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Wang S, Yuan X, Pang L, Song P, Jia R, Song X. Establishment of an assistive diagnostic model for schizophrenia with oxidative stress biomarkers. Front Pharmacol 2023; 14:1158254. [PMID: 37007024 PMCID: PMC10050576 DOI: 10.3389/fphar.2023.1158254] [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: 02/03/2023] [Accepted: 03/06/2023] [Indexed: 03/17/2023] Open
Abstract
Objective: In this study, alterations in oxidative stress-related indicators were evaluated in drug-naïve, first-episode schizophrenia (SCZ) patients, and the effectiveness of blood serum glucose, superoxide dismutase (SOD), bilirubin in the objective assistive diagnosis of schizophrenia was explored. Materials and methods: We recruited 148 drug-naïve, first-episode SCZ patients and 97 healthy controls (HCs). Blood biochemical indexes including blood glucose, SOD, bilirubin and homocysteine (HCY) in participants were measured, the indexes were compared between patients with SCZ and HCs. The assistive diagnostic model for SCZ was established on the basis of the differential indexes. Results: In SCZ patients, the blood serum levels of glucose, total (TBIL), indirect bilirubin (IBIL) and homocysteine (HCY) were significantly higher than those in HCs (p < 0.05), and the serum levels of SOD were significantly lower than those in HCs (p < 0.05). There was a negative correlation between SOD with the general symptom scores and total scores of PANSS. After risperidone treatment, the levels of uric acid (UA) and SOD tended to increase in patients with SCZ (p = 0.02, 0.19), and the serum levels of TBIL and HCY tended to decrease in patients with SCZ (p = 0.78, 0.16). The diagnostic model based on blood glucose, IBIL and SOD was internally cross-validated, and the accuracy was 77%, with an area under the curve (AUC) of 0.83. Conclusion: Our study demonstrated an oxidative state imbalance in drug-naïve, first-episode SCZ patients, which might be associated with the pathogenesis of the disease. Our study proved that glucose, IBIL and SOD may be potential biological markers of schizophrenia, and the model based on these markers can assist the early objective and accurate diagnosis of schizophrenia.
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Affiliation(s)
- Shuying Wang
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Biological Psychiatry International Joint Laboratory of Henan/Zhengzhou University, Zhengzhou, China
- Henan Psychiatric Transformation Research Key Laboratory/Zhengzhou University, Zhengzhou, China
| | - Xiuxia Yuan
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Biological Psychiatry International Joint Laboratory of Henan/Zhengzhou University, Zhengzhou, China
- Henan Psychiatric Transformation Research Key Laboratory/Zhengzhou University, Zhengzhou, China
| | - Lijuan Pang
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Biological Psychiatry International Joint Laboratory of Henan/Zhengzhou University, Zhengzhou, China
- Henan Psychiatric Transformation Research Key Laboratory/Zhengzhou University, Zhengzhou, China
| | - Peilun Song
- School of Information Engineering, Zhengzhou University, Zhengzhou, China
| | - Rufei Jia
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Biological Psychiatry International Joint Laboratory of Henan/Zhengzhou University, Zhengzhou, China
- Henan Psychiatric Transformation Research Key Laboratory/Zhengzhou University, Zhengzhou, China
| | - Xueqin Song
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Biological Psychiatry International Joint Laboratory of Henan/Zhengzhou University, Zhengzhou, China
- Henan Psychiatric Transformation Research Key Laboratory/Zhengzhou University, Zhengzhou, China
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Borkent J, Ioannou M, Folkertsma TS, Wardenaar KJ, Haarman BCM, van Goor H, Sommer IEC, Bourgonje AR. Serum free thiols in recently diagnosed patients with schizophrenia spectrum disorder: A potentially useful biomarker of oxidative stress. Psychiatry Res 2023; 321:115075. [PMID: 36764120 DOI: 10.1016/j.psychres.2023.115075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/13/2023] [Accepted: 01/22/2023] [Indexed: 01/27/2023]
Abstract
Schizophrenia spectrum disorders (SSD) have been linked to oxidative stress (OS). Recent findings from our group show that serum free thiols (R-SH, sulfhydryl groups) can function as an accurate biomarker of systemic OS, since they are readily oxidized by reactive species (ROS), thereby serving as potent antioxidants. The aim of this study is to investigate if reduced R-SH levels can be demonstrated in recently diagnosed patients with SSD compared to healthy controls (HC). In this study, 102 patients with recently diagnosed SSD (< three years), and 42 HC were included. Levels of R-SH were quantified and studied for correlations with age, C-reactive protein (CRP) as proxy of inflammation as well as body mass index (BMI) and total cholesterol as indices of metabolic health. R-SH levels were significantly lower in patients when compared to HC. When correcting for age the difference was borderline significant (p=0.05). Moreover, R-SH correlated significantly with age (r = -0.29) and CRP (r = -0.29) in patients with SSD, but not in the HC. R-SH levels are reduced in SSD as compared to HC and correlate negatively with CRP and age in SSD. Future studies are required to further investigate R-SH and its role in SSD.
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Affiliation(s)
- Jenny Borkent
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells & Systems, Groningen, the Netherlands.
| | - Magdalini Ioannou
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells & Systems, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
| | - Tessa S Folkertsma
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells & Systems, Groningen, the Netherlands
| | - Klaas J Wardenaar
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| | - Bartholomeus C M Haarman
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
| | - Harry van Goor
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Iris E C Sommer
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells & Systems, Groningen, the Netherlands
| | - Arno R Bourgonje
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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3
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Yuan Z, Liu H, Zhang X, He Y, Gu S, Mo D, Wang S, Huang Z, Wu K, Zhou R, Zhong Q, Huang Y, Cao B, Chen H, Wu X. Role of uric acid as a biomarker of cognitive function in schizophrenia during maintenance period. Front Psychiatry 2023; 14:1123127. [PMID: 37032942 PMCID: PMC10073439 DOI: 10.3389/fpsyt.2023.1123127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/27/2023] [Indexed: 04/11/2023] Open
Abstract
Background Previous studies involving uric acid (UA) in some specialized disease populations have found that high UA is associated with enhanced patient function. The mechanism to explain this association may be that UA, an important antioxidant, exerts neuroprotective effects. Patients with schizophrenia (SCZ) have severe oxidative stress abnormalities, and cognitive impairment is a major obstacle to their rehabilitation. Only few studies have been conducted on UA and cognitive impairment in SCZ. This study aims to clarify the relationship between UA and cognitive impairment and explore whether UA could be used as a potential biological marker of cognition in SCZ during maintenance period. Methods A total of 752 cases of SCZ during maintenance period from Baiyun Jingkang Hospital were included. Cognition was measured using the Mini-Mental State Examination scale. UA was measured using the Plus method. The participants were grouped on the basis of UA to evaluate the association of cognition with low-normal (3.50-5.07 mg/dL for men, 2.50-4.19 mg/dL for women), middle-normal (5.07-6.39 mg/dL for men, 4.19-5.18 mg/dL for women), high-normal (6.39-7.00 mg/dL for men, 5.18-6.00 mg/dL for women), and high (>7.00 mg/dL for men, >6.00 mg/dL for women) levels of UA. Multiple logistic regression and linear regression models and restricted cubic spline (RCS) were utilized to evaluate the relationship. Results Uric acid was positively associated with cognitive function. Subgroup analyses showed that high UA was associated with enhanced cognition in participants with low anticholinergic cognitive burden (ACB). Conclusion Uric acid may be used as a simple objective biological indicator to assess cognition in SCZ during maintenance period.
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Affiliation(s)
- Zelin Yuan
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Huamin Liu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Xiaochun Zhang
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, Guangdong, China
| | - Yong He
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, Guangdong, China
| | - Shanyuan Gu
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, Guangdong, China
| | - Dan Mo
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, Guangdong, China
| | - Shaoli Wang
- Department of Psychiatry, Baiyun Jingkang Hospital, Guangzhou, Guangdong, China
| | - Zhiwei Huang
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Keyi Wu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Rui Zhou
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Qi Zhong
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Yining Huang
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Bifei Cao
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Haowen Chen
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
| | - Xianbo Wu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Diseases), Guangzhou, China
- *Correspondence: Xianbo Wu, ; orcid.org/0000-0002-2706-9599
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Effects of antipsychotics on antioxidant defence system in patients with schizophrenia: A meta-analysis. Psychiatry Res 2022; 309:114429. [PMID: 35150976 DOI: 10.1016/j.psychres.2022.114429] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 12/15/2021] [Accepted: 01/30/2022] [Indexed: 12/25/2022]
Abstract
Theory of oxidative stress is suggested in the pathophysiology of schizophrenia. To determine the cause of impaired antioxidant defense system in schizophrenia, a meta-analysis was performed by selecting studies published from 1964 to 2021 from Pubmed and Scopus databases. Data were analysed using Comprehensive Meta-Analysis version 2 and calculated effect sizes were compared between unmedicated and medicated patients with schizophrenia and healthy controls. Heterogeneity, publication bias assessments and subgroup analyses of drug-free and drug-naïve patients, and patients treated with atypical and typical antipsychotics were conducted. Subgroup analysis of confounding factors including age, gender, illness duration and patient status was also conducted. We found that glutathione peroxidase (GPx) was significantly decreased in all patients. Significantly lower catalase (CAT), glutathione (GSH) and albumin (ALB) were found in unmedicated patients only. Both groups showed significantly weakened non-enzymatic antioxidant capacity. Subgroup analyses indicated that weakened non-enzymatic antioxidant capacity may be associated with schizophrenia. Antioxidant status was more impaired in drug-free patients compared with other subgroups. This indicated that antipsychotics may improve antioxidant defense system. Although effect sizes were smaller, future studies may focus on the effect of antipsychotic discontinuation. In overall, schizophrenia was associated with impaired antioxidant defense system especially the non-enzymatic antioxidant system.
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5
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Mijailovic NR, Vesic K, Borovcanin MM. The Influence of Serum Uric Acid on the Brain and Cognitive Dysfunction. Front Psychiatry 2022; 13:828476. [PMID: 35530021 PMCID: PMC9072620 DOI: 10.3389/fpsyt.2022.828476] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/17/2022] [Indexed: 12/12/2022] Open
Abstract
Uric acid is commonly known for its bad reputation. However, it has been shown that uric acid may be actively involved in neurotoxicity and/or neuroprotection. These effects could be caused by oxidative stress or inflammatory processes localized in the central nervous system, but also by other somatic diseases or systemic conditions. Our interest was to summarize and link the current data on the possible role of uric acid in cognitive functioning. We also focused on the two putative molecular mechanisms related to the pathological effects of uric acid-oxidative stress and inflammatory processes. The hippocampus is a prominent anatomic localization included in expressing uric acid's potential impact on cognitive functioning. In neurodegenerative and mental disorders, uric acid could be involved in a variety of ways in etiopathogenesis and clinical presentation. Hyperuricemia is non-specifically observed more frequently in the general population and after various somatic illnesses. There is increasing evidence to support the hypothesis that hyperuricemia may be beneficial for cognitive functioning because of its antioxidant effects but may also be a potential risk factor for cognitive dysfunction, in part because of increased inflammatory activity. In this context, gender specificities must also be considered.
