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氧化还原失调作为儿童创伤与早期精神病患者精神病理学和神经认知特征之间的联系。

Redox dysregulation as a link between childhood trauma and psychopathological and neurocognitive profile in patients with early psychosis.

机构信息

Unit for Research in Schizophrenia, Center for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital (CHUV), CH-1008 Prilly-Lausanne, Switzerland.

Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital (CHUV), CH-1008 Lausanne, Switzerland.

出版信息

Proc Natl Acad Sci U S A. 2018 Dec 4;115(49):12495-12500. doi: 10.1073/pnas.1812821115. Epub 2018 Nov 19.

Abstract

Exposure to childhood trauma (CT) increases the risk for psychosis and affects the development of brain structures, possibly through oxidative stress. As oxidative stress is also linked to psychosis, it may interact with CT, leading to a more severe clinical phenotype. In 133 patients with early psychosis (EPP), we explored the relationships between CT and hippocampal, amygdala, and intracranial volume (ICV); blood antioxidant defenses [glutathione peroxidase (GPx) and thioredoxin/peroxiredoxin (Trx/Prx)]; psychopathological results; and neuropsychological results. Nonadjusted hippocampal volume correlated negatively with GPx activity in patients with CT, but not in patients without CT. In patients with CT with high GPx activity (high-GPx+CT), hippocampal volume was decreased compared with that in patients with low-GPx+CT and patients without CT, who had similar hippocampal volumes. Patients with high-GPx+CT had more severe positive and disorganized symptoms than other patients. Interestingly, Trx and oxidized Prx levels correlated negatively with GPx only in patients with low-GPx+CT. Moreover, patients with low-GPx+CT performed better than other patients on cognitive tasks. Discriminant analysis combining redox markers, hippocampal volume, clinical scores, and cognitive scores allowed for stratification of the patients into subgroups. In conclusion, traumatized EPP with high peripheral oxidation status (high-GPx activity) had smaller hippocampal volumes and more severe symptoms, while those with lower oxidation status (low-GPx activity) showed better cognition and regulation of GPx and Trx/Prx systems. These results suggest that maintained regulation of various antioxidant systems allowed for compensatory mechanisms preventing long-term neuroanatomical and clinical impacts. The redox marker profile may thus represent important biomarkers for defining treatment strategies in patients with psychosis.

摘要

童年创伤(CT)暴露会增加精神病的风险,并影响大脑结构的发育,这可能是通过氧化应激实现的。由于氧化应激也与精神病有关,它可能与 CT 相互作用,导致更严重的临床表型。在 133 名早期精神病(EPP)患者中,我们探讨了 CT 与海马体、杏仁核和颅内体积(ICV)之间的关系;血液抗氧化防御[谷胱甘肽过氧化物酶(GPx)和硫氧还蛋白/过氧化物酶(Trx/Prx)];精神病理学结果;和神经心理学结果。未经调整的海马体体积与 CT 患者的 GPx 活性呈负相关,但与无 CT 的患者无关。在 CT 患者中,高 GPx 活性(高-GPx+CT)的海马体体积与低-GPx+CT 和无 CT 的患者相比有所减少,而这两组患者的海马体体积相似。与其他患者相比,高-GPx+CT 的患者阳性和紊乱症状更为严重。有趣的是,只有在低-GPx+CT 患者中,Trx 和氧化 Prx 水平才与 GPx 呈负相关。此外,低-GPx+CT 的患者在认知任务上的表现优于其他患者。结合氧化还原标志物、海马体体积、临床评分和认知评分的判别分析允许将患者分为亚组。总之,外周氧化状态较高(高-GPx 活性)的创伤性 EPP 患者海马体体积较小,症状更为严重,而氧化状态较低(低-GPx 活性)的患者认知能力更好,且 GPx 和 Trx/Prx 系统的调节能力也更好。这些结果表明,各种抗氧化系统的维持调节允许了防止长期神经解剖和临床影响的代偿机制。因此,氧化还原标志物谱可能代表了定义精神病患者治疗策略的重要生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3b2/6298080/b6e663c5cbb7/pnas.1812821115fig01.jpg

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