winkler L, Kaleta P, Lenzen L, Augustin M, Hovancakova J, Schwemmer L, Stormanns E, Keskin F, Hendricks F, Paulzen M, Gründer G, Schneider F, Mathiak K, Augustin M, Cordes J, Demirel E, Dielentheis T, Dreher J, Eisner P, Finner‐Prével M, Gaebler AJ, Gründer G, Hendricks F, Hovancakova J, Kaleta P, Keskin F, Kirchner M, Kirner‐Veselinovic A, Lammertz S, Lange C, Larcher F, Lenzen LM, Mathiak K, Meisenzahl‐Lechner E, Muysers J, Neff A, Paulzen M, Plum M, Röcher E, Ruttmann A, Schaffrath S, Schneider F, Schwemmer L, Stöhr F, Stormanns E, Trauzeddel A, Winkler L. Vitamin D’s negative impact on antipsychotic drug exposure may counteract its potential benefits in schizophrenia. Br J Clin Pharmacol 2022; 88:3193-3200. [DOI: 10.1111/bcp.15223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 10/19/2021] [Accepted: 12/22/2021] [Indexed: 11/28/2022] Open
Affiliation(s)
- Arnim Johannes Gaebler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Michelle Finner‐Prével
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Sarah Lammertz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Sabrina Schaffrath
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Patrick Eisner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Felix Stöhr
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Erik Röcher
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Lina Winkler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Peter Kaleta
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Laura Lenzen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Marc Augustin
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
- Protestant University of Applied Sciences Bochum Germany
| | - Jana Hovancakova
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Lara Schwemmer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Eva Stormanns
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | | | | | - Michael Paulzen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
- Alexianer Hospital Aachen Germany
| | - Gerhard Gründer
- Central Institute of Mental Health, Department of Molecular Neuroimaging, Medical Faculty Mannheim University of Heidelberg Mannheim Germany
| | - Frank Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
- University Hospital Düsseldorf Germany
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Marc Augustin
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
- Protestant University of Applied Sciences Bochum Germany
| | - Joachim Cordes
- LVR Klinikum Düsseldorf University Hospital Düsseldorf Germany
| | - Emir Demirel
- LVR Klinikum Düsseldorf University Hospital Düsseldorf Germany
| | | | | | - Patrick Eisner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Michelle Finner‐Prével
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Arnim Johannes Gaebler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Gerhard Gründer
- Central Institute of Mental Health, Department of Molecular Neuroimaging, Medical Faculty Mannheim University of Heidelberg Mannheim Germany
| | | | - Jana Hovancakova
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Peter Kaleta
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | | | | | - André Kirner‐Veselinovic
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Sarah Lammertz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | | | - Federico Larcher
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Laura Marianne Lenzen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | | | | | | | - Michael Paulzen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
- Alexianer Hospital Aachen Germany
| | | | - Erik Röcher
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Axel Ruttmann
- LVR Klinikum Düsseldorf University Hospital Düsseldorf Germany
| | - Sabrina Schaffrath
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Frank Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
- University Hospital Düsseldorf Germany
| | - Lara Schwemmer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Felix Stöhr
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | - Eva Stormanns
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
| | | | - Lina Winkler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine RWTH Aachen Germany