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Affiliation(s)
- Natasa R Mijailovic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Katarina Vesic
- Department of Neurology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Milica M Borovcanin
- Department of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
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Xu H, Wei Y, Zheng L, Zhang H, Luo T, Li H, Ma J, Chen J. Relation Between Unconjugated Bilirubin and Peripheral Biomarkers of Inflammation Derived From Complete Blood Counts in Patients With Acute Stage of Schizophrenia. Front Psychiatry 2022; 13:843985. [PMID: 35463529 PMCID: PMC9022903 DOI: 10.3389/fpsyt.2022.843985] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 01/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Inflammation and oxidative stress are the major leading hypothetical causes of schizophrenia. Unconjugated bilirubin (UCB) is an efficient endogenous plasma antioxidant. Inflammation is closely linked to oxidative stress. The relationship between UCB and inflammatory markers should be paid close attention in schizophrenia acute stage. In this paper, combined UCB and inflammatory markers were evaluated for their capability in predicting schizophrenia in the acute stage to find an easy and effective indicator to identify acute schizophrenia. METHODS A total of 6,937 acute schizophrenia patients and 6,404 healthy controls (HCs) were enrolled. UCB and peripheral biomarkers of inflammation derived from complete blood counts (CBC) were investigated in the subjects with acute schizophrenia, and the results were compared with HCs. Simultaneously, Spearman test was employed to assess the correlation between the variables, while logistic regression was adopted to determine the combined equation and receiver operating characteristic curve was used to evaluate the combined value of UCB and peripheral biomarkers of inflammation derived from CBC to predict schizophrenia in the acute stage. RESULTS The study indicates that white blood cells, neutrophil, monocyte, mean platelet volume (MPV), red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) have significantly increased in schizophrenia (p < 0.05 for all), while platelet, lymphocyte, and platelet/lymphocyte ratio (PLR) in schizophrenia have significantly decreased (p < 0.05 for all). UCB exhibits negative correlation with MPV significantly (r = 0.121, p < 0.001), and no correlation with neutrophil and monocyte. The correlations between UCB and other peripheral biomarkers of inflammation derived from CBC are very weak. MPV, RDW, NLR, MLR, PLR, and UCB were taken as independent variables for a logistic regression analysis. The model was as follows: Logit ( P 1 ) = - 6 . 141 + 0 . 827 MPV + 5 . 613 MLR - 0 . 005 PLR - 0 . 346 UBC . The combination demonstrates better effectiveness in predicting schizophrenia in the acute stage (AUC 0.831, 95% CI 0.825 to 0.837). CONCLUSION UCB has a protective effect on acute stage of schizophrenia, which is weak and indirect by affecting the proinflammatory processes. Our findings suggest that a combination of MLR, MPV, PLR, and UBC could be used to predict acute stage of schizophrenia.
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Affiliation(s)
- Haiting Xu
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China
| | - Yanyan Wei
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China
| | - Lina Zheng
- Liaocheng People's Hospital, Liaocheng, China
| | - Hua Zhang
- Dongying People's Hospital, Dongying, China
| | - Tangren Luo
- The Third Hospital of Longyan, Longyan, China
| | - Hongjuan Li
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China
| | - Jinbao Ma
- Capital Medical University Beijing TongRen Hospital, Beijing, China
| | - Jingxu Chen
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China
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Interweaving of Reactive Oxygen Species and Major Neurological and Psychiatric Disorders. ANNALES PHARMACEUTIQUES FRANÇAISES 2021; 80:409-425. [PMID: 34896378 DOI: 10.1016/j.pharma.2021.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 10/27/2021] [Accepted: 11/29/2021] [Indexed: 11/21/2022]
Abstract
Reactive oxygen species are found to be having a wide range of biological effects ranging from regulating functions in normal physiology to alteration and damaging various processes and cell components causing a number of diseases. Mitochondria is an important organelle responsible for energy production and in many signalling mechanisms. The electron transport chain in mitochondria where oxidative phosphorylation takes place is also coupled with the generation of reactive oxygen species (ROS). Changes in normal homeostasis and overproduction of reactive oxygen species by various sources are found to be involved in multiple neurological and major neurodegenerative diseases. This review summarises the role of reactive oxygen species and the mechanism of neuronal loss in major neuronal disorders such as Alzheimer's disease, Parkinson's disease, Huntington's disease, Depression, and Schizophrenia.
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DEMİR B, GÜMÜŞLÜ A, ŞAHİN Ş, ELBOGA G, ALTINDAĞ A. Obsesif kompulsif bozuklukta serum doğal antioksidan düzeyleri. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.841038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Plasma bilirubin levels are reduced in first-episode psychosis patients and associates to working memory and duration of untreated psychosis. Sci Rep 2021; 11:7527. [PMID: 33824398 PMCID: PMC8024299 DOI: 10.1038/s41598-021-87096-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/23/2021] [Indexed: 12/24/2022] Open
Abstract
Schizophrenia is a severe mental disorder and one of its characteristics is cognitive impairments. Findings regarding levels of the heme metabolite and plasma antioxidant bilirubin in schizophrenia are inconclusive. However, a recently published study indicate that low levels of bilirubin may be implicated in the memory impairments seen in the disorder. The aim of this cross-sectional study was to investigate the levels of bilirubin in individuals with a first-episode psychosis (FEP) and to examine if bilirubin levels were associated to cognitive impairments, symptoms and duration of untreated psychosis (DUP). Bilirubin levels were reduced in 39 individuals with FEP compared with 20 HC (median [IQR]: 11.0 [9.0–13.0] µM vs. 15.0 [11.5–18.5] µM). In individuals with FEP, bilirubin levels were also positively correlated to two working memory tests (r = 0.40 and r = 0.32) and inversely correlated to DUP (r = − 0.36). Findings were not influenced by confounding factors. The results confirm the antioxidant deficit previously seen in schizophrenia, but also indicate that these changes may be related to DUP. The study also confirms that bilirubin may be implicated in the cognitive deficits that accompanies the disorder, here for the first time presented in individuals with FEP.
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10
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Caruso G, Grasso M, Fidilio A, Tascedda F, Drago F, Caraci F. Antioxidant Properties of Second-Generation Antipsychotics: Focus on Microglia. Pharmaceuticals (Basel) 2020; 13:ph13120457. [PMID: 33322693 PMCID: PMC7764768 DOI: 10.3390/ph13120457] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/26/2020] [Accepted: 12/09/2020] [Indexed: 02/07/2023] Open
Abstract
Recent studies suggest a primary role of oxidative stress in an early phase of the pathogenesis of schizophrenia and a strong neurobiological link has been found between dopaminergic system dysfunction, microglia overactivation, and oxidative stress. Different risk factors for schizophrenia increase oxidative stress phenomena raising the risk of developing psychosis. Oxidative stress induced by first-generation antipsychotics such as haloperidol significantly contributes to the development of extrapyramidal side effects. Haloperidol also exerts neurotoxic effects by decreasing antioxidant enzyme levels then worsening pro-oxidant events. Opposite to haloperidol, second-generation antipsychotics (or atypical antipsychotics) such as risperidone, clozapine, and olanzapine exert a strong antioxidant activity in experimental models of schizophrenia by rescuing the antioxidant system, with an increase in superoxide dismutase and glutathione (GSH) serum levels. Second-generation antipsychotics also improve the antioxidant status and reduce lipid peroxidation in schizophrenic patients. Interestingly, second-generation antipsychotics, such as risperidone, paliperidone, and in particular clozapine, reduce oxidative stress induced by microglia overactivation, decreasing the production of microglia-derived free radicals, finally protecting neurons against microglia-induced oxidative stress. Further, long-term clinical studies are needed to better understand the link between oxidative stress and the clinical response to antipsychotic drugs and the therapeutic potential of antioxidants to increase the response to antipsychotics.
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Affiliation(s)
- Giuseppe Caruso
- Department of Drug Sciences, University of Catania, 95125 Catania, Italy; (M.G.); (F.C.)
- Correspondence: or
| | - Margherita Grasso
- Department of Drug Sciences, University of Catania, 95125 Catania, Italy; (M.G.); (F.C.)
- Department of Laboratories, Oasi Research Institute—IRCCS, 94018 Troina, Italy
| | - Annamaria Fidilio
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (A.F.); (F.D.)
| | - Fabio Tascedda
- Department of Life Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy;
- Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; (A.F.); (F.D.)
| | - Filippo Caraci
- Department of Drug Sciences, University of Catania, 95125 Catania, Italy; (M.G.); (F.C.)
- Department of Laboratories, Oasi Research Institute—IRCCS, 94018 Troina, Italy
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11
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Ribaudo G, Bortoli M, Pavan C, Zagotto G, Orian L. Antioxidant Potential of Psychotropic Drugs: From Clinical Evidence to In Vitro and In Vivo Assessment and toward a New Challenge for in Silico Molecular Design. Antioxidants (Basel) 2020; 9:E714. [PMID: 32781750 PMCID: PMC7465375 DOI: 10.3390/antiox9080714] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/02/2020] [Accepted: 08/04/2020] [Indexed: 12/13/2022] Open
Abstract
Due to high oxygen consumption, the brain is particularly vulnerable to oxidative stress, which is considered an important element in the etiopathogenesis of several mental disorders, including schizophrenia, depression and dependencies. Despite the fact that it is not established yet whether oxidative stress is a cause or a consequence of clinic manifestations, the intake of antioxidant supplements in combination with the psychotropic therapy constitutes a valuable solution in patients' treatment. Anyway, some drugs possess antioxidant capacity themselves and this aspect is discussed in this review, focusing on antipsychotics and antidepressants. In the context of a collection of clinical observations, in vitro and in vivo results are critically reported, often highlighting controversial aspects. Finally, a new challenge is discussed, i.e., the possibility of assessing in silico the antioxidant potential of these drugs, exploiting computational chemistry methodologies and machine learning. Despite the physiological environment being incredibly complex and the detection of meaningful oxidative stress biomarkers being all but an easy task, a rigorous and systematic analysis of the structural and reactivity properties of antioxidant drugs seems to be a promising route to better interpret therapeutic outcomes and provide elements for the rational design of novel drugs.
