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Langbein K, Hesse J, Gussew A, Milleit B, Lavoie S, Amminger GP, Gaser C, Wagner G, Reichenbach JR, Hipler UC, Winter D, Smesny S. Disturbed glutathione antioxidative defense is associated with structural brain changes in neuroleptic-naïve first-episode psychosis patients. Prostaglandins Leukot Essent Fatty Acids 2018; 136:103-110. [PMID: 29111383 DOI: 10.1016/j.plefa.2017.10.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 09/30/2017] [Accepted: 10/16/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Oxidative stress and impaired antioxidant defense are reported in schizophrenia and are thought to be associated with disturbed neurodevelopment, brain structural alterations, glutamatergic imbalance, negative symptomatology, and cognitive impairment. To test some of these assumptions we investigated the glutathione (GSH) antioxidant defense system (AODS) and brain structural abnormalities in drug-naïve individuals with first acute episode of psychosis (FEP). METHOD The study involved 27 drug-naïve FEP patients and 31 healthy controls (HC). GSH AODS markers and TBARS (thiobarbituric acid reactive substances) were measured in blood plasma and erythrocytes. High-resolution T1-weighted 3T MRI were acquired from all subjects. To investigate brain structural abnormalities and effects of illness on interactions between GSH metabolites or enzyme activities and local grey matter density, voxel-based morphometry (VBM) with the computational anatomy toolbox (CAT12) was used. Symptomatology was assessed using the Positive and Negative Syndrome Scale (PANSS) and the Symptom Checklist 1990 revised (SCL-90-R). RESULTS (i) In FEP patients, glutathione reductase activity (GSR) was lower than in the HC group. GSR activity in plasma was inversely correlated with SCL-90-R scores of depression and PANSS scores of the negative symptom subscale. (ii) A reduction of GM was observed in left inferior frontal, bilateral temporal, as well as parietal cortices of FEP patients. (iii) Interaction analyses revealed an influence of illness on GSR/GM associations in the left orbitofrontal cortex (BA 47). CONCLUSION Our findings support the notion of altered GSH antioxidative defense in untreated acute psychosis as a potential pathomechanism for localized brain structural abnormalities. This pathology relates to a key brain region of social cognition, affective motivation control and decision making, and is clinically accompanied by depressive and negative symptoms.
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Affiliation(s)
- K Langbein
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.
| | - J Hesse
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - A Gussew
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany
| | - B Milleit
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Department of Dermatology, University Hospital Jena, Jena, Germany
| | - S Lavoie
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - G P Amminger
- Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - C Gaser
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Department of Neurology, Jena University Hospital, Jena, Germany
| | - G Wagner
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - J R Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany
| | - U-C Hipler
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - D Winter
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - S Smesny
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
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Smesny S, Milleit B, Hipler UC, Milleit C, Schäfer MR, Klier CM, Holub M, Holzer I, Berger GE, Otto M, Nenadic I, Berk M, McGorry PD, Sauer H, Amminger GP. Omega-3 fatty acid supplementation changes intracellular phospholipase A2 activity and membrane fatty acid profiles in individuals at ultra-high risk for psychosis. Mol Psychiatry 2014; 19:317-24. [PMID: 23478748 DOI: 10.1038/mp.2013.7] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 12/10/2012] [Accepted: 01/02/2013] [Indexed: 02/07/2023]
Abstract
The identification of an ultra-high risk (UHR) profile for psychosis and a greater understanding of its prodrome have led to increasing interest in early intervention to delay or prevent the onset of psychotic illness. In a randomized placebo-controlled trial, we have identified long-chain ω-3 (ω-3) polyunsaturated fatty acid (PUFA) supplementation as potentially useful, as it reduced the rate of transition to psychosis by 22.6% 1 year after baseline in a cohort of 81 young people at UHR of transition to psychosis. However, the mechanisms whereby the ω-3 PUFAs might be neuroprotective are incompletely understood. Here, we report on the effects of ω-3 PUFA supplementation on intracellular phospholipase A2 (inPLA(2)) activity, the main enzymes regulating phospholipid metabolism, as well as on peripheral membrane lipid profiles in the individuals who participated in this randomized placebo-controlled trial. Patients were studied cross-sectionally (n=80) and longitudinally (n=65) before and after a 12-week intervention with 1.2 g per day ω-3 PUFAs or placebo, followed by a 40-week observation period to establish the rates of transition to psychosis. We investigated inPLA(2) and erythrocyte membrane FAs in the treatment groups (ω-3 PUFAs vs placebo) and the outcome groups (psychotic vs non-psychotic). The levels of membrane ω-3 and ω-6 PUFAs and inPLA(2) were significantly related. Some of the significant associations (that is, long-chain ω-6 PUFAs, arachidonic acid) with inPLA(2) activity were in opposite directions in individuals who did (a positive correlation) and who did not (a negative correlation) transition to psychosis. Supplementation with ω-3 PUFA resulted in a significant decrease in inPLA(2) activity. We conclude that ω-3 PUFA supplementation may act by normalizing inPLA(2) activity and δ-6-desaturase-mediated metabolism of ω-3 and ω-6 PUFAs, suggesting their role in neuroprogression of psychosis.