- JARA ‐ Translational Brain Medicine Aachen Germany
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Gaughran F, Stringer D, Wojewodka G, Landau S, Smith S, Gardner-Sood P, Taylor D, Jordan H, Whiskey E, Krivoy A, Ciufolini S, Stubbs B, Casetta C, Williams J, Moore S, Allen L, Rathod S, Boardman A, Khalifa R, Firdosi M, McGuire P, Berk M, McGrath J. Effect of Vitamin D Supplementation on Outcomes in People With Early Psychosis: The DFEND Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2140858. [PMID: 34962559 PMCID: PMC8715346 DOI: 10.1001/jamanetworkopen.2021.40858] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
IMPORTANCE People with psychotic disorders have an increased risk of vitamin D deficiency, which is evident during first-episode psychosis (FEP) and associated with unfavorable mental and physical health outcomes. OBJECTIVE To examine whether vitamin D supplementation contributes to improved clinical outcomes in FEP. DESIGN, SETTING, AND PARTICIPANTS This multisite, double-blind, placebo-controlled, parallel-group randomized clinical trial from the UK examined adults 18 to 65 years of age within 3 years of a first presentation with a functional psychotic disorder who had no contraindication to vitamin D supplementation. A total of 2136 patients were assessed for eligibility, 835 were approached, 686 declined participation or were excluded, 149 were randomized, and 104 were followed up at 6 months. The study recruited participants from January 19, 2016, to June 14, 2019, with the final follow-up (after the last dose) completed on December 20, 2019. INTERVENTIONS Monthly augmentation with 120 000 IU of cholecalciferol or placebo. MAIN OUTCOMES AND MEASURES The primary outcome measure was total Positive and Negative Syndrome Scale (PANSS) score at 6 months. Secondary outcomes included total PANSS score at 3 months; PANSS positive, negative, and general psychopathology subscale scores at 3 and 6 months; Global Assessment of Function scores (for symptoms and disability); Calgary Depression Scale score, waist circumference, body mass index, and glycated hemoglobin, total cholesterol, C-reactive protein, and vitamin D concentrations at 6 months; and a planned sensitivity analysis in those with insufficient vitamin D levels at baseline. RESULTS A total of 149 participants (mean [SD] age, 28.1 (8.5) years; 89 [59.7%] male; 65 [43.6%] Black or of other minoritized racial and ethnic group; 84 [56.4%] White [British, Irish, or of other White ethnicity]) were randomized. No differences were observed in the intention-to-treat analysis in the primary outcome, total PANSS score at 6 months (mean difference, 3.57; 95% CI, -1.11 to 8.25; P = .13), or the secondary outcomes at 3 and 6 months (PANSS positive subscore: mean difference, -0.98; 95% CI, -2.23 to 0.27 at 3 months; mean difference, 0.68; 95% CI, -0.69 to 1.99 at 6 months; PANSS negative subscore: mean difference, 0.68; 95% CI, -1.39 to 2.76 at 3 months; mean difference, 1.56; 95% CI, -0.31 to 3.44 at 6 months; and general psychopathology subscore: mean difference, -2.09; 95% CI, -4.36 to 0.18 at 3 months; mean difference, 1.31; 95% CI, -1.42 to 4.05 at 6 months). There also were no significant differences in the Global Assessment of Function symptom score (mean difference, 0.02; 95% CI, -4.60 to 4.94); Global Assessment of Function disability score (mean difference, -0.01; 95% CI, -5.25 to 5.23), or Calgary Depression Scale score (mean difference, -0.39; 95% CI, -2.05 to 1.26) at 6 months. Vitamin D levels were very low in the study group, especially in Black participants and those who identified as another minoritized racial and ethnic group, 57 of 61 (93.4%) of whom had insufficient vitamin D. The treatment was safe and led to a significant increase in 25-hydroxyvitamin D concentrations. CONCLUSIONS AND RELEVANCE In this randomized clinical trial, no association was found between vitamin D supplementation and mental health or metabolic outcomes at 6 months. Because so few patients with FEP were vitamin D replete, the results of this study suggest that this group would benefit from active consideration in future population health strategies. TRIAL REGISTRATION isrctn.org Identifier: ISRCTN12424842.