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Affiliation(s)
- Giovanni Ribaudo
- Dipartimento di Medicina Molecolare e Traslazionale, Università degli Studi di Brescia, Viale Europa 11, 25123 Brescia, Italy;
| | - Marco Bortoli
- Dipartimento di Scienze Chimiche, Università degli Studi di Padova, Via Marzolo 1, 35131 Padova, Italy;
| | - Chiara Pavan
- Dipartimento di Medicina, Università degli Studi di Padova, Via Giustiniani 2, 35128 Padova, Italy;
| | - Giuseppe Zagotto
- Dipartimento di Scienze del Farmaco, Università degli Studi di Padova, Via Marzolo 5, 35131 Padova, Italy;
| | - Laura Orian
- Dipartimento di Scienze Chimiche, Università degli Studi di Padova, Via Marzolo 1, 35131 Padova, Italy;
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Luo Q, Wen Z, Li Y, Chen Z, Long X, Bai Y, Huang S, Yan Y, Lin R, Mo Z. Assessment Causality in Associations Between Serum Uric Acid and Risk of Schizophrenia: A Two-Sample Bidirectional Mendelian Randomization Study. Clin Epidemiol 2020; 12:223-233. [PMID: 32161502 PMCID: PMC7049772 DOI: 10.2147/clep.s236885] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/16/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose Although increasing lines of evidence showed associations between serum uric acid (UA) levels and schizophrenia, the causality and the direction of the associations remain uncertain. Thus, we aimed to assess whether the relationships between serum UA levels and schizophrenia are causal and to determine the direction of the association. Patients and Methods Two-sample bidirectional Mendelian randomization (MR) analyses and various sensitivity analyses were performed utilizing the summary data from genome-wide association studies within the Global Urate Genetics Consortium and the Psychiatric Genomics Consortium. Secondary MR analyses in both directions were conducted within summary data using genetic risk scores (GRSs) as instrumental variables. Results Three MR methods provided no causal relationship between serum UA and schizophrenia. Furthermore, GRS approach showed similar results in the three MR methods after adjustment for heterogeneity. By contrast, inverse variance weighted method, weighted median and GRS approach suggested a causal effect of schizophrenia risk on serum UA after adjustment for heterogeneity (per 10-symmetric percentage increase in schizophrenia risk, beta: -0.039, standard error (SE): 0.013, P = 0.003; beta: -0.036, SE: 0.018, P = 0.043; beta: -0.039, SE: 0.013, P = 0.002; respectively). Moreover, in both directions' analyses, the heterogeneity and sensitivity tests suggested no strong evidence of bias due to pleiotropy. Conclusion Schizophrenia may causally affect serum UA levels, whereas the causal role of serum UA concentrations in schizophrenia was not supported by our MR analyses. These findings suggest that UA may be a useful potential biomarker for monitoring treatment or diagnosis of schizophrenia rather than a therapeutic target for schizophrenia.
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Affiliation(s)
- Qianqian Luo
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China.,School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Zheng Wen
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China.,School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Yuanfan Li
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China.,School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Zefeng Chen
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China.,School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Xinyang Long
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China.,School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Yulan Bai
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China.,School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Shengzhu Huang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China
| | - Yunkun Yan
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China
| | - Rui Lin
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China.,School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
| | - Zengnan Mo
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Nanning 530021, Guangxi, People's Republic of China.,Guangxi Key Laboratory of Colleges and Universities, Nanning 530021, Guangxi, People's Republic of China.,Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, People's Republic of China
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13
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Abstract
Schizophrenia is a complex syndrome of unknown etiology and difficult to manage. Unconjugated bilirubin has been researched as a potential biological marker of this syndrome. The objective of this review article was to gather the studies published to date on the relationship between this molecule and schizophrenia. Broad inclusion criteria have been used (PRISMA) to include as many relevant studies as possible. Fourteen studies were selected: 3 analyzed the effects of unconjugated hyperbilirubinemia in animal models; 6 demonstrated an increased incidence of schizophrenia in patients with increased unconjugated bilirubin; 2 reported an increased incidence of the disease in patients with decreased unconjugated bilirubin; and 3 linked an increased incidence of schizophrenia with an increased excretion of the oxidative product of bilirubin, the so-called biopyrrins. Because of apparently contradictory reported results, the hypothesis that the relationship between schizophrenia and unconjugated bilirubin was not linear and that there was an inflammatory dysfunction explaining this was considered. The 2 most accepted models for the pathophysiology of schizophrenia are described, and the possible role of the molecule in each is clarified. The bilirubin buffer system and its role in antioxidant defense was explored. The average levels of unconjugated bilirubin in patients with schizophrenia, schizoaffective disorder, and bipolar disorder were also compared, having been hypothesized that these diseases could be different points of a same pathological spectrum. Finally, it was concluded that unconjugated bilirubin is a promising molecule that could be used as a possible biological marker for schizophrenia, and the necessity of subsequent efforts for its research was considered.
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14
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A five-year follow-up study of antioxidants, oxidative stress and polyunsaturated fatty acids in schizophrenia. Acta Neuropsychiatr 2019; 31:202-212. [PMID: 31178002 DOI: 10.1017/neu.2019.14] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Oxidative stress and dysregulated antioxidant defence may be involved in the pathophysiology of schizophrenia. In the present study, we investigated changes in antioxidants and oxidative stress from an acute to a later stable phase. We hypothesised that the levels of oxidative markers are increased in schizophrenia compared with healthy controls; change from the acute to the stable phase; and are associated with the levels of membrane polyunsaturated fatty acids (PUFAs) and symptom severity. METHODS Fifty-five patients with schizophrenia spectrum disorders, assessed during an acute phase and 5 years later during a stable phase, and 51 healthy controls were included. We measured antioxidants (α-tocopherol, uric acid, albumin and bilirubin), markers of oxidative stress (F2-isoprostane and reactive oxygen metabolites) and membrane fatty acids. Antioxidants and oxidative stress markers were compared in schizophrenia versus healthy controls, adjusting for differences in sex, age and smoking, and changes over time. Associations between symptoms and PUFA were also investigated. RESULTS In the acute phase, α-tocopherol was significantly higher (p < 0.001), while albumin was lower (p < 0.001) compared with the stable phase. Changes in α-tocopherol were associated with PUFA levels in the acute phase. In the stable phase, schizophrenia patients had higher uric acid (p = 0.009) and lower bilirubin (p = 0.046) than healthy controls. CRP was higher in patients in the stable phase (p < 0.001), and there was no significant change from the acute phase. CONCLUSION The present findings of change in antioxidant levels in the acute versus stable phase of schizophrenia the present findings suggest that redox regulation is dynamic and changes during different phases of the disorder.
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15
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Association between decreased serum TBIL concentration and immediate memory impairment in schizophrenia patients. Sci Rep 2019; 9:1622. [PMID: 30733572 PMCID: PMC6367384 DOI: 10.1038/s41598-018-38227-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 12/20/2018] [Indexed: 12/23/2022] Open
Abstract
Cognitive impairment is a core feature of schizophrenia (SCH). In addition to the toxic effect of Bilirubin (BIL), it has antioxidant properties that were associated with the psychopathology and cognitive impairment of psychiatric disorders. The aim of this study was to examine the correlation of serum total BIL (TBIL) concentration with cognitive impairment in SCH patients. We recruited 34 SCH patients and 119 healthy controls (HCs) in this case-control design. Cognition was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Serum TBIL concentration was measured using the immunoturbidimetric method. Serum TBIL concentration was significantly decreased in SCH patients compared to HCs after adjusting for age, gender, and education. Serum TBIL concentration in SCH patients was also positively correlated with the RBANS immediate memory score. Further stepwise multiple regression analysis confirmed the positive association between serum TBIL concentration and immediate memory score in SCH patients. Our findings supported that the decline in serum TBIL concentration was associated with the immediate memory impairment and psychopathology of SCH.
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16
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Chen S, Xia HS, Zhu F, Yin GZ, Qian ZK, Jiang CX, Gu XC, Yin XY, Tang WJ, Zhang TH, Wang JJ, Jia QF, Hui L. Association between decreased serum albumin levels and depressive symptoms in patients with schizophrenia in a Chinese Han population: A pilot study. Psychiatry Res 2018; 270:438-442. [PMID: 30316171 DOI: 10.1016/j.psychres.2018.10.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 08/28/2018] [Accepted: 10/04/2018] [Indexed: 12/30/2022]
Abstract
Albumin is a metal-binding protein with free-radical scavenging properties and is recognized as a vital antioxidant. Moreover, an excess of free radicals may contribute to depressive symptoms and the psychopathology of psychiatric disorders. This study examined serum albumin levels, depressive symptoms, and their association in patients with schizophrenia. Thirty-four patients with schizophrenia (diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition) and 136 healthy controls were consecutively enrolled in this case-control study. The clinical psychiatric symptoms in patients with schizophrenia were assessed using the Positive and Negative Syndrome Scale (PANSS). Serum albumin levels were measured in all participants using an immunoturbidimetric method. This study was conducted between 2016 and 2017. Serum albumin levels were significantly lower in patients with schizophrenia compared to healthy controls after adjusting for gender, age and education (F = 16.04, p = 0.000). Serum albumin levels were negatively correlated with the depressive score of PANSS in patients with schizophrenia (r = -0.37, p = 0.03). Additionally, a further stepwise multivariate regression analysis showed that serum albumin levels were significantly associated with the depressive score of PANSS in patients with schizophrenia (ß = -0.37, t = -2.25, p = 0.03). Our data suggested that decreased serum albumin levels may contribute to the psychopathology of schizophrenia and that a decline in serum albumin levels was associated with the severity of depressive symptoms in patients with schizophrenia.
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Affiliation(s)
- Shan Chen
- First School of Clinical Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China; Institute of Mental Health, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, Jiangsu 215137, PR China
| | - Hai Sen Xia
- Mengcheng Brain Health Hospital, Mengcheng, Anhui 286000, PR China
| | - Feng Zhu
- Institute of Mental Health, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, Jiangsu 215137, PR China
| | - Guang Zhong Yin
- Institute of Mental Health, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, Jiangsu 215137, PR China
| | - Zheng Kang Qian
- Institute of Mental Health, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, Jiangsu 215137, PR China
| | - Cai Xia Jiang
- Institute of Mental Health, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, Jiangsu 215137, PR China
| | - Xiao Chu Gu
- Institute of Mental Health, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, Jiangsu 215137, PR China
| | - Xu Yuan Yin
- Institute of Mental Health, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, Jiangsu 215137, PR China
| | - Wen Jie Tang
- First School of Clinical Medicine, Wenzhou Medical University, Wenzhou, Zhejiang 325000, PR China.
| | - Tian Hong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Ji Jun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Qiu Fang Jia
- Institute of Mental Health, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, Jiangsu 215137, PR China.
| | - Li Hui
- Institute of Mental Health, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, Jiangsu 215137, PR China.
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17
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Tunç S, Atagün Mİ, Neşelioğlu S, Bilgin YY, Başbuğ HS, Erel Ö. Ischemia-modified albumin: a unique marker of global metabolic risk in schizophrenia and mood disorders. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1517466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Serhat Tunç
- Department of Psychiatry, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Murat İlhan Atagün
- Department of Psychiatry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Salim Neşelioğlu
- Department of Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | | | - Hamit Serdar Başbuğ
- Department of Cardiovascular Surgery, Faculty of Medicine, Kafkas University, Kars, Turkey
| | - Özcan Erel
- Department of Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
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18
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Nguyen TT, Eyler LT, Jeste DV. Systemic Biomarkers of Accelerated Aging in Schizophrenia: A Critical Review and Future Directions. Schizophr Bull 2018; 44:398-408. [PMID: 29462455 PMCID: PMC5815075 DOI: 10.1093/schbul/sbx069] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Schizophrenia is associated with increased physical morbidity and early mortality, suggesting that the aging process may be accelerated in schizophrenia. However, the biological underpinnings of these alterations in aging in schizophrenia are unclear. METHOD We conducted a detailed search of peer-reviewed empirical studies to evaluate evidence for accelerated biological aging in schizophrenia based on systemic, age-related biomarkers. We included studies that investigated differences between persons with schizophrenia and healthy comparison subjects in levels of biomarkers known to be associated with aging and examined the relationship of these biomarkers to age in the 2 groups. RESULTS Forty-two articles that met our selection criteria were reviewed. Nearly 75% reported abnormal biomarker levels among individuals with schizophrenia, including indices of inflammation, cytotoxicity, oxidative stress, metabolic health, gene expression, and receptor/synaptic function, with medium to large effect sizes reported in many studies. Twenty-nine percent of the studies observed differential age-related decline in schizophrenia. Markers of receptor/synaptic function and gene expression were most frequently differentially related to age in schizophrenia. Schizophrenia patients with greater disease severity and longer illness duration exhibited higher levels of inflammatory and oxidative stress biomarkers and shorter telomere length. CONCLUSIONS Most studies show biomarker abnormalities in schizophrenia, and there is some suggestion for accelerated aging. Although definitive interpretation is limited by cross-sectional design of the published reports, findings in the area of gene expression and synaptic function are promising and pave the way for future longitudinal studies needed to fully test this hypothesis.
