The Promise of Biological Markers for Treatment Response in First-Episode Psychosis: A Systematic Review

Fond, Guillaume; d’Albis, Marc-Antoine; Jamain, Stéphane; Tamouza, Ryad; Arango, Celso; Fleischhacker, W. Wolfgang; Glenthøj, Birte; Leweke, F. Markus; Lewis, Shôn; McGuire, Philip; Meyer‐Lindenberg, Andreas; Sommer, Iris E.; Rossum, Inge Winter-van; Kapur, Shitij; Kahn, René S.; Rujescu, Dan; Leboyer, Marion

doi:10.1093/schbul/sbv002

Cited by 90 publications

(73 citation statements)

References 138 publications

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“…As changes in cytokine profile come with the onset of the disorder, studying inflammatory biomarkers in untreated FEP is relevant, since antipsychotic drugs are known to influence their levels [8]. However, few studies have so far assessed the association between cytokine levels and treatment response in FEP [8].…”

Section: Immunoinflammatory Biomarkersmentioning

confidence: 99%

“…Biomarkers are objective, quantifiable characteristics of biological processes, disease states, or responses to treatment [8,9]. Lack of objective tools to identify common patient characteristics, makes the development of biomarkers critical in psychiatry for the application of a more directed and individualised treatment [8,10].…”

Section: Introductionmentioning

confidence: 99%

“…Lack of objective tools to identify common patient characteristics, makes the development of biomarkers critical in psychiatry for the application of a more directed and individualised treatment [8,10]. A biomarker of therapeutic response will be clinically useful if it is accurate, reproducible, easy to interpret, has an adequate sensitivity and specificity, and is acceptable to the patient [11].…”

Section: Introductionmentioning

confidence: 99%

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Biomarkers and schizophrenia: a qualitative review

Silva¹,

Pinto²

2017

IJCNMH

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Schizophrenia (SCZ) is a psychiatric disorder with a broad spectrum of biological and clinical manifestations of yet not completely clear pathophysiological mechanisms. Several lines of evidence have been supporting the idea that immunoinflammatory, oxidative, hormonal and cellular dysfunctions are implicated on the biomolecular basis of SCZ. However, accurate diagnosis and selection of appropriate treatments remains challenging as a result of the scarcity of objective tests. Furthermore, there is a compelling need to find biomarkers that could predict drug response and tailor pharmacological treatment, particularly in drug-naïve first episode psychosis (FEP). Hence, numerous technologies have been employed in order to search for SCZ biological markers, but evidence relating them to treatment efficacy is lacking. In this regard, some preliminary data suggest promising results. The current review provides information on: (1) potential biomarkers associated with biological disturbances and (2) biological markers associated with treatment response.

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Section: Immunoinflammatory Biomarkersmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Biomarkers and schizophrenia: a qualitative review

Silva¹,

Pinto²

2017

IJCNMH

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“…Attempts from various perspectives, including genetics and neuroimaging, have investigated whether it is possible to predict treatment response and drug safety [59,60]. Although some look promising, they have not yet reached a stage in which they can be applied to everyday clinical practice.…”

Section: Prediction Of Treatment Response and Safetymentioning

confidence: 99%

Pharmacological Treatment of Schizophrenia:

Fleischhacker

Miyamoto

2016

CNPT

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In the past decade, four main topics have shaped research and clinical practice. 1) In randomized controlled trials, researchers have investigated whether treating prodromal symptoms of schizophrenia helps to reduce the conversion risk to full-blown schizophrenia. Results are ambiguous and the discussion on whether or not an intervention at the stage is justified is ongoing. 2) Following the enhanced understanding of the pathophysiology of schizophrenia, also with respect to specific symptom domains, pharmacological targets beyond D 2 receptor antagonism have been explored. Much work and enthusiasm has revolved around nicotinergic and glutamatergic compounds, so far with mostly discouraging results. 3) Several new-generation antipsychotics have become available as long-acting formulations. All of them have demonstrated a significant positive impact on relapse rates in placebo controlled studies. Whether these compounds also have advantages over first-generation depots and/or oral antipsychotics is still debated. The development of an inhalable antipsychotic has complemented the treatment options for the management of acutely agitated patients. 4) Lastly, attempts from various perspectives, including genetics and neuroimaging, have investigated whether it is possible to predict treatment response and drug safety. Although some look promising, they have not yet reached a stage in which they can be applied to everyday clinical practice. What has become clear, though, is that early non response predicts late non response, leading to the recommendation to switch antipsychotics much earlier than stated in most treatment guidelines.

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“…psychological stress, nutrition, medication, comorbid illnesses, etc.). There are also some preliminary studies showing that biomarkers related to immunoinflammatory or oxidative stress abnormalities have been associated with treatment response [9]. Taken together, these make immunological oxidative stress a fashion that may ultimately improve the course in subgroups of patients with different psychiatric disorders.…”

mentioning

confidence: 99%

Science and fashion: inflammation and oxidative stress in psychiatry

Arango

2018

Eur Arch Psychiatry Clin Neurosci

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Science is not immune to fashion, and from time to time, some topics become very trendy in different areas of medicine. The booming interest in inflammation and oxidative stress in medical research in the last decade is a good example. Areas such as oncology and cardiology have taken the lead regarding interest in the role of inflammatory and oxidative stress markers as signs of underlying pathophysiology and their potential therapeutic implications. Psychiatry has followed that lead, and the number of papers addressing immune/inflammatory and oxidative/nitrosative markers has burgeoned in recent years. Many studies show a relationship between these markers, in the form of an imbalance between pro-and anti-inflammatory activity, and almost any psychiatric disorder [1][2][3][4]. Two papers in this issue deal with oxidative disorders in different psychiatric disorders.Bartoli et al.[5] provide a systematic review and metaanalysis of papers assessing uric acid levels in patients with major depressive disorder (MDD). Uric acid is a major antioxidant that accounts for high free radical scavenging activity in humans, including in the central nervous system. In the meta-analysis, MDD patients had significantly lower uric acid levels than healthy controls. Most importantly, the difference with healthy controls was significant only among studies with drug-naïve patients, but not among those involving treated patients. In a limited number of longitudinal studies (n = 4 with 220 patients) assessing uric acid, levels significantly increased after antidepressant treatment. Of course, the results raised a very relevant hypothesis to be tested regarding the effects of drugs used to treat depression on the oxidative and inflammatory systems. However, the present study cannot rule out the possibility that the change in the studies' antioxidants is not related to another epiphenomenon (such as a result of the improvement or stress reduction).Jordan et al.[6] precisely address one of the most fundamental questions on the relationship between oxidative stress and psychiatric disorders (in their study, schizophrenia and depression), that is, whether oxidative stress factors and immune dysregulation are related to the pathophysiology of those disorders or are just a mere epiphenomenon. In a longitudinal study with drug-naïve first-episode patients, they show that most elevated markers in patients were not related to age, sex, disease severity, medication, or adipose tissue mass. However, markers such as 8-iso-PGF2α were associated with smoking or endocrine stress axis activation. The authors highlight the role of lipid peroxidation and the importance of taking into account other confounding factors in biomarker studies of oxidative stress. Despite the fact that, at baseline or after 6 weeks of treatment, oxidative stress measures did not seem to be affected by age, gender, or occasional cannabis use in the whole group of subjects or in each diagnostic group separately, the results should be considered preliminary, given the small sam...

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The Promise of Biological Markers for Treatment Response in First-Episode Psychosis: A Systematic Review

Cited by 90 publications

References 138 publications

Biomarkers and schizophrenia: a qualitative review

Biomarkers and schizophrenia: a qualitative review

Pharmacological Treatment of Schizophrenia:

Science and fashion: inflammation and oxidative stress in psychiatry

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