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Affiliation(s)
- Fiona Gaughran
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
- South London and Maudsley National Health Service (NHS) Foundation Trust, London, UK
| | - Dominic Stringer
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
- King’s Clinical Trials Unit, King’s College London, London, UK
| | - Gabriella Wojewodka
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Sabine Landau
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
- King’s Clinical Trials Unit, King’s College London, London, UK
| | - Shubulade Smith
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Poonam Gardner-Sood
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - David Taylor
- South London and Maudsley National Health Service (NHS) Foundation Trust, London, UK
| | - Harriet Jordan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
- South London and Maudsley National Health Service (NHS) Foundation Trust, London, UK
| | - Eromona Whiskey
- South London and Maudsley National Health Service (NHS) Foundation Trust, London, UK
| | - Amir Krivoy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Simone Ciufolini
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
- South London and Maudsley National Health Service (NHS) Foundation Trust, London, UK
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Cecilia Casetta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
- South London and Maudsley National Health Service (NHS) Foundation Trust, London, UK
| | - Julie Williams
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Susan Moore
- Department of Psychiatry, St Vincent’s University Hospital, Dublin, Ireland
- Department of Psychiatry, Royal College of Surgeons, Dublin, Ireland
| | - Lauren Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Shanaya Rathod
- Clinical Trials Facility, Research Department, Tom Rudd Unit, Moorgreen Hospital, Southampton, UK
| | | | - Rehab Khalifa
- Kent and Medway NHS & Social Care Partnership Trust, NHS Trust, London, UK
| | - Mudasir Firdosi
- South West London and St George’s Mental Health NHS Trust, Queen Mary’s Hospital, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
- South London and Maudsley National Health Service (NHS) Foundation Trust, London, UK
| | - Michael Berk
- Institute for Mental and Physical Health and Clinical Translation, Deakin University, School of Medicine, Barwon Health, Geelong, Australia
| | - John McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
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Viani-Walsh D, Kennedy-Williams S, Taylor D, Gaughran F, Lally J. Vitamin D deficiency in schizophrenia implications for COVID-19 infection. Ir J Psychol Med 2021; 38:278-287. [PMID: 32912355 PMCID: PMC7545242 DOI: 10.1017/ipm.2020.107] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 07/28/2020] [Accepted: 09/04/2020] [Indexed: 12/12/2022]
Abstract
Vitamin D deficiency is associated with an increased risk of acute respiratory infection. There is an excess of respiratory infections and deaths in schizophrenia, a condition where vitamin D deficiency is especially prevalent. This potentially offers a modifiable risk factor to reduce the risk for and the severity of respiratory infection in people with schizophrenia, although there is as yet no evidence regarding the risk of COVID-19. In this narrative review, we describe the prevalence of vitamin D deficiency in schizophrenia, report the research examining the relationship between vitamin D levels and COVID-19 and discuss the associations between vitamin D deficiency and respiratory infection, including its immunomodulatory mechanism of action.
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Affiliation(s)
- D. Viani-Walsh
- Graduate Entry Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - S. Kennedy-Williams
- Graduate Entry Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - D. Taylor
- Director of Pharmacy and Pathology, South London and Maudsley NHS Foundation Trust, London, UK
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - F. Gaughran
- National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - J. Lally
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- St Vincent’s Hospital Fairview, Dublin, Ireland
- Department of Psychiatry, Mater Misericordiae University Hospital, Dublin, Ireland
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Neriman A, Hakan Y, Ozge U. The psychotropic effect of vitamin D supplementation on schizophrenia symptoms. BMC Psychiatry 2021; 21:309. [PMID: 34130647 PMCID: PMC8204117 DOI: 10.1186/s12888-021-03308-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/11/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Schizophrenia is a multifactorial disease involving interactions between genetic and environmental factors. Vitamin D has recently been linked to many metabolic diseases and schizophrenia. Vitamin D plays essential roles in the brain in the context of neuroplasticity, neurotransmitter biosynthesis, neuroprotection, and neurotransmission. Vitamin D receptors are demonstrated in most brain regions that are related to schizophrenia. However, very few studies in the literature examine the effects of 25-hydroxyvitamin D (25OHD) on schizophrenia symptoms. METHODS This study aimed to examine the effects of vitamin D replacement on positive, negative, and cognitive symptoms of schizophrenia. Serum 25OHD levels of 52 schizophrenia patients were measured. SANS and SAPS were used to evaluate the severity of schizophrenia symptoms, and the Wisconsin Card Sorting Test: CV4 was used for cognitive assessment. The study was completed with 40 patients for various reasons. The patients whose serum 25OHD reached optimal levels after vitamin D replacement were reevaluated with the same scales in terms of symptom severity. The SPSS 25 package program was used for statistical analysis. The Independent-Samples t-test was used to examine the relationship between the variables that may affect vitamin D levels and the vitamin D level and to examine whether vitamin D levels had an initial effect on the scale scores. RESULTS The mean plasma 25OHD levels of the patients was 17.87 ± 5.54. A statistically significant relationship was found only between the duration of sunlight exposure and 25 OHD level (p < 0.05). The mean SANS and SAPS scores of the participants after 25OHD replacement (23.60 ± 15.51 and 7.78 ± 8.84, respectively) were statistically significantly lower than mean SANS and SAPS scores before replacement (51.45 ± 17.96 and 18.58 ± 15.59, respectively) (p < 0.001 for all). Only the total attention score was significantly improved after replacement (p < 0.05). CONCLUSION The data obtained from our study suggest that eliminating the 25OHD deficiency together with antipsychotic treatment can improve the total attention span and positive and negative symptoms in schizophrenia. The 25OHD levels should be regularly measured, replacement should be started when necessary, and the patients should be encouraged to get sunlight exposure to keep optimal 25OHD levels.