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Affiliation(s)
- Tanya T Nguyen
- VA San Diego Healthcare System, Mental Illness Research, Education, and Clinical Center (MIRECC), San Diego, CA,Department of Psychiatry, University of California, San Diego, CA
| | - Lisa T Eyler
- VA San Diego Healthcare System, Mental Illness Research, Education, and Clinical Center (MIRECC), San Diego, CA,Department of Psychiatry, University of California, San Diego, CA
| | - Dilip V Jeste
- Department of Psychiatry, University of California, San Diego, CA,Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA,To whom correspondence should be addressed; Estelle and Edgar Levi Chair in Aging, Sam and Rose Stein Institute for Research on Aging, Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive #0664, La Jolla, CA 92093, US; tel: 858-534-4020, fax: 858-543-5475, e-mail:
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19
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Thiol/disulfide homeostasis in untreated schizophrenia patients. Psychiatry Res 2017; 251:212-216. [PMID: 28214778 DOI: 10.1016/j.psychres.2017.02.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 11/23/2016] [Accepted: 02/05/2017] [Indexed: 12/14/2022]
Abstract
BACKROUND The aim of the study was to investigate dynamic thiol/disulfide (SH/SS) homeostasis in untreated schizophrenia. METHODS Blood thiol/disulfide homeostasis status, which reflects native thiol-disulfide exchanges, was investigated in 87 untreated patients (52 males, 35 females), and the obtained results were compared with 86 healthy controls. Blood serum native thiol and total thiol (ToSH) concentrations were measured in a paired test. The half value of the difference between native thiol and ToSH concentrations was calculated as the disulfide bond amount. RESULTS SH and ToSH concentrations were found to be significantly lower (p<0.001 for both) in patients with untreated schizophrenia compared with the control group, whereas disulfide levels were significantly higher (p<0.001). Schizophrenia patients had significantly higher SS/ToSH and SS/SH ratios and a significantly lower SH/ToSH ratio compared to those of healthy individuals. CONCLUSIONS SH and ToSH amounts were found to be insufficient in untreated schizophrenia patients. Additionally, according to the results of the study, thiol/disulfide homeostasis was also disturbed by a shift to the disulfide bond formation side. This might affect the neurotransmission processes, which are known to be related with many symptoms observed in schizophrenia. The replacement of the thiol gap and the reduction of excess SS amounts might have a positive effect in supporting therapy for schizophrenia patients.
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20
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Kim E, Winkler TE, Kitchen C, Kang M, Banis G, Bentley WE, Kelly DL, Ghodssi R, Payne GF. Redox Probing for Chemical Information of Oxidative Stress. Anal Chem 2017; 89:1583-1592. [PMID: 28035805 PMCID: PMC5300039 DOI: 10.1021/acs.analchem.6b03620] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
![]()
Oxidative
stress is implicated in many diseases yet no simple,
rapid, and robust measurement is available at the point-of-care to
assist clinicians in detecting oxidative stress. Here, we report results
from a discovery-based research approach in which a redox mediator
is used to probe serum samples for chemical information relevant to
oxidative stress. Specifically, we use an iridium salt (K2IrCl6) to probe serum for reducing activities that can
transfer electrons to iridium and thus generate detectable optical
and electrochemical signals. We show that this Ir-reducing assay can
detect various biological reductants and is especially sensitive to
glutathione (GSH) compared to alternative assays. We performed an
initial clinical evaluation using serum from 10 people diagnosed with
schizophrenia, a mental health disorder that is increasingly linked
to oxidative stress. The measured Ir-reducing capacity was able to
discriminate people with schizophrenia from healthy controls (p < 0.005), and correlations were observed between Ir-reducing
capacity and independent measures of symptom severity.
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Affiliation(s)
- Eunkyoung Kim
- Institute for Bioscience and Biotechnology Research, University of Maryland , College Park, Maryland 20742, United States.,Fischell Department of Bioengineering, University of Maryland , College Park, Maryland 20742, United States
| | - Thomas E Winkler
- Fischell Department of Bioengineering, University of Maryland , College Park, Maryland 20742, United States.,MEMS Sensors and Actuators Laboratory (MSAL), University of Maryland , College Park, Maryland 20742, United States
| | - Christopher Kitchen
- Maryland Psychiatric Research Center, University of Maryland School of Medicine , Baltimore, Maryland 21228, United States
| | - Mijeong Kang
- Institute for Bioscience and Biotechnology Research, University of Maryland , College Park, Maryland 20742, United States.,Fischell Department of Bioengineering, University of Maryland , College Park, Maryland 20742, United States
| | - George Banis
- Fischell Department of Bioengineering, University of Maryland , College Park, Maryland 20742, United States.,MEMS Sensors and Actuators Laboratory (MSAL), University of Maryland , College Park, Maryland 20742, United States
| | - William E Bentley
- Institute for Bioscience and Biotechnology Research, University of Maryland , College Park, Maryland 20742, United States.,Fischell Department of Bioengineering, University of Maryland , College Park, Maryland 20742, United States
| | - Deanna L Kelly
- Maryland Psychiatric Research Center, University of Maryland School of Medicine , Baltimore, Maryland 21228, United States
| | - Reza Ghodssi
- Fischell Department of Bioengineering, University of Maryland , College Park, Maryland 20742, United States.,MEMS Sensors and Actuators Laboratory (MSAL), University of Maryland , College Park, Maryland 20742, United States.,Department of Electrical and Computer Engineering, Institute for Systems Research, University of Maryland , College Park, Maryland 20742, United States
| | - Gregory F Payne
- Institute for Bioscience and Biotechnology Research, University of Maryland , College Park, Maryland 20742, United States.,Fischell Department of Bioengineering, University of Maryland , College Park, Maryland 20742, United States
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21
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Lee EE, Eyler LT, Wolkowitz OM, Martin AS, Reuter C, Kraemer H, Jeste DV. Elevated plasma F2-isoprostane levels in schizophrenia. Schizophr Res 2016; 176:320-326. [PMID: 27318521 PMCID: PMC5026902 DOI: 10.1016/j.schres.2016.06.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 06/06/2016] [Accepted: 06/09/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND Schizophrenia is one of the most disabling psychiatric disorders with increased morbidity and mortality. Both schizophrenia and oxidative stress have been associated with accelerated aging. Previous studies found increased oxidative stress in individuals with schizophrenia, though only one study measured F2-isoprostanes and did so in urine. To our knowledge, the present study is the first to assess plasma F2-isoprostane levels, the putative gold standard measure of systemic oxidative stress in vivo, in schizophrenia. METHODS We compared plasma F2-isoprostane levels in 134 stable outpatients with schizophrenia and 120 age- and gender-matched healthy comparison (HC) subjects. Sociodemographic and clinical data were collected in both groups. RESULTS Plasma F2-isoprostane levels were significantly higher in the schizophrenia group than in the HC group. Women had higher F2-isoprostane levels compared to men, and those with higher body mass index (BMI) had higher levels, within each group. F2-isoprostane levels correlated with BMI, physical functioning, and medical comorbidity but not with severity of psychopathology or executive function. Linear models showed significant effects of diagnosis, gender, and BMI on F2-isoprostane levels, but no interactions. DISCUSSION Our finding of increased oxidative stress in schizophrenia is consistent with reports of increased morbidity and mortality as well as accelerated aging in schizophrenia. The significant associations between F2-isoprostane levels and both gender and BMI warrant further study.
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Affiliation(s)
- Ellen E. Lee
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Lisa T. Eyler
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States,Desert-Pacific Mental Illness Research Education and Clinical Center, Veterans Affairs San Diego Healthcare System, San Diego
| | | | - Averria Sirkin Martin
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States,Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, La Jolla, CA, United States
| | - Chase Reuter
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States,Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, La Jolla, CA, United States
| | - Helena Kraemer
- Department of Psychiatry, Stanford University, Palo Alto
| | - Dilip V. Jeste
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States,Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, La Jolla, CA, United States,Center for Healthy Aging, University of California, San Diego, La Jolla, CA, United States,Department of Neurosciences, University of California, San Diego
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22
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Debbané M, Salaminios G, Luyten P, Badoud D, Armando M, Solida Tozzi A, Fonagy P, Brent BK. Attachment, Neurobiology, and Mentalizing along the Psychosis Continuum. Front Hum Neurosci 2016; 10:406. [PMID: 27597820 PMCID: PMC4992687 DOI: 10.3389/fnhum.2016.00406] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 08/02/2016] [Indexed: 11/22/2022] Open
Abstract
In this review article, we outline the evidence linking attachment adversity to psychosis, from the premorbid stages of the disorder to its clinical forms. To better understand the neurobiological mechanisms through which insecure attachment may contribute to psychosis, we identify at least five neurobiological pathways linking attachment to risk for developing psychosis. Besides its well documented influence on the hypothalamic-pituary-adrenal (HPA) axis, insecure attachment may also contribute to neurodevelopmental risk through the dopaminergic and oxytonergic systems, as well as bear influence on neuroinflammation and oxidative stress responses. We further consider the neuroscientific and behavioral studies that underpin mentalization as a suite of processes potentially moderating the risk to transition to psychotic disorders. In particular, mentalization may help the individual compensate for endophenotypical impairments in the integration of sensory and metacognitive information. We propose a model where embodied mentalization would lie at the core of a protective, resilience response mitigating the adverse and potentially pathological influence of the neurodevelopmental cascade of risk for psychosis.
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Affiliation(s)
- Martin Debbané
- Faculty of Psychology and Educational Sciences, University of GenevaGeneva, Switzerland
- Research Department of Clinical, Educational and Health Psychology, University College LondonLondon, UK
- Office Médico-PédagogiqueGeneva, Switzerland
| | - George Salaminios
- Research Department of Clinical, Educational and Health Psychology, University College LondonLondon, UK
| | - Patrick Luyten
- Research Department of Clinical, Educational and Health Psychology, University College LondonLondon, UK
- Faculty of Psychology and Educational Sciences, University of LeuvenLeuven, Belgium
| | - Deborah Badoud
- Faculty of Psychology and Educational Sciences, University of GenevaGeneva, Switzerland
| | | | | | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College LondonLondon, UK
| | - Benjamin K. Brent
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical SchoolBoston, MA, USA
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23
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Porcelli S, Crisafulli C, Calabrò M, Serretti A, Rujescu D. Possible biomarkers modulating haloperidol efficacy and/or tolerability. Pharmacogenomics 2016; 17:507-29. [PMID: 27023437 DOI: 10.2217/pgs.16.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Haloperidol (HP) is widely used in the treatment of several forms of psychosis. Despite of its efficacy, HP use is a cause of concern for the elevated risk of adverse drug reactions. adverse drug reactions risk and HP efficacy greatly vary across subjects, indicating the involvement of several factors in HP mechanism of action. The use of biomarkers that could monitor or even predict HP treatment impact would be of extreme importance. We reviewed the elements that could potentially be used as peripheral biomarkers of HP effectiveness. Although a validated biomarker still does not exist, we underlined the several potential findings (e.g., about cytokines, HP metabolites and genotypic biomarkers) which could pave the way for future research on HP biomarkers.
