1
|
Barak R, Goshtasbi G, Fatehi R, Firouzabadi N. Signaling pathways and genetics of brain Renin angiotensin system in psychiatric disorders: State of the art. Pharmacol Biochem Behav 2024; 236:173706. [PMID: 38176544 DOI: 10.1016/j.pbb.2023.173706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 12/19/2023] [Accepted: 12/28/2023] [Indexed: 01/06/2024]
Abstract
Along the conventional pathways, Renin-angiotensin system (RAS) plays a key role in the physiology of the CNS and pathogenesis of psychiatric diseases. RAS is a complex regulatory pathway which is composed of several peptides and receptors and comprises two counter-regulatory axes. The classical (ACE1/AngII/AT1 receptor) axis and the contemporary (ACE2/Ang (1-7)/Mas receptor) axis. The genes coding for elements of both axes have been broadly studied. Numerous functional polymorphisms on components of RAS have been identified to serve as informative disease and treatment markers. This review summarizes the role of each peptide and receptor in the pathophysiology of psychiatric disorders (depression, bipolar disorders and schizophrenia), followed by a concise look at the role of genetic polymorphism of the RAS in the pathophysiology of these disorders.
Collapse
Affiliation(s)
- Roya Barak
- Department of Pharmacology & Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Ghazal Goshtasbi
- Department of Pharmacology & Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reihaneh Fatehi
- Department of Pharmacology & Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Negar Firouzabadi
- Department of Pharmacology & Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
2
|
Arya S, Kamyab A, Sanatkar SA, Pourmehdiardebili M, Ebrahimi A, Kamyab P, Alavi K, Zarei Z, Ahmadkhaniha HR. Evaluating the association of vitamin D3, parathyroid hormone, and C-reactive protein serum levels in patients with an acute psychotic episode: a cross-sectional study in tertiary centre in Iran. BMC Psychiatry 2023; 23:724. [PMID: 37803327 PMCID: PMC10557165 DOI: 10.1186/s12888-023-05234-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 09/29/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND The high impact of vitamin D on brain development and its relationship with inflammatory markers in the clinical course of psychiatric disorders have compelled researchers to investigate the potential association between vitamin D levels, C-reactive protein (CRP) levels, and the incidence of mental disorders. In the present study, we aimed to compare the serum levels of vitamin D and its related markers, including calcium, phosphorus, and parathyroid hormone (PTH), along with CRP, in 3 groups of patients with acute psychotic episodes, including schizophrenia, bipolar disorder, and methamphetamine-induced psychosis, with a standard control group of the Iranian population. METHODS This descriptive cross-sectional study was conducted at a psychiatric hospital in Tehran, Iran, and involved a total of 185 subjects. The subjects included four groups: acute phase of schizophrenia (n = 49), acute manic episodes of bipolar disorder (n = 43), methamphetamine-induced psychotic disorder (n = 46), and control group (n = 47). Among 138 patients in acute psychotic episodes, 33 patients were in their first episode of psychosis, while 105 patients were in acute exacerbation of their chronic psychotic disorders. The Brief Psychiatric Rating Scale (BPRS) was measured by an expert attending psychiatrist for all patients. Then, serum levels of calcium, phosphorus, parathormone, vitamin D, and CRP were assessed in all study groups. RESULTS Among our 185 study subjects, it was observed that individuals with higher education levels and those who were married had a lower prevalence of mental disorders. In all patient groups, the serum levels of CRP were significantly higher, and PTH levels were significantly lower than in the control group (p < 0.001). The serum levels of calcium, phosphorus, and vitamin D were not statistically significantly different between the patient and control groups of the study. In chronic psychotic patients, CRP levels were significantly higher (p < 0.031), and vitamin D levels were significantly lower (p < 0.044) compared to first-episode psychotic patients. CONCLUSION This study suggests that CRP levels are significantly higher and PHT level is significantly lower in acute psychotic patients. Moreover, vitamin D levels were significantly lower in chronic psychotic patients compared to first-episode psychotic patients.