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Affiliation(s)
- Aras Neriman
- Department of Psychiatry, Samsun Mental Health and Disorders Hospital, Samsun, Turkey.
| | - Yilmaz Hakan
- Department of Psychiatry, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Ucuncu Ozge
- grid.31564.350000 0001 2186 0630Department of Endocrinology and Metabolism, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
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Abstract
Many epidemiological studies have highlighted the link between vitamin D deficiency and schizophrenia. In particular, two prominent studies report an association between neonatal vitamin D deficiency and an increased risk of schizophrenia. In parallel, much has been learnt about the role of vitamin D in the developing central nervous system over the last two decades. Studies in rodent models of developmental vitamin D (DVD)-deficiency describe how brain development is altered leading to a range of neurobiological and behavioral phenotypes of interest to schizophrenia. While glutamate and gamma aminobutyric acid (GABA) systems have been little investigated in these models, alterations in developing dopamine systems are frequently reported. There have been far more studies reporting patients with schizophrenia have an increased risk of vitamin D deficiency compared to well controls. Here we have conducted a systematic review and meta-analysis that basically confirms this association and extends this to first-episode psychosis. However, patients with schizophrenia also have poorer general health, poorer diets, are frequently less active and also have an increased risk of other medical conditions, all factors which reduce circulating vitamin D levels. Therefore, we would urge caution in any causal interpretation of this association. We also summarize the inconsistent results from existing vitamin D supplementation trials in patients with schizophrenia. In respect to animal models of adult vitamin D deficiency, such exposures produce subtle neurochemical alterations and effects on cognition but do not appear to produce behavioral phenotypes of relevance to schizophrenia. We conclude, the hypothesis that vitamin D deficiency during early life may increase the risk of schizophrenia remains plausible and warrants ongoing research.
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Cha HY, Yang SJ. Anti-Inflammatory Diets and Schizophrenia. Clin Nutr Res 2020; 9:241-257. [PMID: 33204665 PMCID: PMC7644368 DOI: 10.7762/cnr.2020.9.4.241] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 10/02/2020] [Accepted: 10/07/2020] [Indexed: 12/13/2022] Open
Abstract
Schizophrenia is a mental illness characterized by symptoms such as hallucinations, delusions, disorganized speech, disorganized or catatonic behavior, and negative symptoms (emotional flatness, apathy, and lack of speech). It causes social and economic burdens to patients and their family. Although etiology of schizophrenia is still uncertain, dopamine dysregulation is traditionally considered as a main etiological factor of schizophrenia, which has been utilized to develop drugs for treating schizophrenia. Recently, inflammation has presented being a risk factor for schizophrenia in that neuroinflammation contributes to the pathophysiology of schizophrenia and the exacerbation of symptom severity. Various factors including diet can regulate inflammatory state. Specific foods or dietary patterns have anti- or pro-inflammatory potentials. Increased levels of pro-inflammatory cytokines and microglia activation have been reported in schizophrenia populations and were related to the pathogenesis of schizophrenia. Omega-3 fatty acids were often recommended to schizophrenia patients because of their anti-inflammatory activities. In this review, we investigate the inflammation-related pathogenesis of schizophrenia and summarize potential nutritional approaches to inhibit the manifestation of symptoms and to alleviate symptom severity using anti-inflammatory nutrients or functional components.
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Affiliation(s)
- Hee Yun Cha
- Department of Food and Nutrition, Seoul Women's University, Seoul 01797, Korea
| | - Soo Jin Yang
- Department of Food and Nutrition, Seoul Women's University, Seoul 01797, Korea
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