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Affiliation(s)
- Stefano Porcelli
- Department of Biomedical & NeuroMotor Sciences, University of Bologna, Italy
| | - Concetta Crisafulli
- Department of Biomedical Science & Morphological & Functional Images, University of Messina, Italy
| | - Marco Calabrò
- Department of Biomedical Science & Morphological & Functional Images, University of Messina, Italy
| | - Alessandro Serretti
- Department of Biomedical & NeuroMotor Sciences, University of Bologna, Italy
| | - Dan Rujescu
- Department of Psychiatry, University of Halle, Halle, Germany
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Kim SW, Jhon M, Kim JM, Smesny S, Rice S, Berk M, Klier CM, McGorry PD, Schäfer MR, Amminger GP. Relationship between Erythrocyte Fatty Acid Composition and Psychopathology in the Vienna Omega-3 Study. PLoS One 2016; 11:e0151417. [PMID: 26963912 PMCID: PMC4786267 DOI: 10.1371/journal.pone.0151417] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 02/26/2016] [Indexed: 12/20/2022] Open
Abstract
This study investigated the relationship between erythrocyte membrane fatty acid (FA) levels and the severity of symptoms of individuals at ultra-high risk (UHR) for psychosis. Subjects of the present study consisted of 80 neuroleptic-naïve UHR patients. Partial correlation coefficients were calculated between baseline erythrocyte membrane FA levels, measured by gas chromatography, and scores on the Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning Scale, and Montgomery–Asberg Depression Rating Scale (MADRS) after controlling for age, sex, smoking and cannabis use. Subjects were divided into three groups according to the predominance of positive or negative symptoms based on PANSS subscale scores; membrane FA levels in the three groups were then compared. More severe negative symptoms measured by PANSS were negatively correlated with two saturated FAs (myristic and margaric acids), one ω-9 monounsaturated FA (MUFA; nervonic acid), and one ω-3 polyunsaturated FA (PUFA; docosapentaenoic acid), and were positively correlated with two ω-9 MUFAs (eicosenoic and erucic acids) and two ω-6 PUFAs (γ-linolenic and docosadienoic acids). More severe positive symptoms measured by PANSS were correlated only with nervonic acid. No associations were observed between FAs and MADRS scores. In subjects with predominant negative symptoms, the sum of the ω-9 MUFAs and the ω-6:ω-3 FA ratio were both significantly higher than in those with predominant positive symptoms, whereas the sum of ω-3 PUFAs was significantly lower. In conclusion, abnormalities in FA metabolism may contribute to the neurobiology of psychopathology in UHR individuals. In particular, membrane FA alterations may play a role in negative symptoms, which are primary psychopathological manifestations of schizophrenia-related disability.
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Affiliation(s)
- Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Stefan Smesny
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | - Simon Rice
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Michael Berk
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia.,IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia
| | - Claudia M Klier
- Department of Child and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Patrick D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Miriam R Schäfer
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - G Paul Amminger
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia.,Department of Child and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
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Chen X, Hong Y, Zheng P. Efficacy and safety of extract of Ginkgo biloba as an adjunct therapy in chronic schizophrenia: A systematic review of randomized, double-blind, placebo-controlled studies with meta-analysis. Psychiatry Res 2015; 228:121-7. [PMID: 25980333 DOI: 10.1016/j.psychres.2015.04.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 03/20/2015] [Accepted: 04/18/2015] [Indexed: 01/06/2023]
Abstract
Our study was to review and evaluate the efficacy and safety of extract of Gb (EGb) as an adjuvant therapy to antipsychotics in chronic schizophrenia treatment. We searched Pubmed/Medline, Embase, PsycINFO, the Cochrane library, and especially the Chinese periodical databases. Finally, eight randomized, double-blind, placebo-controlled trials (RCTs) of 1033 patients were enrolled, with 571 cases in EGb group and 462 in placebo. The result showed that EGb had a significant difference in ameliorating total and negative symptoms of chronic schizophrenia as an adjuvant therapy to antipsychotics. Thus, the EGb therapy plus antipsychotics might be more efficacious. Although the studies describing adverse reactions showed no distinguishable difference between EGb and placebo group in mean total scores of Treatment Emergent Symptom Scale (TESS) or a Rating Scale for Extrapyramidal Side Effects (RSESE), the results of subscores varied in different studies. In addition, the severity of side effects of EGb might be related to its daily dosage. Therefore, the safety of EGb therapy in chronic schizophrenia treatment might need more evidence. And all of these eight trials were carried out in China; thus, the results might be restricted to the race and we need more high-quality studies of multi-center and randomized double-blind clinical trials to compare, analyze, and confirm the findings further.
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Affiliation(s)
- Xichuang Chen
- Department of Pharmacy, Affiliated Wuxi No. 9 People׳s Hospital, Soochow University & Wuxi Hand Surgery Hospital, Liangxi Road 999, Wuxi, Jiangsu 214062, China.
| | - Yuan Hong
- Department of Pharmacy, Affiliated Wuxi Children׳s Hospital, Nanjing Medical University, Wuxi, Jiangsu 214023, China.
| | - Panpan Zheng
- Department of Pharmacy, Ningbo No. 6 Hospital, Ningbo, Zhejiang 315450, China
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Marthoenis M, Aichberger MC, Puteh I, Syahrial S, Schouler-Ocak M. Metabolic syndrome among psychiatric inpatients with schizophrenia in Indonesia. Asian J Psychiatr 2015; 15:10-4. [PMID: 25910596 DOI: 10.1016/j.ajp.2015.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 03/26/2015] [Accepted: 04/03/2015] [Indexed: 12/31/2022]
Abstract
Despite the fact that antipsychotic medication increases the risk of metabolic syndrome (MetS), the rate of MetS among psychiatric patients in Indonesia is rarely reported. This study aimed to investigate the prevalence of MetS among inpatients with schizophrenia in Indonesia. Eighty-six hospitalised psychiatric patients with schizophrenia were randomly recruited, and underwent physical examination including a blood test. MetS was assessed based on the International Diabetes Federation (IDF) criteria for South Asia. Among the sample, only eight patients (9.3%) met the IDF criteria for MetS. Women have a higher rate of MetS than men (23.8% vs 4.6%; p=0.02). Reduced high-density lipoprotein (HDL) cholesterol was the most frequent (81.4%) metabolic abnormality among them, followed by central obesity (29.1%), raised triglycerides (23.3%), raised fasting plasma glucose (12.8%), and raised blood pressure (10.5%). Among the various antipsychotics, no differences in MetS prevalence were observed in this population. The rate of MetS among the psychiatric inpatients in this study is lower compared both to the previously reported rate in the general population and to the findings among psychiatric patients with schizophrenia in developed countries. Several factors related to the reduced rate of MetS in this psychiatric inpatient population will be discussed.
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Affiliation(s)
| | - Marion C Aichberger
- Departments of Psychiatry and Psychotherapy, Charité University Clinic, Berlin, Germany
| | - Ibrahim Puteh
- Departments of Psychiatry, Syiah Kuala University, Banda Aceh, Indonesia
| | | | - Meryam Schouler-Ocak
- University Psychiatric Clinic of Charité at St. Hedwig's Hospital, Berlin, Germany
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Nasyrova RF, Ivashchenko DV, Ivanov MV, Neznanov NG. Role of nitric oxide and related molecules in schizophrenia pathogenesis: biochemical, genetic and clinical aspects. Front Physiol 2015; 6:139. [PMID: 26029110 PMCID: PMC4426711 DOI: 10.3389/fphys.2015.00139] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 04/18/2015] [Indexed: 12/14/2022] Open
Abstract
Currently, schizophrenia is considered a multifactorial disease. Over the past 50 years, many investigators have considered the role of toxic free radicals in the etiology of schizophrenia. This is an area of active research which is still evolving. Here, we review the recent data and current concepts on the roles of nitric oxide (NO) and related molecules in the pathogenesis of schizophrenia. NO is involved in storage, uptake and release of mediators and neurotransmitters, including glutamate, acetylcholine, noradrenaline, GABA, taurine and glycine. In addition, NO diffuses across cell membranes and activates its own extrasynaptic receptors. Further, NO is involved in peroxidation and reactive oxidative stress. Investigations reveal significant disturbances in NO levels in the brain structures (cerebellum, hypothalamus, hippocampus, striatum) and fluids of subjects with schizophrenia. Given the roles of NO in central nervous system development, these changes may result in neurodevelopmental changes associated with schizophrenia. We describe here the recent literature on NOS gene polymorphisms on schizophrenia, which all point to consistent results. We also discuss how NO may be a new target for the therapy of mental disorders. Currently there have been 2 randomized double-blind placebo-controlled trials of L-lysine as an NOS inhibitor in the CNS.
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Affiliation(s)
- Regina F Nasyrova
- V.M. Bekhterev Saint Petersburg Psychoneurological Research Institute Saint Petersburg, Russia
| | - Dmitriy V Ivashchenko
- V.M. Bekhterev Saint Petersburg Psychoneurological Research Institute Saint Petersburg, Russia
| | - Mikhail V Ivanov
- V.M. Bekhterev Saint Petersburg Psychoneurological Research Institute Saint Petersburg, Russia
| | - Nikolay G Neznanov
- V.M. Bekhterev Saint Petersburg Psychoneurological Research Institute Saint Petersburg, Russia
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Lam V, Albrecht MA, Takechi R, Heidari-Nejad S, Foster JK, Mamo JCL. Neuropsychological performance is positively associated with plasma albumin in healthy adults. Neuropsychobiology 2015; 69:31-8. [PMID: 24458291 DOI: 10.1159/000356967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 11/02/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Albumin serves a range of physiological functions that are vital to overall brain and cognitive health. Indeed, associations between cognitive performance and albumin have been demonstrated in individuals with chronic liver or kidney disease and in patients with a high urinary excretion of albumin. However, an association of plasma albumin with cognitive performance has not been reported in otherwise healthy participants with clinically acceptable plasma albumin concentrations. METHOD This study utilized a wide-ranging neuropsychological test battery to investigate the relationship between cognitive performance and plasma albumin homeostasis in 222 healthy participants (143 females) between the ages of 43 and 84 years (mean 65 years). RESULTS Albumin both with and without the covariates of age, sex and acute-phase proteins was positively associated with enhanced performance on a range of neuropsychological domains including perceptual speed, Stroop and verbal ability. Albumin manifested generally positive but less robust associations with secondary and primary memory. CONCLUSION The results indicate that there is a positive association between albumin and cognitive performance in physiologically healthy participants free of chronic renal or liver disease.