Collapse
Affiliation(s)
- Shahrzad Arya
- Research Center for Addiction and Risky Behaviors, Iran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Alireza Ebrahimi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parnia Kamyab
- Faculty of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Kaveh Alavi
- Department of Psychiatry, Mental Health Research Center, School of Behavioral Sciences & Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Zhina Zarei
- Research Center for Addiction and Risky Behaviors, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Ahmadkhaniha
- Research Center for Addiction and Risky Behaviors, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
3
|
Llorca-Bofí V, Bioque M, Font M, Gich I, Mur M. Correlation between C-reactive protein and the inflammatory ratios in acute schizophrenia inpatients: are they associated? J Psychiatr Res 2023; 165:191-196. [PMID: 37515951 DOI: 10.1016/j.jpsychires.2023.07.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/13/2023] [Accepted: 07/18/2023] [Indexed: 07/31/2023]
Abstract
C-reactive protein (CRP) and inflammatory ratios have been proposed to study immune dysregulation in schizophrenia. Nevertheless, links between CRP and inflammatory ratios in acute SCZ inpatients have been understudied. This study investigated the relationship between CRP and inflammatory ratios (Neutrophil-Lymphocyte Ratio [NRL], Platelet-Lymphocyte Ratio [PLR], Monocyte-Lymphocyte ratio [MLR] and Basophil-Lymphocyte Ratio [BLR]) in a total of 698 acute SCZ inpatients; and analysed how this relationship is affected by sex and type of episode. CRP correlated with NLR (rs = 0.338, p < 0.001), PLR (rs = 0.271, p < 0.001) and MLR (rs = 0.148, p < 0.001) but not with BLR (rs = 0.059, p = 0.121). Multiple lineal regression analysis showed that high levels of NLR, MLR and PLR but not BLR were independently associated with high CRP levels. No sex-related variations were found. Significant associations were maintained for NLR and MLR in first-episode and multiepisode SCZ, although the strength of the association was stronger in multiepisode SCZ. Again, no sex-related differences were found in these associations. In conclusion, inflammatory ratios were low to moderately associated with CRP in acute SCZ inpatients. NLR and multiepisode SCZ showed the highest associations with CRP. Future studies should consider inflammatory ratios not as a substitute for CRP but as a complementary biomarker.
Collapse
Affiliation(s)
- Vicent Llorca-Bofí
- Department of Medicine, University of Barcelona, Barcelona, Spain; Department of Psychiatry, Santa Maria University Hospital Lleida, Lleida, Spain; Institut de Recerca Biomèdica de Lleida (IRBLleida), Spain
| | - Miquel Bioque
- Department of Medicine, University of Barcelona, Barcelona, Spain; Barcelona Clínic Schizophrenia Unit (BCSU), Neuroscience Institute, Hospital Clínic de Barcelona, CIBERSAM, IDIBAPS, Barcelona, Spain
| | - Maria Font
- Laboratory Department, Arnau de Vilanova University Hospital, Lleida, Spain
| | - Ignasi Gich
- CIBER Epidemiología y Salud Pública (CIBERESP), Department of Clinical Epidemiology and Public Health, HSCSP, Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
| | - Maria Mur
- Department of Medicine and Surgery, Universitat de Lleida, Spain; Department of Psychiatry, Santa Maria University Hospital Lleida, Lleida, Spain; Institut de Recerca Biomèdica de Lleida (IRBLleida), Spain.
