Inflammatory markers of symptomatic remission at 6 months in patients with first-episode schizophrenia

Abstract

Neuroinflammation contributes to the pathophysiology of various mental illnesses including schizophrenia. We investigated peripheral inflammatory cytokines as a biomarker for predicting symptomatic remission in patients with first-episode schizophrenia. The study included 224 patients aged 15–60 years who fulfilled the criteria for schizophrenia spectrum disorder with a treatment duration ≤6 months. Serum levels of tumor necrosis factor (TNF) -α, interferon-γ, interleukin (IL)-1α, IL-1β, IL-6, IL-8, IL-10, and IL-12 were measured. Psychotic symptoms, depressive symptoms, and general functioning were assessed using the Positive and Negative Syndrome Scale, Beck Depression Inventory (BDI), Calgary Depression Scale for Schizophrenia, and Personal and Social Performance scale, respectively. Duration of untreated psychosis (DUP) was also recorded. We investigated the factors associated with remission for each sex in logistic regression analysis. In total, 174 patients achieved remission at the 6-month follow-up (females, 83.5%; males, 70.9%). Remission was associated with older age and lower BDI scores in male patients and with lower TNF-α levels and shorter DUP in female patients. Our findings suggest that peripheral inflammatory cytokines may impede early symptomatic remission in female patients with schizophrenia. In addition, depressive symptoms in males and long DUP in females may be poor prognostic factors for early remission in patients with first-episode psychosis.

The Underlying Neurobiological Mechanisms of Psychosis: Focus on Neurotransmission Dysregulation, Neuroinflammation, Oxidative Stress, and Mitochondrial Dysfunction

“…It has also been reported that increased concentrations of pro-inflammatory cytokines were seen not only in first episode psychosis patients, but in young at-risk adults prior to the onset of psychosis [ 41 , 42 ], and it has been hypothesized that these cytokines may be useful trait markers for psychosis [ 41 ]. A recent clinical study by Kim et al [ 43 ] also examined the longitudinal relationship between peripheral pro-inflammatory cytokines and symptomology in first-episode schizophrenia patients, and the results revealed a strong correlation between cytokine concentration and symptomology [ 43 ]. The chronic use of methamphetamine has also been linked to a perturbed immune homeostasis characterized by increased pro-inflammatory cytokine concentrations [ 44 ].…”

Increased blood–brain barrier leakage in schizophrenia spectrum disorders compared to healthy controls in dynamic contrast-enhanced magnetic resonance imaging

“…FEP have been associated with reduced antioxidant status, a proinflammatory imbalance [66] and higher pro-inflammatory cytokine (PIC) levels [67], suggesting inflammatory mechanisms to be of high relevance in the initial disease stage [68]. This is of clinical relevance, as inflammatory processes such as high levels of PICs have been reported to impede early symptomatic remission [69]. Circulating PICs (e.g.…”