Uric Acid Potential Role in Systemic Inflammation and Negative Symptoms After Acute Antipsychotic Treatment in Schizophrenia

Abstract

Uric acid (UA) has been shown to have neuroprotective or neurotoxic properties, in relation to specific tissues and diseases that have been studied. Previous studies provided contradictory results on the role of UA in schizophrenia as a neurodegenerative disorder. The aim of this brief report was an additional analysis of UA sera levels in different phases of schizophrenia. Here, 86 patients with first-episode psychosis (FEP) vs. 45 patients with schizophrenia in relapse (SC in relapse) vs. 35 healthy control subjects (HC) were studied before and 1 month after antipsychotic therapy. Further, we aimed to explore the possible correlation of UA with scores presenting clinical features and with serum concentrations of the proinflammatory cytokines interleukin (IL)-6 and IL-17. When comparing the data between all three groups, we did not find significant differences in UA levels, either before or after the applied therapy. Also, comparing sera concentrations of UA in every single group, the analysis did not reveal statistically significant differences between FEP patients, but statistically, a significant difference was found in SC in relapse before and after treatment (334.71 ± 116.84 vs. 289.37 ± 109.15 μmol/L, p = 0.05). Uric acid serum levels correlated with negative sub-score (p = 0.001, r = 0.306), general sub-score (p = 0.015, r = 0.236), and total PANSS score (p = 0.009, r = 0.3) after 1 month of therapy. We have established a statistically significant positive correlation between serum concentrations of UA and IL-6 in exacerbation (p = 0.01, r = 0.220) and with IL-17 after treatment and in the stabilization of psychosis (p = 0.01, r = 0.34), suggesting potential cascades in different phases of schizophrenia that potentiate inflammation.

Role of uric acid as a biomarker of cognitive function in schizophrenia during maintenance period

“…The reduction in UA levels has been previously confirmed to be a marker of abnormal antioxidant defense systems in patients with SCZ (48). Indeed, this was the case given that UA levels are significantly lower in patients with SCZ than in healthy controls (31,49,50). Uric acid levels have been associated with negative symptoms after treatment in patients with SCZ in the acute phase (51) and negatively associated with symptom severity (52).…”

“…Uric acid levels have been associated with negative symptoms after treatment in patients with SCZ in the acute phase ( 51 ) and negatively associated with symptom severity ( 52 ). Studies on UA and cognitive impairment (one of the three major symptoms of SCZ and the main barrier to SCZ rehabilitation) in patients with SCZ have only been conducted on first-episode, drug-free populations and found no statistically significant associations ( 53 ).…”

Clinical Values of Serum Uric Acid Levels in the Occurrence of Cognitive Impairment in AlcoholDependent Patients

“…Finally, previous studies have shown that oxidative stress and neuroinflammation are significantly associated with psychiatric disorders such as depression, anxiety, and schizophrenia. 31 , 32 There is a lack of studies on the association between UA and inflammation and oxidative stress in this study, so it is necessary to actively explore the correlation between cognitive impairment or UA level and inflammation and oxidative stress in future studies. In conclusion, the occurrence of cognitive impairment caused by alcohol dependence is closely related to the increase of serum UA levels in alcohol-dependent patients.…”

Neuroimmune, clinical and treatment challenges in multiple sclerosis-related psychoses

“…This hypothesis is supported by the fact that disseminated activation of microglial cells is the primary characteristic of the chronic phase of the illness[ 44 ]. There is ample evidence of biomarkers indicating a link between immunological processes, psychotic disorders and MS. Elevated levels of different inflammatory markers have been found in the blood and cerebrospinal fluid (CSF) of patients with psychosis and MS, with particularly high levels in patients with first-episode psychosis or acute relapse[ 45 , 46 ]. Dysregulation of regulatory T cells and Th17 cells may be essential for immunological homeostasis and play a role in the development of both diseases[ 47 , 48 ].…”