| |
Collapse
|
4
|
Leung KK, Wong YC, Shea KS, Chan SC, Chang WC, Mo YMF, Chan SMS. Altered neutrophil-to-lymphocyte ratio in patients with non-affective first episode psychosis and its relationship with symptom severity and cognitive impairment. Sci Rep 2023; 13:11453. [PMID: 37454218 PMCID: PMC10349799 DOI: 10.1038/s41598-023-37846-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 06/28/2023] [Indexed: 07/18/2023] Open
Abstract
Signatures of immune dysregulation as clinical biomarker for psychosis have remained unclear. We aimed to compare the Neutrophil-to-lymphocyte ratio (NLR) of patients with acute non-affective first-episode psychosis (FEP) with healthy controls after accounting for emotional states. We also explored the associations of NLR with symptom severity, onset profile and cognitive functions. The NLR was enumerated from complete blood count taken within a week of assessment. All FEP patients were rated on the Positive and Negative Syndrome Scale (PANSS) and the Clinician Global Impression-Severity (CGI-S) with verbal memory and executive functions assessed with the Cambridge Neuropsychological Test Automated Battery. Prevailing emotional state was measured with Beck Depression Inventory-II and Beck Anxiety Inventory. Out of seventy-nine consecutive FEP patients presenting to the study site, twenty-seven subjects were eligible and recruited. Twenty-seven age-/sex-matched controls were recruited. FEP patients had an NLR of 1.886 over the controls after accounting for scores on emotional states. The NLR of FEP patients was positively associated with CGI-S scores, PANSS positive symptom, disorganization and excitation scores. There was no significant correlation between NLR with the duration of untreated psychosis and cognitive performances. These findings support using NLR as a clinical biomarker in FEP, purporting further prospective study to measure NLR changes in the course of treatment.
Collapse
Affiliation(s)
- Kwan Keung Leung
- Department of Psychiatry, Tai Po Hospital, G30, Ground Floor, Multicentre, Tai Po Hospital, Tai Po, New Territories, Hong Kong, SAR, China
- Department of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
| | - Yip Chau Wong
- Department of Psychiatry, Tai Po Hospital, G30, Ground Floor, Multicentre, Tai Po Hospital, Tai Po, New Territories, Hong Kong, SAR, China
- Department of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
| | - Ka Sin Shea
- Department of Psychiatry, Tai Po Hospital, G30, Ground Floor, Multicentre, Tai Po Hospital, Tai Po, New Territories, Hong Kong, SAR, China
- Department of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
| | - Sheung Chun Chan
- Department of Psychiatry, Tai Po Hospital, G30, Ground Floor, Multicentre, Tai Po Hospital, Tai Po, New Territories, Hong Kong, SAR, China
- Department of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
| | - Wing Chung Chang
- Department of Psychiatry, Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yi Man Flora Mo
- Department of Psychiatry, Tai Po Hospital, G30, Ground Floor, Multicentre, Tai Po Hospital, Tai Po, New Territories, Hong Kong, SAR, China
- Department of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
| | - Sau Man Sandra Chan
- Department of Psychiatry, Tai Po Hospital, G30, Ground Floor, Multicentre, Tai Po Hospital, Tai Po, New Territories, Hong Kong, SAR, China.
- Department of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China.
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| |
Collapse
|
5
|
Bhatt S, Dhar AK, Samanta MK, Suttee A. Effects of Current Psychotropic Drugs on Inflammation and Immune System. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1411:407-434. [PMID: 36949320 DOI: 10.1007/978-981-19-7376-5_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
The immune system and inflammation are involved in the pathological progression of various psychiatric disorders such as depression or major depressive disorder (MDD), generalized anxiety disorder (GAD) or anxiety, schizophrenia, Alzheimer's disease (AD), and Huntington's disease. It is observed that levels of inflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and other markers are highly increased in the abovementioned disorders. The inflammation and immune component also lead to enhance the oxidative stress. The oxidative stress and increased production of reactive oxygen species (ROS) are considered as important factors that are involved in pathological progression of psychiatric disorders. Increase production of ROS is associated with excessive inflammation followed by cell necrosis and death. The psychotropic drugs are mainly work through modulations of neurotransmitter system. However, it is evident that inflammation and immune modulation are also having important role in the progression of psychiatric disorders. Rationale of the use of current psychotropic drugs is modulation of immune system by them. However, the effects of psychotropic drugs on the immune system and how these might contribute to their efficacy remain largely unclear. The drugs may act through modification of inflammation and related markers. The main purpose of this book chapter is to address the role of current psychotropic drugs on inflammation and immune system. Moreover, it will also address the role of inflammation in the progression of psychiatric disorders.