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Affiliation(s)
- Virginie Lam
- School of Public Health, Curtin University, Perth, W.A., Australia
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Labad J, Stojanovic-Pérez A, Montalvo I, Solé M, Cabezas Á, Ortega L, Moreno I, Vilella E, Martorell L, Reynolds RM, Gutiérrez-Zotes A. Stress biomarkers as predictors of transition to psychosis in at-risk mental states: roles for cortisol, prolactin and albumin. J Psychiatr Res 2015; 60:163-9. [PMID: 25466832 DOI: 10.1016/j.jpsychires.2014.10.011] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 10/29/2014] [Accepted: 10/31/2014] [Indexed: 01/08/2023]
Abstract
Stress and inflammation are thought to play a role in the risk of developing a psychotic disorder. We aimed to identify stress-related biomarkers for psychosis transition in help-seeking individuals with an at-risk mental state (ARMS). We studied 39 ARMS subjects who were attending an Early Intervention Service. We included a control group of 44 healthy subjects (HS) matched by sex and age. Stressful life events and perceived stress were assessed. Stress-related biomarkers were determined in serum (cortisol, prolactin, C-reactive protein and albumin), plasma (fibrinogen) or saliva (morning cortisol, cortisol awakening response). All ARMS were followed-up at our Unit for at least one year. We divided the ARMS group into two subgroups based on the development of a psychotic disorder (ARMS-P, N = 10) or not (ARMS-NP, N = 29). ARMS-P reported more stressful life events and perceived stress than HS and ARMS-NP groups. In relation to baseline stress biomarkers, ARMS-P subjects had increased prolactin and lower albumin levels in serum, when compared to ARMS-NP and HS groups. These results did not change when repeated in a subsample of antipsychotic-naïve ARMS subjects. We also found significant differences between groups in the cortisol secretion after awakening. In a multinomial logistic regression adjusting for age, sex and life stress, prolactin was a predictor of psychosis transition whereas albumin levels had a protective effect. Our study underscores the role of stress and stress-related biomarkers (cortisol awakening response, prolactin and albumin) in the pathogenesis of psychosis.
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Affiliation(s)
- Javier Labad
- Early Intervention Service and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
| | - Alexander Stojanovic-Pérez
- Early Intervention Service and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Itziar Montalvo
- Department of Psychiatry, Corporació Sanitària i Universitària Parc Taulí, Sabadell, Barcelona, Spain
| | - Montse Solé
- Early Intervention Service and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Ángel Cabezas
- Early Intervention Service and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Laura Ortega
- Early Intervention Service and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Irene Moreno
- Early Intervention Service and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Elisabet Vilella
- Early Intervention Service and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Lourdes Martorell
- Early Intervention Service and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Rebecca M Reynolds
- Endocrinology Unit, University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Alfonso Gutiérrez-Zotes
- Early Intervention Service and Research Department, Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
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Antioxidant Interventions in Neuropsychiatric Disorders. OXIDATIVE STRESS IN APPLIED BASIC RESEARCH AND CLINICAL PRACTICE 2015. [DOI: 10.1007/978-1-4939-0440-2_25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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31
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Gültekin BK, Kesebir S, Kabak SG, Ergün FF, Tatlidil Yaylaci E. Are Uric Acid Levels Different from Healthy Subjects in Bipolar Affective Disorder and Schizophrenia?: Relationship Between Clinical Improvement and Episode Severity in Male Patients. Noro Psikiyatr Ars 2014; 51:229-232. [PMID: 28360631 DOI: 10.4274/npa.y6827] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 12/04/2012] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Purinergic system dysfunction has been shown both in patients with bipolar disorder (BD) and those with schizophrenia. The aim of this study was to evaluate whether uric acid levels in male BD patients with manic episode and schizophrenia patients with psychotic relapse differ from healthy male subjects. Secondly to assess whether uric acid levels in both patient groups correlate with episode severity and if a decrease in uric acid levels correlate with clinical improvement. METHOD A total of 55 BD patients with manic episode and 59 schizophrenic patients with psychotic relapse were evaluated at baseline and at weeks 1, 2, 3 using the Young Mania Rating Scale (YMRS) and the Positive and Negative Syndrome Scale (PANSS), and their plasma uric acid levels were measured. 60 age-matched healthy males without history of any previous or current psychiatric diagnosis and treatment constituted the control group. In order to determine plasma uric acid levels, blood samples were centrifuged at 3000 × g for 15 minutes, stored at -80°C and measured in milligrams per deciliter. RESULTS Uric acid levels in both patient groups with manic episode and psychotic relapse were found higher than in healthy controls (f=6.122, p=.027). The difference between repeated measurements of uric acid levels in BD patient group was found to be between baseline and first week measurements (after Bonferroni correction) (p<.001). No correlation was found between YMRS and PANSS scores and uric acid levels at 4 assessment times. CONCLUSION Uric acid levels in male BD and schizophrenia patients with manic episode and psychotic relapse were similar with each other, and higher than in healthy males. No correlation was found between uric acid levels and episode severity in both groups. However, for patients with BD, a decrease in uric acid levels between baseline and first week seems to be correlated with clinical improvement.
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Affiliation(s)
- Bülent Kadri Gültekin
- Clinic of Psychiatry, Erenköy Psychiatric Training and Research Hospital, İstanbul, Turkey
| | - Sermin Kesebir
- Clinic of Psychiatry, Erenköy Psychiatric Training and Research Hospital, İstanbul, Turkey
| | - Sevgi Gül Kabak
- Clinic of Psychiatry, Erenköy Psychiatric Training and Research Hospital, İstanbul, Turkey
| | - Ferzan Fikret Ergün
- Clinic of Psychiatry, Erenköy Psychiatric Training and Research Hospital, İstanbul, Turkey
| | - Elif Tatlidil Yaylaci
- Clinic of Psychiatry, Erenköy Psychiatric Training and Research Hospital, İstanbul, Turkey
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Bouwens JA, Hubers AAM, van Duijn E, Cobbaert CM, Roos RAC, van der Mast RC, Giltay EJ. Acute-phase proteins in relation to neuropsychiatric symptoms and use of psychotropic medication in Huntington's disease. Eur Neuropsychopharmacol 2014; 24:1248-56. [PMID: 24957738 DOI: 10.1016/j.euroneuro.2014.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 05/01/2014] [Accepted: 05/09/2014] [Indexed: 10/25/2022]
Abstract
Activation of the innate immune system has been postulated in the pathogenesis of Huntington's disease (HD). We studied serum concentrations of C-reactive protein (CRP) and low albumin as positive and negative acute-phase proteins in HD. Multivariate linear and logistic regression was used to study the association between acute-phase protein levels in relation to clinical, neuropsychiatric, cognitive, and psychotropic use characteristics in a cohort consisting of 122 HD mutation carriers and 42 controls at first biomarker measurement, and 85 HD mutation carriers and 32 controls at second biomarker measurement. Significant associations were found between acute-phase protein levels and Total Functioning Capacity (TFC) score, severity of apathy, cognitive impairment, and the use of antipsychotics. Interestingly, all significant results with neuropsychiatric symptoms disappeared after additional adjusting for antipsychotic use. High sensitivity CRP levels were highest and albumin levels were lowest in mutation carriers who continuously used antipsychotics during follow-up versus those that had never used antipsychotics (mean difference for CRP 1.4 SE mg/L; P=0.04; mean difference for albumin 3 SE g/L; P<0.001). The associations found between acute-phase proteins and TFC score, apathy, and cognitive impairment could mainly be attributed to the use of antipsychotics. This study provides evidence that HD mutation carriers who use antipsychotics are prone to develop an acute-phase response.
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Affiliation(s)
- J A Bouwens
- Department of Psychiatry, Leiden University Medical Center, The Netherlands.
| | - A A M Hubers
- Department of Psychiatry, Leiden University Medical Center, The Netherlands
| | - E van Duijn
- Department of Psychiatry, Leiden University Medical Center, The Netherlands; Center for Mental Health Care Delfland, Delft, The Netherlands
| | - C M Cobbaert
- Department of Clinical Chemistry, Leiden University Medical Center, The Netherlands
| | - R A C Roos
- Department of Neurology, Leiden University Medical Center, The Netherlands
| | - R C van der Mast
- Department of Psychiatry, Leiden University Medical Center, The Netherlands
| | - E J Giltay
- Department of Psychiatry, Leiden University Medical Center, The Netherlands
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D’Alessandro A, Zolla L. The SODyssey: superoxide dismutases from biochemistry, through proteomics, to oxidative stress, aging and nutraceuticals. Expert Rev Proteomics 2014; 8:405-21. [DOI: 10.1586/epr.11.13] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Wu JQ, Chen DC, Tan YL, Tan SP, Wang ZR, Xiu MH, Yang FD, Zhang XY. Cognition impairment in schizophrenia patients with tardive dyskinesia: association with plasma superoxide dismutase activity. Schizophr Res 2014; 152:210-6. [PMID: 24325977 DOI: 10.1016/j.schres.2013.11.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 11/06/2013] [Accepted: 11/10/2013] [Indexed: 01/31/2023]
Abstract
Long-term antipsychotic treatment for schizophrenia is often associated with the emergence of tardive dyskinesia (TD), and TD presence is also accompanied by more severe cognitive impairment. Oxidative stress-induced damage may be involved in the development of TD and contribute to cognitive deficits in schizophrenia. We examined the role of oxidative stress in relation to TD and cognitive deficits in schizophrenia using plasma manganese superoxide dismutase (MnSOD) as a biomarker. We recruited 83 male chronic patients with (n=32) and without TD (n=51) meeting DSM-IV criteria for schizophrenia, and 58 male control subjects. We examined the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and MnSOD activity for all subjects. Positive and Negative Symptom Scale (PANSS) and the Abnormal Involuntary Movement Scale (AIMS) were assessed in the patients. MnSOD activity was lower in patients with TD than non-TD, and either TD or non-TD group had lower MnSOD levels than controls (all p<0.05). Patients with TD had lower RBANS total (p<0.05) and Visuospatial/Constructional subscale scores than non-TD patients (p<0.01), and either TD or non-TD group scored lower than the controls on all RBANS subscales (all p<0.001) except for the Visuospatial/Constructional index. Multiple regression analysis showed that in either TD or non-TD group, MnSOD was an independent contributor to the RBANS total score (both p<0.05). These findings suggest that TD patients suffered oxidative stress and cognition impairment at a more severe level than non-TD patients. Oxidative stress might serve as a functionally linking node between TD development and cognition dysfunction in schizophrenia.
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Affiliation(s)
- Jing Qin Wu
- School of Biomedical Sciences and Pharmacy, Faculty of Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Schizophrenia Research Institute, Sydney, Australia; Biological Psychiatry Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Da Chun Chen
- Biological Psychiatry Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yun Long Tan
- Biological Psychiatry Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Shu Ping Tan
- Biological Psychiatry Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Zhi Ren Wang
- Biological Psychiatry Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Mei Hong Xiu
- Biological Psychiatry Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Fu De Yang
- Biological Psychiatry Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Xiang Yang Zhang
- Biological Psychiatry Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, China; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, TX, USA.
