Medical College of Georgia, Augusta University, Augusta, GA, United States.
Department of Psychiatry, Augusta University, Augusta, GA, United States.
Schizophr Res. 2020 Oct;224:58-66. doi: 10.1016/j.schres.2020.10.003. Epub 2020 Oct 22.
Schizophrenia is associated with abnormal levels of blood inflammatory markers, which may be correlated with levels of psychopathology. Few previous studies have explored whether baseline inflammatory marker levels predict longitudinal changes in psychopathology. In the present study, we explored this association in a cohort of patients with schizophrenia.
We investigated inflammatory markers and psychopathology after 3, 6, and 12 months of antipsychotic treatment for subjects with baseline and follow-up data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial. Linear regression models, controlling for multiple potential confounding factors, were used to investigate these associations.
There was a significant decrease in monocyte, ICAM, and adiponectin levels between baseline and 12 months. Higher baseline blood interleukin-6 (IL-6) predicted greater reduction in PANSS total and general subscale scores at 3 and 6 months, and PANSS negative subscale scores at 3 months (β = -0.10 to -0.16, p < 0.05 for each). Higher baseline blood leptin levels predicted greater reduction in PANSS total, negative and general subscale scores at 6 months (β = -0.09 to -0.11, p < 0.05 for each). In post-hoc analyses, associations between baseline IL-6 levels and symptom reduction were strongest in patients treated with either ziprasidone or quetiapine. Changes in blood inflammatory markers were generally not associated with changes in psychopathology.
Our findings provide additional support that measuring blood inflammatory markers may be relevant to the clinical care of patients with schizophrenia. Specifically, these markers may help guide selection of antipsychotic treatment towards more personalized medicine approaches for patients with schizophrenia.
精神分裂症与血液炎症标志物水平异常有关，而这些标志物可能与精神病理学水平相关。先前的研究较少探讨基线炎症标志物水平是否能预测精神病理学的纵向变化。本研究旨在探讨精神分裂症患者队列中这种关联。
我们对参加临床抗精神病药物干预疗效试验（CATIE）的精神分裂症患者进行了随访，分析了基线和随访数据。在接受抗精神病药物治疗 3、6 和 12 个月后，我们检测了炎症标志物和精神病理学指标。采用线性回归模型，控制了多个潜在的混杂因素，对这些关联进行了分析。
与基线相比，在 12 个月时单核细胞、ICAM 和脂联素水平显著下降。较高的基线血白细胞介素 6（IL-6）水平预示着 PANSS 总分和一般量表评分在 3 个月和 6 个月时的降幅更大，3 个月时 PANSS 阴性量表评分的降幅更大（β=-0.10 至-0.16，p<0.05）。较高的基线血瘦素水平预示着在 6 个月时 PANSS 总分、阴性和一般量表评分的降幅更大（β=-0.09 至-0.11，p<0.05）。在事后分析中，IL-6 基线水平与症状改善之间的关联在接受齐拉西酮或喹硫平治疗的患者中最强。血液炎症标志物的变化通常与精神病理学的变化无关。
我们的研究结果进一步支持了测量血液炎症标志物可能与精神分裂症患者的临床护理相关。具体而言，这些标志物可能有助于指导精神分裂症患者的抗精神病药物治疗选择，朝着更个性化的医学方法发展。