Collapse
Affiliation(s)
- Shvetank Bhatt
- School of Pharmacy, Dr. Vishwanath Karad MIT World Peace University, Pune, Maharashtra, India
- Amity Institute of Pharmacy, Amity University Madhya Pradesh, Gwalior, India
| | | | | | - Ashish Suttee
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| |
Collapse
|
6
|
Demir N, Yıldırım O. A Comparison of the Relationship Between C-Reactive Protein Levels and Cognitive Functions in Patients with Schizophrenia, First-Episode Psychosis, and Healthy Controls. PSYCHIAT CLIN PSYCH 2022; 32:274-284. [PMID: 38764885 PMCID: PMC11082596 DOI: 10.5152/pcp.2022.22447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 11/25/2022] [Indexed: 05/21/2024] Open
Abstract
Background There are several hypotheses on what causes schizophrenia, some of which include inflammatory responses. Additionally, it might be challenging to control and treat cognitive abnormalities, which represent the primary symptoms, and may be related to inflammation. This study aims to determine whether there is a relationship between C-reactive protein levels and cognitive abilities by assessing neuropsychological tests of drug-free patients with schizophrenia and first-episode psychosis. Methods The patient group consisted of 36 patients with schizophrenia or "first-episode psychosis," while the control group comprised 31 healthy people. The control group consisted of healthy participants without any medical or psychiatric diseases. Structured Clinical Interview for DSM-5 axis I disorders was applied for diagnosis, while Wisconsin card sorting test, Stroop color and word test, trail making tests, Rey auditory verbal learning test, and digit span test were applied for cognitive assessment of both groups. Clinical characteristics of patients were evaluated by using the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, and the Calgary Depression Scale for Schizophrenia. The patient group and healthy control group were evaluated in terms of inflammation levels. The C-reactive protein levels were measured, and their relationship with cognitive status was examined. The serum samples were analyzed by the immunoturbidimetric method in C-reactive protein C8000 Architect (Abbott, Ill, USA) to measure the C-reactive protein levels. Results C-reactive protein levels were found to be higher in the patient group (P = .003), while the Scale for the Assessment of Negative Symptoms and Scale for the Assessment of Positive Symptoms scores were found to be positively correlated with C-reactive protein levels. Cognitive functions in the patient group were significantly lower compared to the healthy group. There was a statistically weak correlation between C-reactive protein and the number of word color reading errors in the Stroop test, which was associated with complex and frontal attention; however, no correlation was found with digit span test, Rey auditory verbal learning test, or Wisconsin card sorting test points. Conclusion Elevated peripheral levels of C-reactive protein are associated with poorer cognitive function in patients with first-episode psychosis and schizophrenia, particularly, complex attention associated with the Stroop test. Inflammation may have an impact on cognitive impairment in psychosis.
Collapse
Affiliation(s)
- Nefise Demir
- Department of Psychiatry, Karabük University, School of Medicine, Karabük, Turkey
| | - Osman Yıldırım
- Department of Psychiatry, Reyap Hospital İstanbul, İstanbul Rumeli University, İstanbul, Turkey
| |
Collapse
|
7
|
Lestra V, Romeo B, Martelli C, Benyamina A, Hamdani N. Could CRP be a differential biomarker of illness stages in schizophrenia? A systematic review and meta-analysis. Schizophr Res 2022; 246:175-186. [PMID: 35785580 DOI: 10.1016/j.schres.2022.06.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 05/13/2022] [Accepted: 06/22/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Patients with schizophrenia display peripheral inflammation but the impact of illness phase is not clear. Our meta-analysis investigated the difference in CRP levels between patients with schizophrenia and controls according to their illness phase. METHODS After a systematic search, all studies measuring CRP in patients with schizophrenia and controls were included. Standardized mean differences were calculated between patients and controls according to illness phase. The influence of sociodemographic and clinical variables on our results was investigated using a meta-regression analysis. RESULTS Fifty studies were included in this meta-analysis. Patients with schizophrenia had higher CRP levels than controls in the acute (p < 0.00001) and stable (p < 0.00001) stage of their disease. Patients with acute exacerbation of schizophrenia had higher CRP levels than stable patients (p = 0.02) but this difference did not persist when considering antipsychotic-medicated patients in both phases. Meta-regressions found that the increase of CRP in acutely ill patients as compared to controls was influenced by age (p < 0.01), BMI (p = 0.01) and first episode (p = 0.02), whereas the increase in CRP levels of stable patients as compared to controls was moderated by BMI (p = 0.004). CONCLUSIONS In conclusion, this meta-analysis provides strong evidence that patients with schizophrenia have higher CRP levels than controls, but also show an increase in inflammatory response in the acute stage of the disease as compared to the stable stage. CRP could thus be considered as a state marker and a trait marker of the disease.
