Department of Psychiatry, Gulhane Training and Research Hospital, Ankara, Turkey.
Noro Saglik Brain Trainings Research Application Center, Istanbul, Turkey.
Synapse. 2019 Nov;73(11):e22127. doi: 10.1002/syn.22127. Epub 2019 Aug 18.
The aim of the present study was to explore the role of N-methyl-D-aspartate receptor (NMDAR) related amino acids in drug-naive first episode psychosis (FEP) patients. The medication naïve patients with FEP (n = 40) and healthy volunteers with no family history of schizophrenia (n = 35) were recruited to the study and followed up for 10 weeks. Liquid chromatography-mass spectrometry method was used to measure plasma levels of the amino acids. The plasma glutamine, glutamic acid, proline, serine, asparagine, and hydroxyproline levels were significantly higher in the FEP patients compared to healthy controls (p values < .0001). The glutamine/glutamic acid ratio in FEP patients was not different from the healthy controls (p > .05). After the antipsychotic treatment, plasma glutamic acid, proline, and hydroxyproline levels were significantly increased (p values < .05) while the asparagine level and glutamine/glutamic acid ratio were decreased (p values < .05). The serine and glutamine levels did not show any differences with the treatment (p > .05). The initial plasma glutamine levels were negatively correlated with the initial Scale for the Assessment of Positive Symptoms (SAPS) score (r = -.45, p = .003). The initial plasma proline levels were negatively correlated with the initial and follow-up SAPS scores (r = -.51 and -.39, p values < .05). The initial plasma proline and hydroxyproline levels were both negatively correlated with the initial Brief Psychiatric Rating Scale score (r = -.37, p = .017 and r = -.33, p = .033, respectively). Increase in NMDAR-related amino acid levels during the FEP may be a compensatory response to glutamatergic hypofunction. Their plasma levels were significantly correlated with several psychotic symptoms before and after 10-week treatment. Antipsychotic treatment has differential effects on the plasma levels of these amino acids.
本研究旨在探讨 N-甲基-D-天冬氨酸受体（NMDAR）相关氨基酸在未经药物治疗的首发精神分裂症（FEP）患者中的作用。招募了 40 例未经药物治疗的 FEP 患者（n=40）和 35 例无精神分裂症家族史的健康志愿者（n=35）作为研究对象，并进行了 10 周的随访。采用液相色谱-质谱法测量氨基酸的血浆水平。与健康对照组相比，FEP 患者的血浆谷氨酰胺、谷氨酸、脯氨酸、丝氨酸、天冬酰胺和羟脯氨酸水平显著升高（p 值均<0.0001）。FEP 患者的谷氨酰胺/谷氨酸比值与健康对照组无差异（p>0.05）。抗精神病治疗后，血浆谷氨酸、脯氨酸和羟脯氨酸水平显著升高（p 值均<0.05），而天冬酰胺水平和谷氨酰胺/谷氨酸比值降低（p 值均<0.05）。丝氨酸和谷氨酰胺水平与治疗无差异（p>0.05）。初始血浆谷氨酰胺水平与初始阳性症状评定量表（SAPS）评分呈负相关（r=-0.45，p=0.003）。初始血浆脯氨酸水平与初始和随访时的 SAPS 评分呈负相关（r=-0.51 和 -0.39，p 值均<0.05）。初始血浆脯氨酸和羟脯氨酸水平均与简明精神病评定量表评分呈负相关（r=-0.37，p=0.017 和 r=-0.33，p=0.033）。在 FEP 期间 NMDAR 相关氨基酸水平的增加可能是谷氨酸能功能低下的代偿反应。它们的血浆水平与治疗前和治疗后 10 周的几种精神病症状显著相关。抗精神病治疗对这些氨基酸的血浆水平有不同的影响。