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Affiliation(s)
- S Smesny
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | - B Milleit
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | - U-C Hipler
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - C Milleit
- 1] Department of Psychiatry, University Hospital Jena, Jena, Germany [2] Department of Dermatology, University Hospital Jena, Jena, Germany
| | - M R Schäfer
- 1] Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria [2] Orygen Youth Health Research Centre, University of Melbourne, Melbourne, VIC, Australia
| | - C M Klier
- Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria
| | - M Holub
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - I Holzer
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - G E Berger
- Department of Adolescent Psychiatry Winterthur-Zürcher Unterland, Switzerland
| | - M Otto
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | - I Nenadic
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | - M Berk
- 1] Orygen Youth Health Research Centre, University of Melbourne, Melbourne, VIC, Australia [2] Deakin University of Melbourne, School of Medicine, Barwon Health, Geelong, VIC, Australia [3] Florey Institute for Neuroscience and Mental Health, Melbourne, VIC, Australia
| | - P D McGorry
- Orygen Youth Health Research Centre, University of Melbourne, Melbourne, VIC, Australia
| | - H Sauer
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | - G P Amminger
- 1] Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria [2] Orygen Youth Health Research Centre, University of Melbourne, Melbourne, VIC, Australia
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Smesny S, Milleit B, Schäfer M, Milleit C, Otto M, Hipler UC, Berger G, Sauer H, Amminger P. N-3 Fatty Acid Supplementation Influences Membrane Fatty Acids and Phospholipase A 2 Activity in Patients at Risk to Develop Psychosis. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)72834-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
IntroductionDecreased levels of polyunsaturated membrane fatty acids (PUFA) and increased activity of cytosolic phospholipase A2 (PLA2) enzymes (key regulating enzymes of membrane remodelling and PUFA availability) are supporting pillars of the “membrane phospholipids concept of schizophrenia”. Assuming that membrane PUFA profile and PLA2 activity are altered during the at risk phase of disorder and influenced by fatty acid supplementation, we investigated PUFA profiles and PLA2 activity simultaneously in ultra high-risk (UHR) subjects before and after (n-3) fatty acids supplementation.MethodIn 81 UHR patients (aged between 13 and 25 years) PUFA levels were assessed in erythrocyte membranes using gas chromatography, and cytosolic PLA2 activity was measured in blood serum using a fluorometric HPTLC-based assay. Measurements were performed before and after a 6 month interval of placebo-controlled supplementation with n-3 fatty acids.ResultsAt baseline significant associations were found between (n-9) and (n-6)-PUFA levels and psychopathology (especially in negative symptoms) assessed by the PANSS according to PACE criteria. (n-3)-PUFA supplementation caused significant changes in (n-3)- and (n-6)-PUFA levels and a significant decrease of PLA2 activity.ConclusionOur results support associations between membrane biochemistry and psychopathology (especially negative symptoms) in people at risk to develop psychosis. Supplementation of n-3 PUFA increases PUFA availability at membrane level and modulates membrane repair and remodelling processes. Assuming that PLA2 activity reflects neuronal damage, PUFA supplementation might unfold neuroprotective effects.
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