Collapse
Affiliation(s)
- V Lestra
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800 Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions, PSYCOMADD 4872, Université Paris-Sud - AP-HP, Université Paris Saclay, France
| | - B Romeo
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800 Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions, PSYCOMADD 4872, Université Paris-Sud - AP-HP, Université Paris Saclay, France.
| | - C Martelli
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800 Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions, PSYCOMADD 4872, Université Paris-Sud - AP-HP, Université Paris Saclay, France; Institut National de la Santé et de la Recherche Médicale U1299, Research unit, NeuroImaging and Psychiatry, Paris Sud University, Paris Saclay University, Paris Descartes University, Digiteo Labs, Bâtiment 660, Gif-sur-Yvette, France
| | - A Benyamina
- APHP, Paul Brousse Hospital, Department of Psychiatry and Addictology, F-94800 Villejuif, France; Unité Psychiatrie-Comorbidités-Addictions, PSYCOMADD 4872, Université Paris-Sud - AP-HP, Université Paris Saclay, France
| | - N Hamdani
- Unité Psychiatrie-Comorbidités-Addictions, PSYCOMADD 4872, Université Paris-Sud - AP-HP, Université Paris Saclay, France; Cédiapsy, 87 rue d'Assas, 75006 Paris, France
| |
Collapse
|
8
|
Coentre R, Levy P, Góis C, Figueira ML. Metabolic syndrome following a first episode of psychosis: results of a 1-year longitudinal study conducted in metropolitan Lisbon, Portugal. J Int Med Res 2022; 50:3000605221106703. [PMID: 35726606 PMCID: PMC9218473 DOI: 10.1177/03000605221106703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective We aimed to assess the prevalence and course of metabolic syndrome (MetS) and the associated metabolic parameters during the year following a first episode pf psychosis (FEP). Methods We performed a 1-year longitudinal observation of 60 patients who experienced FEP. MetS was defined using the modified definition of the National Cholesterol Education Program Adult Treatment Panel III. We assessed the metabolic parameters and socio-demographic and psychopathological data for the participants. Results The mean age of the participants was 27.1 years, and 33.3% of them were women. There was an increase in the prevalence of MetS from 6.7% to 11.7% during the year following the baseline assessment during the year following the baseline assessment (p = 0.250). There were also significant increases in the prevalences of abnormal triglyceride concentration, waist circumference, and high-density lipoprotein (HDL)-cholesterol concentration during this period. In addition, there was a considerable worsening of the metabolic profile of the participants. No baseline parameters were identified to be predictors of MetS over the 1-year follow-up period. Conclusions We can conclude that metabolic abnormalities are common in patients with FEP and that these rapidly worsen during the first year following the diagnosis of FEP. Studies on interventions are needed to reduce metabolic risk to cardiovascular diseases following the FEP.
Collapse
Affiliation(s)
- Ricardo Coentre
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Department of Psychiatry, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - Pedro Levy
- Department of Psychiatry, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | - Carlos Góis
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Department of Psychiatry, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
| | | |
Collapse
|
9
|
Kang KY, Jung YE, Jang H, Kim MD, Bahk WM. Relationship between Handgrip Strength and Low-grade Inflammation in Older Adults with Depression. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:721-730. [PMID: 34690127 PMCID: PMC8553523 DOI: 10.9758/cpn.2021.19.4.721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 01/08/2023]
Abstract
Objective The relationship among physical functional decline, low-grade inflammation, and depression remains unclear. The aim of this study was to examine the association between hand grip strength (HGS) and high-sensitivity C-reactive protein (hs-CRP) in a large sample with depression. Methods This study used data obtained from a representative Korean sample of 9,402 people who participated in the seventh Korean National Health and Nutrition Examination Survey. Physical function was assessed using a digital grip strength dynamometer. Depression was identified using a cutoff of 5 on the Patient Health Questionnaire-9 (PHQ-9), and high hs-CPR level was defined as ≥ 3.0 mg/L. Results In older adults (≥ 60 years) with depression, 43.8% of those with high hs-CRP levels had low HGS, compared to 21.8% of those with hs-CRP levels < 3.0 mg/L (p = 0.002). Multivariate analysis revealed that, after adjustments for potentially confounding factors, high hs-CRP was independently associated with lower HGS (B = −2.25; 95% confidence interval = −4.49 to −0.02) in older adults with depression, but not in younger or middle-aged adults with depression. Conclusion These findings suggest a significant correlation between physical functional decline and low-grade inflammation in older adults with depression.
