Department of Pharmacy, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; The Institute of Clinical Pharmacy, Central South University, Changsha 410011, Hunan, China.
Schizophr Res. 2020 Dec;226:95-110. doi: 10.1016/j.schres.2019.03.009. Epub 2019 Mar 29.
Due to the limitations of analytical techniques and the complicity of schizophrenia, nowadays it is still a challenge to diagnose and stratify schizophrenia patients accurately. Many attempts have been made to identify and validate available biomarkers for schizophrenia from CSF and/or peripheral blood in clinical studies with consideration to disease stages, antipsychotic effects and even gender differences. However, conflicting results handicap the validation and application of biomarkers for schizophrenia. In view of availability and feasibility, peripheral biomarkers have superior advantages over biomarkers in CNS. Meanwhile, schizophrenia is considered to be a devastating neuropsychiatric disease mainly taking place in CNS featured by widespread defects in multiple metabolic pathways whose dynamic interactions, until recently, have been difficult to difficult to investigate. Evidence for these alterations has been collected piecemeal, limiting the potential to inform our understanding of the interactions among relevant biochemical pathways. Taken these points together, it will be interesting to investigate possible associations of biomarkers between CNS and periphery. Numerous studies have suggested putative correlations within peripheral and CNS systems especially for dopaminergic and glutamatergic metabolic biomarkers. In addition, it has been demonstrated that blood concentrations of BDNF protein can also reflect its changes in the nervous system. In turn, BDNF also interacts with glutamatergic, dopaminergic and serotonergic systems. Therefore, this review will summarize metabolic biomarkers identified both in the CNS (brain tissues and CSF) and peripheral blood. Further, more attentions will be paid to discussing possible physical and functional associations between CNS and periphery, especially with respect to BDNF.
由于分析技术的局限性和精神分裂症的复杂性，目前仍然难以准确诊断和分层精神分裂症患者。许多研究试图从 CSF 和/或外周血中鉴定和验证现有的精神分裂症生物标志物，并考虑到疾病阶段、抗精神病药物的疗效，甚至性别差异。然而，相互矛盾的结果妨碍了精神分裂症生物标志物的验证和应用。鉴于可用性和可行性，外周生物标志物优于中枢神经系统中的生物标志物。同时，精神分裂症被认为是一种主要发生在中枢神经系统的破坏性神经精神疾病，其特点是多个代谢途径广泛缺陷，这些途径的动态相互作用直到最近才难以研究。这些改变的证据是零碎收集的，限制了我们了解相关生化途径相互作用的潜力。综上所述，研究中枢神经系统和外周之间生物标志物的可能相关性将是有趣的。许多研究表明，外周和中枢系统之间存在假定的相关性，特别是在多巴胺能和谷氨酸能代谢生物标志物方面。此外，已经证明 BDNF 蛋白的血液浓度也可以反映其在神经系统中的变化。反过来，BDNF 也与谷氨酸能、多巴胺能和 5-羟色胺能系统相互作用。因此，本综述将总结在中枢神经系统（脑组织和 CSF）和外周血中鉴定出的代谢生物标志物。此外，将更多地关注讨论中枢神经系统和外周之间可能存在的物理和功能联系，特别是关于 BDNF。
