Research Division, Institute of Mental Health, Singapore.
Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Brain Behav Immun. 2017 Oct;65:337-341. doi: 10.1016/j.bbi.2017.06.006. Epub 2017 Jun 13.
There is a growing interest in the association between schizophrenia and the activation of inflammatory system with signs of acute phase (AP) response. Majority of such studies had focused on C-reactive protein (CRP). The aims of the present study were (i) to examine the gene expression profiles of other acute phase proteins (APP), namely haptoglobin (HP), alpha-1 antitrypsin (A1T), and alpha-2 macroglobulin (A2M) in patients with first episode psychosis (FEP) over a period of three months and (ii) to explore the association between APP levels and severity of symptoms.
In this study, HP, A1T and A2M gene expression levels from whole blood were measured at recruitment, 1- and 3-month follow-up visits using quantitative PCR (qPCR) in 43 patients with FEP and in 57 healthy controls. Diagnoses was ascertained on the Structured Clinical Interview for DSM-IV-TR. Severity of symptoms in patients was assessed on the Positive and Negative Syndrome Scale (PANSS) and a previously validated 5-factor PANSS structure was applied in the subsequent analyses.
The FEP sample comprised of 28 (65.1%) individuals with schizophrenia, 12 (27.9%) with schizophreniform disorder and 3 (7%) with schizoaffective disorder. HP gene expression level was noted to be significantly higher in patients than controls at all three time points: recruitment (P=0.049), 1-month follow up (P=0.002) and 3-month follow up (P=0.005). PANSS positive, depression, and excitement symptom factors showed significant associations with HP (P=0.002), A1T (P=0.016) and A2M (P=0.034), respectively. These findings remained significant after controlling for age, gender, smoking status and accumulated chlorpromazine dosage.
The current study provides information on HP, A1T and A2M gene expression profiles in FEP patients and their associations with psychopathology. This provides support for the hypothesis that inflammation is related to schizophrenia and further encourages studies on immune-inflammatory markers to understand the relationship between inflammation and schizophrenia.
人们对精神分裂症与炎症系统激活（伴有急性期反应迹象）之间的关联越来越感兴趣。大多数此类研究都集中在 C 反应蛋白（CRP）上。本研究的目的是：（i）在三个月的时间内，检测首发精神病（FEP）患者其他急性期蛋白（APP），即触珠蛋白（HP）、α-1 抗胰蛋白酶（A1T）和α-2 巨球蛋白（A2M）的基因表达谱；（ii）探讨 APP 水平与症状严重程度之间的关系。
本研究采用定量 PCR（qPCR）法检测 43 例 FEP 患者和 57 例健康对照者全血中 HP、A1T 和 A2M 的基因表达水平，在招募时、1 个月和 3 个月随访时进行。诊断采用 DSM-IV-TR 结构临床访谈确定。患者的症状严重程度采用阳性和阴性综合征量表（PANSS）进行评估，并在随后的分析中应用了先前验证的 PANSS 5 因子结构。
FEP 样本包括 28 例（65.1%）精神分裂症患者、12 例（27.9%）分裂样障碍患者和 3 例（7%）分裂情感障碍患者。在所有三个时间点，患者的 HP 基因表达水平均显著高于对照组：招募时（P=0.049）、1 个月随访时（P=0.002）和 3 个月随访时（P=0.005）。PANSS 阳性、抑郁和兴奋症状因子与 HP（P=0.002）、A1T（P=0.016）和 A2M（P=0.034）显著相关。在控制年龄、性别、吸烟状况和累积氯丙嗪剂量后，这些发现仍然具有统计学意义。
本研究提供了 FEP 患者 HP、A1T 和 A2M 基因表达谱及其与精神病理学之间关系的信息。这为炎症与精神分裂症有关的假说提供了支持，并进一步鼓励对免疫炎症标志物进行研究，以了解炎症与精神分裂症之间的关系。