Collapse
Affiliation(s)
- Kwi Young Kang
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Division of Rheumatology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Young-Eun Jung
- Department of Psychiatry, College of Medicine, Jeju National University, Jeju, Korea
| | - Hwan Jang
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Moon-Doo Kim
- Department of Psychiatry, College of Medicine, Jeju National University, Jeju, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
10
|
Kozłowska E, Brzezińska-Błaszczyk E, Agier J, Wysokiński A, Żelechowska P. Alarmins (IL-33, sST2, HMGB1, and S100B) as potential biomarkers for schizophrenia. J Psychiatr Res 2021; 138:380-387. [PMID: 33957300 DOI: 10.1016/j.jpsychires.2021.04.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/03/2021] [Accepted: 04/12/2021] [Indexed: 12/17/2022]
Abstract
There is growing evidence that immune/inflammatory processes are related to the etiology of schizophrenia. Danger-/damage-associated molecular patterns (DAMPs), also called alarmins, are recognized as inflammatory mediators that play an important role in the development of many infection-induced or sterile inflammatory diseases. The importance of DAMPs particles in various mental disorders is still not clear. Therefore, this study aimed to evaluate serum levels of the most promising alarmins (IL-33, sST2, HMGB1, and S100B), as potent schizophrenia biomarkers. Sixty-eight adult patients with chronic schizophrenia and twenty-nine healthy volunteers were included in this prospective study. Enzyme-linked immunosorbent assay (ELISA) was used to assess the serum concentration of IL-33, sST2, HMGB1, and S100B. We documented that the serum levels of IL-33 (p = 0.006), sST2 (p = 0.02), HMGB1 (p = 0.01), and S100B (p = 0.04) are significantly higher in patients with schizophrenia than in healthy subjects. In male, but not in female, patients with schizophrenia, we found a significant difference in the serum IL-33, sST2, and HMGB1 concentrations as compared to the healthy men. In both male and female patients with schizophrenia, there was no significant difference in the serum concentrations of S100B in comparison to control subjects. In patients with schizophrenia, no significant correlations were noticed neither between any studied alarmins and PANSS scores nor between CDSS scores. Given that all investigated alarmins participate in the course of the neuroinflammatory process, they might be considered as biomarkers of neuroinflammatory process underlying schizophrenia. Based on our observations, it seems that the most useful biological indicator of schizophrenia would be IL-33.
Collapse
Affiliation(s)
- Elżbieta Kozłowska
- Department of Experimental Immunology, Medical University of Lodz, Lodz, Poland.
