Mohite Satyajit, Yang Fang, Amin Pooja A, Zunta-Soares Giovana, Colpo Gabriela D, Stertz Laura, Sharma Ajaykumar N, Fries Gabriel R, Walss-Bass Consuelo, Soares Jair C, Okusaga Olaoluwa O
UT Harris County Psychiatric Center, 2800 S MacGregor Way, Houston, Texas, United States of America.
Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas, United States of America.
PLoS One. 2017 Mar 23;12(3):e0174073. doi: 10.1371/journal.pone.0174073. eCollection 2017.
Immune dysfunction has been implicated in the pathophysiology of schizophrenia. Leukocyte migration to the site of inflammation is a fundamental step of immune response which involves P-, E-, and L-selectins. Elevated selectin levels have been reported in un-medicated first-episode patients with schizophrenia but not in medicated patients with multi-episode schizophrenia. We measured fasting plasma soluble P-, E-, and L-selectin in 39 medicated patients with multi-episode schizophrenia and 19 healthy controls. In patients, psychotic symptom severity and cognitive function were assessed with the Positive and Negative Syndrome Scale (PANSS) and the NIH Toolbox Cognitive Test Battery respectively. C-reactive protein (CRP) and Body Mass Index (BMI) were measured in patients and controls. Comparison of selectin levels between patients and controls was done with t-tests and linear regression. Pearson correlation coefficients between plasma selectins and PANSS and cognitive measures were calculated. Geometric mean plasma soluble L-selectin level was lower in patients compared to controls from unadjusted (606.7 ± 1.2 ng/ml vs. 937.7 ± 1.15 ng/ml, p < 0.001) and adjusted analyses (β = 0.59; CI 0.41 to 0.88, p = 0.011). There was a trend towards higher plasma soluble P-selectin in patients compared to controls (90.4 ± 1.2ng/ml vs. 71.8 ± 1.2ng/ml, p = 0.059) in the unadjusted analysis. There was no association between the selectins and psychotic symptoms or cognitive function in the patients. In addition, the selectins were not significantly associated with CRP or BMI. The limitations of this study include small sample size and unavailability of information on medications and blood cell counts. The potential utility of soluble L-selectin as a biomarker of antipsychotic exposure in patients with schizophrenia and the concomitant change in immune response with the use of antipsychotics should be further evaluated.
免疫功能障碍与精神分裂症的病理生理学有关。白细胞迁移到炎症部位是免疫反应的一个基本步骤，这涉及P-、E-和L-选择素。据报道，未接受药物治疗的首发精神分裂症患者的选择素水平升高，但多发作精神分裂症的药物治疗患者则不然。我们测量了39例多发作精神分裂症的药物治疗患者和19名健康对照者的空腹血浆可溶性P-、E-和L-选择素。在患者中，分别用阳性和阴性症状量表（PANSS）和美国国立卫生研究院工具箱认知测试电池评估精神病症状严重程度和认知功能。在患者和对照者中测量了C反应蛋白（CRP）和体重指数（BMI）。用t检验和线性回归比较患者和对照者之间的选择素水平。计算血浆选择素与PANSS和认知指标之间的Pearson相关系数。未经调整的分析（606.7±1.2 ng/ml对937.7±1.15 ng/ml，p<0.001）和调整后的分析（β=0.59；CI 0.41至0.88，p=0.011）显示，患者的血浆可溶性L-选择素几何平均水平低于对照者。未经调整的分析显示，与对照者相比，患者的血浆可溶性P-选择素呈升高趋势（90.4±1.2ng/ml对71.8±1.2ng/ml，p=0.059）。患者的选择素与精神病症状或认知功能之间没有关联。此外，选择素与CRP或BMI没有显著关联。本研究的局限性包括样本量小以及缺乏药物和血细胞计数信息。可溶性L-选择素作为精神分裂症患者抗精神病药物暴露生物标志物的潜在效用以及使用抗精神病药物时免疫反应的伴随变化应进一步评估。