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Polyphenols from Berries of Aronia melanocarpa Reduce the Plasma Lipid Peroxidation Induced by Ziprasidone. SCHIZOPHRENIA RESEARCH AND TREATMENT 2014; 2014:602390. [PMID: 25061527 PMCID: PMC4099167 DOI: 10.1155/2014/602390] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Revised: 05/21/2014] [Accepted: 05/26/2014] [Indexed: 02/07/2023]
Abstract
Background. Oxidative stress in schizophrenia may be caused partially by the treatment of patients with antipsychotics. The aim of the study was to establish the effects of polyphenol compounds derived from berries of Aronia melanocarpa (Aronox) on the plasma lipid peroxidation induced by ziprasidone in vitro. Methods. Lipid peroxidation was measured by the level of thiobarbituric acid reactive species (TBARS). The samples of plasma from healthy subjects were incubated with ziprasidone (40 ng/ml; 139 ng/ml; and 250 ng/ml) alone and with Aronox (5 ug/ml; 50 ug/ml). Results. We observed a statistically significant increase of TBARS level after incubation of plasma with ziprasidone (40 ng/ml; 139 ng/ml; and 250 ng/ml) (after 24 h incubation: P = 7.0 × 10(-4), P = 1.6 × 10(-3), and P = 2.7 × 10(-3), resp.) and Aronox lipid peroxidation caused by ziprasidone was significantly reduced. After 24-hour incubation of plasma with ziprasidone (40 ng/ml; 139 ng/ml; and 250 ng/ml) in the presence of 50 ug/ml Aronox, the level of TBARS was significantly decreased: P = 6.5 × 10(-8), P = 7.0 × 10(-6), and P = 3.0 × 10(-5), respectively. Conclusion. Aronox causes a distinct reduction of lipid peroxidation induced by ziprasidone.
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Pandya CD, Howell KR, Pillai A. Antioxidants as potential therapeutics for neuropsychiatric disorders. Prog Neuropsychopharmacol Biol Psychiatry 2013; 46:214-23. [PMID: 23123357 PMCID: PMC3615047 DOI: 10.1016/j.pnpbp.2012.10.017] [Citation(s) in RCA: 152] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Revised: 10/24/2012] [Accepted: 10/24/2012] [Indexed: 12/25/2022]
Abstract
Oxidative stress has been implicated in the pathophysiology of many neuropsychiatric disorders such as schizophrenia, bipolar disorder, major depression etc. Both genetic and non-genetic factors have been found to cause increased cellular levels of reactive oxygen species beyond the capacity of antioxidant defense mechanism in patients of psychiatric disorders. These factors trigger oxidative cellular damage to lipids, proteins and DNA, leading to abnormal neural growth and differentiation. Therefore, novel therapeutic strategies such as supplementation with antioxidants can be effective for long-term treatment management of neuropsychiatric disorders. The use of antioxidants and PUFAs as supplements in the treatment of neuropsychiatric disorders has provided some promising results. At the same time, one should be cautious with the use of antioxidants since excessive antioxidants could dangerously interfere with some of the protective functions of reactive oxygen species. The present article will give an overview of the potential strategies and outcomes of using antioxidants as therapeutics in psychiatric disorders.
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Affiliation(s)
- Chirayu D Pandya
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Georgia Health Sciences University, Augusta, GA, USA
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Lee SY, Lee SJ, Han C, Patkar AA, Masand PS, Pae CU. Oxidative/nitrosative stress and antidepressants: targets for novel antidepressants. Prog Neuropsychopharmacol Biol Psychiatry 2013; 46:224-35. [PMID: 23022673 DOI: 10.1016/j.pnpbp.2012.09.008] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Revised: 08/10/2012] [Accepted: 09/17/2012] [Indexed: 10/27/2022]
Abstract
The brain is an organ predisposed to oxidative/nitrosative stress. This is especially true in the case of aging as well as several neurodegenerative diseases. Under such circumstances, a decline in the normal antioxidant defense mechanisms leads to an increase in the vulnerability of the brain to the deleterious effects of oxidative damage. Highly reactive oxygen/nitrogen species damage lipids, proteins, and mitochondrial and neuronal genes. Unless antioxidant defenses react appropriately to damage inflicted by radicals, neurons may experience microalteration, microdysfunction, and degeneration. We reviewed how oxidative and nitrosative stresses contribute to the pathogenesis of depressive disorders and reviewed the clinical implications of various antioxidants as future targets for antidepressant treatment.
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Affiliation(s)
- Seung-Yup Lee
- Department of Medicine, Medical Science, The Graduate School of Catholic University of Korea, Seoul, Republic of Korea
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Wu JQ, Kosten TR, Zhang XY. Free radicals, antioxidant defense systems, and schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2013; 46:200-6. [PMID: 23470289 DOI: 10.1016/j.pnpbp.2013.02.015] [Citation(s) in RCA: 236] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 02/20/2013] [Accepted: 02/26/2013] [Indexed: 01/13/2023]
Abstract
The etiopathogenic mechanisms of schizophrenia are to date unknown, although several hypotheses have been suggested. Accumulating evidence suggests that excessive free radical production or oxidative stress may be involved in the pathophysiology of schizophrenia as evidenced by increased production of reactive oxygen or decreased antioxidant protection in schizophrenic patients. This review aims to summarize the basic molecular mechanisms of free radical metabolism, the impaired antioxidant defense system and membrane pathology in schizophrenia, their interrelationships with the characteristic clinical symptoms and the implications for antipsychotic treatments. In schizophrenia, there is accumulating evidence of altered antioxidant enzyme activities and increased levels of lipid peroxidation, as well as altered levels of plasma antioxidants. Moreover, free radical-mediated abnormalities may contribute to specific aspects of schizophrenic symptomatology and complications of its treatment with antipsychotic drugs, as well as the development of tardive dyskinesia (TD). Finally, the potential therapeutic strategies implicated by the accumulating data on oxidative stress mechanisms for the treatment of schizophrenia are discussed.
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Affiliation(s)
- Jing Qin Wu
- School of Biomedical Sciences and Pharmacy, Faculty of Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Schizophrenia Research Institute, Sydney, Australia; Psychiatry Research Center, Beijing Hui Long Guan Hospital, Peking University, Beijing 100096, China
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Flatow J, Buckley P, Miller BJ. Meta-analysis of oxidative stress in schizophrenia. Biol Psychiatry 2013; 74:400-9. [PMID: 23683390 PMCID: PMC4018767 DOI: 10.1016/j.biopsych.2013.03.018] [Citation(s) in RCA: 338] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 03/20/2013] [Accepted: 03/22/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND Schizophrenia is associated with impaired antioxidant defense, including abnormal serum, plasma, and red blood cell (RBC) oxidative stress parameters. We performed a meta-analysis of these associations, considering the effect of clinical status and antipsychotic treatment after an acute exacerbation of psychosis. METHODS We identified articles by searching PubMed, PsychInfo, and Institute for Scientific Information, and the reference lists of identified studies. RESULTS Forty-four studies met the inclusion criteria. Total antioxidant status seemed to be a state marker, because levels were significantly decreased in cross-sectional studies of serum and plasma in first-episode psychosis (FEP) and significantly increased in longitudinal studies of antipsychotic treatment for acute exacerbations of psychosis (p < .01 for each). The RBC catalase and plasma nitrite seemed to be state-related markers, because levels in cross-sectional studies were significantly decreased in FEP (p < .01) and significantly increased in stable outpatients (p = .01). In contrast, RBC superoxide dismutase seemed to be a trait marker for schizophrenia, because levels in cross-sectional studies were significantly decreased in acutely relapsed inpatients, FEP, and stable outpatients (p < .01 for each). CONCLUSIONS Oxidative stress abnormalities in FEP suggest an effect that might be independent of antipsychotic medications. Although some parameters (total antioxidant status, RBC catalase, and plasma nitrite) might be state markers for acute exacerbations of psychosis, others (RBC superoxide dismutase) might be trait markers; however, more longitudinal studies are needed. Our findings suggest that oxidative stress might serve as a potential biomarker in the etiopathophysiology and clinical course of schizophrenia.
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Affiliation(s)
- Joshua Flatow
- Medical College of Georgia, Georgia Regents University, Augusta, GA 30912, USA
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Jiang Z, Cowell RM, Nakazawa K. Convergence of genetic and environmental factors on parvalbumin-positive interneurons in schizophrenia. Front Behav Neurosci 2013; 7:116. [PMID: 24027504 PMCID: PMC3759852 DOI: 10.3389/fnbeh.2013.00116] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 08/13/2013] [Indexed: 11/13/2022] Open
Abstract
Schizophrenia etiology is thought to involve an interaction between genetic and environmental factors during postnatal brain development. However, there is a fundamental gap in our understanding of the molecular mechanisms by which environmental factors interact with genetic susceptibility to trigger symptom onset and disease progression. In this review, we summarize the most recent findings implicating oxidative stress as one mechanism by which environmental insults, especially early life social stress, impact the development of schizophrenia. Based on a review of the literature and the results of our own animal model, we suggest that environmental stressors such as social isolation render parvalbumin-positive interneurons (PVIs) vulnerable to oxidative stress. We previously reported that social isolation stress exacerbates many of the schizophrenia-like phenotypes seen in a conditional genetic mouse model in which NMDA receptors (NMDARs) are selectively ablated in half of cortical and hippocampal interneurons during early postnatal development (Belforte et al., 2010). We have since revealed that this social isolation-induced effect is caused by impairments in the antioxidant defense capacity in the PVIs in which NMDARs are ablated. We propose that this effect is mediated by the down-regulation of PGC-1α, a master regulator of mitochondrial energy metabolism and anti-oxidant defense, following the deletion of NMDARs (Jiang et al., 2013). Other potential molecular mechanisms underlying redox dysfunction upon gene and environmental interaction will be discussed, with a focus on the unique properties of PVIs.
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Affiliation(s)
- Zhihong Jiang
- Unit on Genetics of Cognition and Behavior, National Institute of Mental Health, NIH Bethesda, MD, USA
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Zhang XY, Chen DC, Xiu MH, Tan YL, Yang FD, Zhang LY, Zhang LY, Haile CN, Kosten TR. Clinical symptoms and cognitive impairment associated with male schizophrenia relate to plasma manganese superoxide dismutase activity: a case-control study. J Psychiatr Res 2013; 47:1049-53. [PMID: 23611682 DOI: 10.1016/j.jpsychires.2013.03.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 03/08/2013] [Accepted: 03/13/2013] [Indexed: 02/05/2023]
Abstract
Several lines of evidence suggest that excessive reactive oxygen species-induced oxidative damage may underlie cognitive impairment in psychiatric disorders. A growing body of evidence show that oxidative damage may relate to the range of cognitive deficits associated with schizophrenia. In this study we examine one of the primary antioxidant defense enzymes manganese superoxide dismutase (MnSOD), and whether it relates to cognitive deficits in schizophrenia. We recruited 185 chronic male schizophrenia patients and 132 male controls and compared results from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and plasma MnSOD activity between groups. Symptom severity in patients with schizophrenia was assessed with the Positive and Negative Syndrome Scale (PANSS). Our results showed that MnSOD activities were significantly lower in patients than controls (p<0.05). Cognitive scores on the RBANS and nearly all of its five subscales (all p<0.001) except for the Visuospatial/Constructional index were significantly lower in schizophrenia patients than normal controls. MnSOD was negatively correlated with the general psychopathology subscale of PANSS, PANSS total score, positive symptoms and RBANS total score in patients with schizophrenia. Our findings add to growing evidence that oxidative stress may be involved in the psychopathology of male schizophrenia, and its associated cognitive impairment.
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Affiliation(s)
- Xiang Yang Zhang
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Michael E. DeBakey VA Medical Center, Houston,TX 77030 , USA.