| | | | - Justyna Agier
- Department of Experimental Immunology, Medical University of Lodz, Lodz, Poland
| | - Adam Wysokiński
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Lodz, Poland
| | - Paulina Żelechowska
- Department of Experimental Immunology, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
11
|
Li C, Shi Z, Ji J, Niu G, Liu Z. Associations of C-Reactive Protein, Free Triiodothyronine, Thyroid Stimulating Hormone and Creatinine Levels with Agitation in Patients with Schizophrenia: A Comparative Cross-Sectional Study. Neuropsychiatr Dis Treat 2021; 17:2575-2585. [PMID: 34408419 PMCID: PMC8364367 DOI: 10.2147/ndt.s322005] [Citation(s) in RCA: 6] [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: 05/28/2021] [Accepted: 08/01/2021] [Indexed: 01/11/2023] Open
Abstract
PURPOSE Agitation is prevalent among inpatients with schizophrenia. The aim of this study was to investigate whether biochemical parameters are associated with agitation in schizophrenia. PATIENTS AND METHODS Agitation was evaluated by the Positive and Negative Syndrome Scale-Excited Component questionnaire (PANSS-EC). Fasting serum levels of C-reactive protein (CRP), free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), uric acid (UA), creatinine, glucose and lipids were measured. RESULTS The analysis included 154 inpatients with schizophrenia (71 with agitation, 83 without agitation) and 75 healthy control subjects. Patients with schizophrenia and agitation had higher serum levels of CRP, FT3, FT4 and UA as well as lower levels of serum TSH and creatinine than patients without agitation (all P < 0.05). Multivariate logistic regression analysis indicated that serum CRP (odds ratio [OR] = 1.470, P = 0.001), FT3 (OR = 13.026, P < 0.001), TSH (OR = 0.758, P = 0.033) and creatinine (OR = 0.965, P = 0.004) were significantly associated with agitation in schizophrenia. CRP, FT3, TSH and creatinine achieved an area under the ROC curve of 0.626, 0.728, 0.620 and 0.663 respectively in discriminating schizophrenia with or without agitation. CONCLUSION Increased serum CRP and FT3 levels and decreased serum TSH and creatinine levels are independent risk factors for agitation in hospitalized patients with schizophrenia. Inflammation, thyroid hormones and renal function may be involved in the pathogenesis of agitation in schizophrenia.
Collapse
Affiliation(s)
- Chao Li
- Department of Psychiatry, Jining Medical University, Jining, 272067, People's Republic of China
| | - Zhenchun Shi
- Department of Psychiatry, Shandong Mental Health Center, Jinan, 250014, People's Republic of China
| | - Jiacui Ji
- Department of Psychiatry, Shandong Mental Health Center, Jinan, 250014, People's Republic of China
| | - Gengyun Niu
- Department of Psychiatry, Jining Medical University, Jining, 272067, People's Republic of China
| | - Zengxun Liu
- Department of Psychiatry, Shandong Mental Health Center, Jinan, 250014, People's Republic of China
| |
Collapse
|
12
|
Sahpolat M, Ari M, Kokacya MH. Plasma Apelin, Visfatin and Resistin Levels in Patients with First Episode Psychosis and Chronic Schizophrenia. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2020; 18:109-115. [PMID: 31958911 PMCID: PMC7006973 DOI: 10.9758/cpn.2020.18.1.109] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/21/2019] [Accepted: 07/23/2019] [Indexed: 01/15/2023]
Abstract
Objective This study aims to investigate the possible relationship between plasma concentrations of apelin, visfatin and resistin levels of first episode psychosis patients and chronic schizophrenia patients. Methods A total number of 29 untreated patients with first episode psychosis, 30 chronic schizophrenia and 29 randomly selected weight- and body mass index-matched healthy volunteers were included. The Diagnostic and Statistical Manual of Mental Disorders 4th edition, Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression Scale were applied to the patient groups. The enzyme-linked immunosorbent assay method was used to measure plasma apelin, visfatin and resistin levels. Results There was no difference in age, marital status, occupation, and BMI between the groups. Plasma apelin levels were significantly higher in first episode psychosis group than chronic schizophrenia and control group. There was no statistically significant difference in plasma visfatin levels between the groups: first episode psychosis group, chronic schizophrenia and control group. Plasma resistin levels were higher in both first episode psychosis group and chronic schizophrenia group than the control group. There was no statistically significant correlation between plasma apelin and resistin levels and total PANSS scores in the group of patients. Conclusion To our knowledge, this study is the first which investigates the plasma apelin, visfatin and resistin levels in patients with first episode psychosis and chronic schizophrenia. Based on the results of this study, apelin and resistin may be related with some central nervous system pathologies, including the severity of a psychiatric disorder.
