This study aimed to investigate the efficacy and safety of antitumor necrosis factor-alpha (TNF-α) therapy using adalimumab in patients with chronic schizophrenia. This is a randomized, double-blind, placebo-controlled clinical trial carried out at Roozbeh Hospital (Tehran, Iran) from June 2020 to October 2021. The patients were randomly divided into two parallel adalimumab + risperidone and placebo + risperidone groups. Participants in the intervention group received adalimumab subcutaneous injection (40 mg) by pen-injector at weeks 0 and 4. Using the Positive and Negative Symptoms Scale (PANSS), patients’ positive and negative symptoms were assessed at weeks 0, 4, and 8. Forty patients (20 in each group) were included. PANSS total (t = 4.43, df = 38, P < 0.001), negative (t = 2.88, df = 38, P = 0.006), and general psychopathology (t = 4.06, df = 38, P < 0.001) scores demonstrated a significantly greater decline in adalimumab compared with the placebo group from baseline study endpoint. However, improvement of PANSS positive subscale scores showed no significant difference from the baseline study endpoint. There was no significant between-group difference regarding levels of C-reactive protein, interleukin (IL)-1β, TNF-α, IL-6, and IL-8 at baseline and also at the week 8 visit (P > 0.05 for all). The current study found adalimumab adjunctive therapy effective in treating schizophrenia, particularly its negative and general psychopathology symptoms, with no side effects.

Background: In response to the poor prognosis of oral squamous cell carcinoma (OSCC), the most frequent cancer in the oral cavity, efforts have been made to create more effective treatment methods based on natural products. Lichens are a source of active pharmacologic compounds, which have lately been discovered to be helpful in cancer treatment. Current research seeks to evaluate the impact of Ramalina sinensis (R. sinensis) lichen on the cell viability and apoptosis of OSCC cell lines, considering lichens’ anti-inflammatory and anticancer capabilities. Methods: R. sinensis was selected for investigation of its effects on human oral squamous cell carcinoma cell line (KB cell line, NCBI Code: C152) and acetone and effect of methanol extract of R. sinensison OSCC cell line was investigated. The chemical composition and metabolic profiling of R. sinensis were investigated. Viability was assessed by MTT assay analysis, and apoptotic cells were measured using flow cytometry analysis. Scratch assay was used to assess cell migration. Results: The chemical composition of R. sinensis was investigated using LC-ESI-MS/MS, and 33 unique compounds in acetone and methanol extract of R. sinensis were detected. The proliferation of KB cells was gradually but significantly inhibited by 6.25, 12.5, 25, 50, 100, and 200 μg/mL in a time-dependent manner. There was a statistically significant difference between acetone and methanol extract in the inhibition of cell proliferation. Flow cytometry results indicate an increase in apoptosis of OSCC cells by acetone extract. R. sinensis significantly inhibited the migration and invasion of OSCC cells in a concentration-dependent manner. Conclusion: The results of the present study showed the positive effects of R. sinensis extract on the apoptosis of OSCC cells and the anticancer effects of R. sinensisextracts.