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Albayrak Y, Ünsal C, Beyazyüz M, Ünal A, Kuloğlu M. Reduced total antioxidant level and increased oxidative stress in patients with deficit schizophrenia: a preliminary study. Prog Neuropsychopharmacol Biol Psychiatry 2013; 45:144-9. [PMID: 23657077 DOI: 10.1016/j.pnpbp.2013.04.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 04/28/2013] [Accepted: 04/29/2013] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Deficit schizophrenia (DS) is defined for identifying a relatively homogeneous subgroup of patients with diagnosis of schizophrenia, characterized by the presence of primary and enduring negative symptoms. There have been several studies which investigated the status of oxidative stress and total antioxidant level in patients with schizophrenia. However, there is not any study which researched differences between DS and nondeficit schizophrenia (NDS) in terms of status of oxidative stress and antioxidant level. We hypothesized that patients with DS would have different status of oxidative stress and antioxidant levels compared with patients with NDS. METHODS Twenty-three patients with DS, 42 patients with NDS and 31 age, sex and smoking status matched healthy controls (HC) were included to study. Five milliliters of blood was drawn from control subjects and patients for assessing total antioxidant potential (TAOP) and total peroxide levels (TPEROX). The ratio of TPEROX to TAOP is referred as oxidative stress index (OSI). RESULTS We noticed that serum TAOP level was significantly lower in DS group compared with NDS and HC groups. The OSI was also found to be higher in DS group compared with NDS and HC groups. Furthermore, serum TAOP level and status of OSI were similar between NDS and HC groups. CONCLUSION Our study is the first to demonstrate differences between DS and NDS in terms of status of oxidative stress and serum total antioxidant level. We suggest that our study represents novel and important results in terms of supporting provides and hypothesis which considered DS as a different disease entity with respect to NDS. Further studies are needed for investigating the status of antioxidants and oxidative stress and their clinical implications in deficit schizophrenia.
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Affiliation(s)
- Yakup Albayrak
- Department of Psychiatry, Kırklareli State Hospital, Kırklareli, Turkey.
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Ramos-Loyo J, Medina-Hernández V, Estarrón-Espinosa M, Canales-Aguirre A, Gómez-Pinedo U, Cerdán-Sánchez LF. Sex differences in lipid peroxidation and fatty acid levels in recent onset schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2013; 44:154-61. [PMID: 23421976 DOI: 10.1016/j.pnpbp.2013.02.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Revised: 01/17/2013] [Accepted: 02/08/2013] [Indexed: 01/14/2023]
Abstract
Sex differences in the symptomatology and course of illness have been reported among schizophrenic patients. Hence, the principal objective of the present study was to investigate sex differences in the concentrations of the lipid peroxidation metabolites MDA and 4-HNE, and in the membrane phospholipid levels of ARA, EPA and DHA in patients with schizophrenia. A total of 46 paranoid schizophrenics (25 women) with short-term evolution who were in an acute psychotic stage and 40 healthy controls (23 women) participated in the study. Psychopathology was evaluated by BPRS and PANSS. Lipid peroxidation sub-products (MDA, 4-HNE) and fatty acid levels (ARA, EPA, DHA) were determined in erythrocyte membranes. The men in both groups showed higher lipid peroxidation levels and those values were higher in schizophrenic patients than controls, with only EPA fatty acid concentrations found to be lower in the former than the latter. These results suggest that men may suffer greater oxidative neuronal damage than women, and that this could worsen the course of illness and result in greater disease severity.
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Status of antioxidant defense and lipid peroxidation in schizophrenics with positive, negative and cognitive symptoms. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.fra.2013.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Zhang XY, Chen DC, Xiu MH, Yang FD, Tan YL, He S, Kosten TA, Kosten TR. Thioredoxin, a novel oxidative stress marker and cognitive performance in chronic and medicated schizophrenia versus healthy controls. Schizophr Res 2013; 143:301-6. [PMID: 23238053 DOI: 10.1016/j.schres.2012.11.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Revised: 11/15/2012] [Accepted: 11/19/2012] [Indexed: 02/05/2023]
Abstract
Oxidative stress-induced damage to neurons may contribute to cognitive deficits during aging and in neurodegenerative disorders. Schizophrenia has a range of cognitive deficits that may evolve from oxidative stress. Thioredoxin (TRX), a redox-regulating protein with antioxidant activity recognized as an oxidative-stress marker has recently been found to be involved in pathogenesis and psychopathology of schizophrenia. The aim of this study was to examine the association of TRX with cognitive deficits in schizophrenia. We recruited 45 chronic schizophrenic patients and 66 healthy control subjects and examined the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and serum TRX in both groups. Schizophrenic symptoms were assessed using the positive and negative syndrome scale (PANSS). We found no significant difference in TRX levels between patients and healthy controls. Cognitive scores on the RBANS and four of its five subscales (all p<0.001) except for the Visuospatial/Constructional index (p>0.05) were significantly lower in schizophrenic patients than normal controls. For the patients, TRX was inversely associated with the Attention domain of cognitive deficits in schizophrenia; however, TRX was positively associated with Attention in controls. The significantly lower TRX levels in attention impaired schizophrenia compared to controls suggest that oxidative stress may be involved in the cognitive impairment, especially attention in schizophrenia. The differential association of TRX and cognitive performance in schizophrenia and controls may be related to the impaired oxidative stress status of schizophrenia patients.
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Affiliation(s)
- Xiang Yang Zhang
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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Mabrouk H, Houas I, Mechria H, Mechri A, Douki W, Gaha L, Najjar M. Oxidative stress markers in schizophrenic patients. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.immbio.2012.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Baranyi A, Rothenhäusler HB. The impact of intra- and postoperative albumin levels as a biomarker of delirium after cardiopulmonary bypass: results of an exploratory study. Psychiatry Res 2012; 200:957-63. [PMID: 22749153 DOI: 10.1016/j.psychres.2012.05.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 02/20/2012] [Accepted: 05/25/2012] [Indexed: 12/18/2022]
Abstract
In this prospective study the frequency of delirium after cardiac surgery with cardiopulmonary bypass (CPB) was determined. Furthermore, we investigated the impact of intra- and postoperative levels of albumin as a biomarker of delirium. Thirty-four patients who underwent elective CPB at the Department of Cardiac Surgery, Ludwig-Maximilians-University of Munich, Germany, were enroled in this prospective study. During the intensive care unit (ICU) stay and shortly after discharge from the ICU, delirious state was evaluated daily using the Delirium-Rating-Scale. Albumin was assayed pre-anaesthesia, immediately after induction of anaesthesia, at the beginning of the heart-lung-apparatus period, immediately before the opening and 5min after the opening of the aortic clamp, 24h and 48h postoperatively and on the day before discharge. After CPB, a clinical significant delirious state was observed in 11 patients (32.4%). The albumin level decreased during the surgical intervention and increased postoperatively with a maximum level at the time of discharge. CPB patients with delirious state showed a significantly lower albumin level 24h and 48h postoperatively than those without delirium. A low level of postoperative albumin seems to be a useful biomarker to identify patients with high risk of delirious state after CPB.
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Affiliation(s)
- Andreas Baranyi
- Department of Psychiatry, University of Medicine of Graz, Auenbruggerplatz 31, 8036 Graz, Austria.
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Zhang XY, Chen DC, Xiu MH, Tang W, Zhang F, Liu L, Chen Y, Liu J, Yao JK, Kosten TA, Kosten TR. Plasma total antioxidant status and cognitive impairments in schizophrenia. Schizophr Res 2012; 139:66-72. [PMID: 22555016 DOI: 10.1016/j.schres.2012.04.009] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 04/04/2012] [Accepted: 04/06/2012] [Indexed: 12/22/2022]
Abstract
Oxidative stress-induced damage to neurons may contribute to cognitive deficits during aging and in neurodegenerative disorders. Schizophrenia has a range of cognitive deficits that may evolve from oxidative stress, and this study examines this association of oxidative stress with cognitive deficits in schizophrenia. We recruited 296 chronic schizophrenia patients and 181 healthy control subjects and examined the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and plasma total antioxidant status (TAS) in both groups. Schizophrenia symptoms were assessed using the positive and negative syndrome scale (PANSS). Our results showed that TAS levels were significantly lower in patients than controls (179.6 ± 81.0 U/ml vs. 194.8 ± 46.0 U/ml, p<0.05). Cognitive scores on the RBANS and nearly all of its five subscales (all p<0.001) except for the Visuospatial/Constructional index (p>0.05) were significantly lower in schizophrenia patients than normal controls. For the patients, TAS was inversely associated with some domains of cognitive deficits in schizophrenia, such as Attention and Immediate Memory. Our findings suggest that oxidative stress may be involved in the pathophysiology of schizophrenia, and its associated cognitive impairment.
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Affiliation(s)
- Xiang Yang Zhang
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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Bentsen H, Solberg DK, Refsum H, Bøhmer T. Clinical and biochemical validation of two endophenotypes of schizophrenia defined by levels of polyunsaturated fatty acids in red blood cells. Prostaglandins Leukot Essent Fatty Acids 2012; 87:35-41. [PMID: 22705264 DOI: 10.1016/j.plefa.2012.05.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Revised: 04/13/2012] [Accepted: 05/17/2012] [Indexed: 01/29/2023]
Abstract
BACKGROUND Polyunsaturated fatty acids (PUFAs) are bimodally distributed in acute schizophrenia, suggesting two endophenotypes. We intended to characterize these endophenotypes clinically. Our a priori hypothesis was that low PUFA patients have more negative symptoms. PATIENTS AND METHODS Patients (aged 18-39) with schizophrenia, schizoaffective or schizophreniform disorders were recruited at hospital admission during an acute episode. The baseline Positive and Negative Syndrome Scale, vital signs and biochemical variables were measured in 97 patients with available RBC PUFA levels. Adjustment for multiple testing was not performed. RESULTS The median Negative Subscale score was higher (p=0.04) in the low PUFA (25 points, n=30) than in the high PUFA group (19 points, n=67). Among 95 patients with measurements of serum triglycerides, hypertriglyceridaemia was more prevalent (p=0.009) among low PUFA patients (66%) than high PUFA patients (36%). PUFA modified the effect of antipsychotics on triglycerides (p=0.046). Serum glucose and mean corpuscular haemoglobin were higher (p=0.03, 0.001, respectively) in low PUFA than in high PUFA patients. Low PUFA men were heavier (p=0.04) than high PUFA men. CONCLUSIONS During an acute episode of schizophrenia, patients with low RBC PUFA have more negative symptoms and more metabolic and haematological abnormalities than those with high PUFA. This indicates that PUFA levels define two clinically distinct endophenotypes of the disorder.
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Affiliation(s)
- H Bentsen
- Center for Psychopharmacology, Diakonhjemmet Hospital, 0319 Oslo, Norway.
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Zhang XY, Zhou DF, Shen YC, Zhang PY, Zhang WF, Liang J, Chen DC, Xiu MH, Kosten TA, Kosten TR. Effects of risperidone and haloperidol on superoxide dismutase and nitric oxide in schizophrenia. Neuropharmacology 2012; 62:1928-34. [DOI: 10.1016/j.neuropharm.2011.12.014] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Revised: 12/05/2011] [Accepted: 12/10/2011] [Indexed: 01/01/2023]
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