Collapse
Affiliation(s)
- Musa Sahpolat
- Department of Psychiatry, Kilis State Hospital, Kilis, Turkey
| | - Mustafa Ari
- eparment of Psychiatry, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey
| | - Mehmet Hanifi Kokacya
- eparment of Psychiatry, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey
| |
Collapse
|
13
|
Hong J, Bang M. Anti-inflammatory Strategies for Schizophrenia: A Review of Evidence for Therapeutic Applications and Drug Repurposing. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2020; 18:10-24. [PMID: 31958901 PMCID: PMC7006977 DOI: 10.9758/cpn.2020.18.1.10] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 09/12/2019] [Accepted: 11/04/2019] [Indexed: 02/06/2023]
Abstract
Schizophrenia is a debilitating psychiatric disorder with a substantial socioeconomic and humanistic burden. Currently available treatment strategies mostly rely on antipsychotic drugs, which block dopaminergic effects in the mesolimbic pathway of the brain. Although antipsychotic drugs help relieve psychotic symptoms, a definitive cure for schizophrenia has yet to be achieved. Recent advances in neuroinflammation research suggest that proinflammatory processes in the brain could cause alterations in neurobehavioral development and increase vulnerability to schizophrenia. With a growing need for novel strategies in the treatment of schizophrenia, it would be meaningful to review the current evidence supporting the therapeutic potential of anti-inflammatory strategies. This review details the key findings of clinical trials that investigate the efficacy of anti-inflammatory agents as adjuvants to antipsychotic treatment. We further discuss the possibilities of repurposing anti-inflammatory agents and developing novel strategies for the treatment of schizophrenia.
Collapse
Affiliation(s)
- Jonghee Hong
- CHA University School of Medicine, Seongnam, Korea
| | - Minji Bang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| |
Collapse
|
14
|
Chang CH, Lane HY, Liu CY, Cheng PC, Chen SJ, Lin CH. C-reactive protein is associated with severity of thought and language dysfunction in patients with schizophrenia. Neuropsychiatr Dis Treat 2019; 15:2621-2627. [PMID: 31571879 PMCID: PMC6750161 DOI: 10.2147/ndt.s223278] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 08/26/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Numerous studies have demonstrated an association between C-reactive protein (CRP) levels and schizophrenia. However, the findings on psychotic severity and cognition remain inconsistent. The relationship between CRP and formal thought disorder in subdomains remains unclear. METHODS We enrolled stable patients (defined as those who had no treatment changes during the 4-week period before evaluation) with a diagnosis of schizophrenia or schizoaffective disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. We used the 30-item Thought and Language Disorder (TALD) scale to evaluate thought and language dysfunction over four subscales. We assessed psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS). We collected fasting venous blood and measured plasma CRP levels. RESULTS We enrolled 60 patients with schizophrenia. All patients received TALD and PANSS evaluation, and 33 of them had their CRP levels checked. The multivariate regression analysis indicated that CRP levels were significantly associated with the total score on the TALD (t=2.757, P=0.010) and the TALD Objective Positive subscale (t=2.749, P=0.011), after sex, age, duration of illness (in years), and use of atypical antipsychotics were adjusted for. Additionally, CRP was significantly associated with the PANSS positive subscale (t=2.102, P=0.045). A significantly positive correlation was observed between the total scores on the TALD scale and PANSS (ρ =0.751, P<0.001). CONCLUSION Our results suggest that abnormal CRP levels are significantly associated with formal thought and language dysfunction in the Objective Positive subdomain and positive psychotic symptoms.
Collapse
Affiliation(s)
- Chun-Hung Chang
- Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.,Department of Psychiatry & Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan.,An Nan Hospital, China Medical University, Tainan, Taiwan
| | - Hsien-Yuan Lane
- Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.,Department of Psychiatry & Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.,Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
| | - Chieh-Yu Liu
- Biostatistical Consulting Laboratory, Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Po-Chih Cheng
- Biostatistical Consulting Laboratory, Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shaw-Ji Chen
- Department of Psychiatry, Mackay Memorial Hospital Taitung Branch, Taitung, Taiwan.,Department of Medicine, Mackay Medical College, New Taipei, Taiwan
| | - Chieh-Hsin Lin
- Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.,Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| |
Collapse
|