Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
Department of Neurosciences, Imaging and Clinical Sciences, Univerity of Chieti, Chieti, Italy.
Curr Top Med Chem. 2021 Oct 25;21(16):1457-1470. doi: 10.2174/1568026621666210701105839.
In the past few decades, increasing evidence in the literature has appeared describing the role of the antioxidant defense system and redox signaling in the multifactorial pathophysiology of psychosis. It is of interest to clinicians and researchers alike that abnormalities of the antioxidant defense system are associated with alterations of cellular membranes, immune functions and neurotransmission, all of which have some clinical implications.
This narrative review summarizes the evidence regarding oxidative stress in the early stages of psychosis. We included 136 peer-reviewed articles published from 2007 to 2020 on PubMed EMBASE, The Cochrane Library and Google Scholar.
Patients affected by psychotic disorders show a decreased level of non-enzymatic antioxidants, an increased level of lipid peroxides, nitric oxides, and a homeostatic imbalance of purine catabolism. In particular, a significantly reduced antioxidant defense has been described in the early onset first episode of psychosis, including reduced levels of glutathione. Also, it has been shown that a decreased basal low-antioxidant capacity correlates with cognitive deficits and negative symptoms, mostly related to glutamate-receptor hypofunction. In addition, atypical antipsychotic drugs seem to show significant antioxidant activity. These factors are critical in order to treat cases of first-onset psychosis effectively.
This systematic review indicates the importance that must be given to anti-oxidant defense systems.
在过去的几十年中，越来越多的文献证据表明，抗氧化防御系统和氧化还原信号在精神疾病的多因素病理生理学中起着重要作用。抗氧化防御系统的异常与细胞膜、免疫功能和神经传递的改变有关，这引起了临床医生和研究人员的兴趣，而这些改变都与一些临床意义相关。
本综述总结了关于精神分裂症早期阶段氧化应激的证据。我们在 PubMed、EMBASE、The Cochrane Library 和 Google Scholar 上检索了 2007 年至 2020 年发表的 136 篇同行评议的文章。
患有精神障碍的患者表现出非酶抗氧化剂水平降低，脂质过氧化物、一氧化氮水平升高，以及嘌呤分解的体内平衡失调。特别是，在精神分裂症的首发早期阶段，描述了明显的抗氧化防御能力降低，包括谷胱甘肽水平降低。此外，研究表明，基础低抗氧化能力降低与认知缺陷和阴性症状相关，这主要与谷氨酸受体功能低下有关。此外，非典型抗精神病药物似乎具有显著的抗氧化活性。这些因素对于有效治疗首发精神疾病至关重要。
本系统综述表明必须重视抗氧化防御系统。
