High mobility group box-1 levels in schizophrenia: Potential biomarker of remission phase

Abstract

Background: Schizophrenia is a chronic mental disorder, characterized by acute exacerbation and remission phases. Immune system has a role in the pathophysiology of schizophrenia. High mobility group box-1 (HMGB-1) is a macrophage secreted protein activating immune cells to produce cytokines. The aim of this study was to evaluate HMGB-1 levels among patients with schizophrenia both in acute exacerbation and remission phases.
 Methods: Consecutive schizophrenia patients in acute exacerbation and remission phases were enrolled and compared with each other and with age-sex matched healthy subjects. Patients were assessed with the Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS), Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression Scale (CGI).
 Results: Mean HMGB-1 levels were not significantly different in acute exacerbation phase versus remission phase schizophrenia patients (2139±564 pg/ml vs. 2326±471 pg/ml, p=0.335) and both were individually higher than the control group (1791±444 pg/ml, p=0.05 for acute exacerbation vs control, p=0.002 for remission vs control). In remission phase schizophrenic patients, HMGB-1 levels were positively correlated with Scale For The Assessment of Positive Symptoms (r=0.447, p=0.015) and BPRS (r=0.397, p=0.033) scores and HMGB-1 levels were independently associated with BPRS.
 Conclusion: Serum HMGB-1 levels were shown to be increased in patients with schizophrenia patients irrespective of phase and HMGB-1 levels were related to symptom severity according to psychiatric scales among patients in remission phase of schizophrenia.

Alterations in innate immune defense distinguish first-episode schizophrenia patients from healthy controls

“…Our result showed that HMGB1 concentration had the largest effect size for difference between the FES patients and HCs, as indicated by partial η 2 , among the three molecules we measured. A few studies have described the involvement of HMGB1 in psychosis, and our results are highly consistent with existing findings in different stages of SCZ, including patients with FES ( 21 ), patients in acute exacerbation phase and chronic patients ( 17 , 42 , 43 ), which all display that SCZ is characterized by increased levels of HMGB1 as compared with HCs. HMGB1 is released by two distinct pathways: passive release by damaged or necrotic cells, and active secretion from activated innate immune cells (such as monocytes, macrophages, and microglia) ( 15 ).…”

Systematic Review and Meta-Analysis of Damage Associated Molecular Patterns HMGB1 and S100B in Schizophrenia

“…One article was applicable for inclusion in both S100B and HMGB1 analysis [ 45 ]. Two other articles were suitable for inclusion in the HMGB1 group [ 46 , 47 ] and 28 articles were applicable for inclusion in the S100B group which are systematically reported in Supplementary Table 1 (in the online-only Data Supplement). Quantitative analysis of HMGB1 concentration was performed on serum samples from participants using an ELISA assay for all three studies.…”

“…Quantitative analysis of HMGB1 concentration was performed on serum samples from participants using an ELISA assay for all three studies. Kozłowska et al [ 45 ], (2021), measured clinical symptom severity using the Scale for assessment of Negative Symptoms (SANS), and Calgary Depression Scale for Schizophrenia (CDSS), while Mousa et al [ 46 ], (2021) and Yilmaz et al [ 47 ], (2021) used the Positive and Negative Symptom Scale (PANSS).…”

Advanced Biomarkers of Hepatotoxicity in Psychiatry: A Narrative Review and Recommendations for New Psychoactive Substances

“…Yilmaz et al show that serum HMGB1 levels are elevated in schizophrenic patients, irrespective of the phase of the illness, both in the exacerbation and remission phases. Biomarker concentrations were higher in the serum of the study group compared with that of the healthy controls [101]. Furthermore, Mousa et al confirmed higher levels of HMGB1 in schizophrenic patients and additionally identified HMGB1 as one of the six main predictors of scores on the FF scale (the fibromyalgia and chronic fatigue syndrome rating scale in schizophrenics) [102,103].…”