Garip Beyazit, Khokhar Jibran Y, Kayir Hakan
Gulhane Training and Research Hospital, Department of Psychiatry, Ankara, Turkey.
Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
Schizophrenia (Heidelb). 2024 Nov 6;10(1):103. doi: 10.1038/s41537-024-00528-3.
This study assessed plasma levels of essential amino acids (EAA) in drug-naïve first episode psychosis (FEP) patients at diagnosis and after 10 weeks of antipsychotic treatment. Forty FEP patients were enrolled at baseline, with blood samples collected before and after a 10-week antipsychotic treatment period. Plasma EAA levels were measured using an LC/MS/MS method. Psychotic symptoms were evaluated using standardized inventories before and after treatment. A decrease in BPRS score of more than 40% was used to indicate treatment response. Thirty-five healthy volunteers served as the control group. Baseline plasma levels of Thr, Met, Leu, Lys, His, and Tyr were higher in FEP patients than in healthy controls. After 10 weeks of treatment, Leu, His, and Tyr increased further, primarily in treatment-responsive patients. Conversely, Val level was lower than controls in patients at baseline and remained unchanged after treatment. Increased EAA levels were correlated with lower (less severe) scores in positive symptom scales. Treatment non-responders had persistently low Tyr/large neutral amino acid (LNAA) ratio. Tyr/LNAA ratio increased after treatment, specifically in treatment-responders. Phe/Tyr ratio decreased post-treatment in both responder and non-responder groups. Elevated EAA levels in FEP patients may signify compensatory responses to increased physiological demand for neurotransmitters or energy. Combining specific EAA supplementation with antipsychotic treatment may enhance treatment response in these patients.
本研究评估了初发未用药的首发精神病（FEP）患者在诊断时及抗精神病药物治疗10周后的血浆必需氨基酸（EAA）水平。40例FEP患者在基线时入组，在10周抗精神病药物治疗期前后采集血样。采用液相色谱/串联质谱法测量血浆EAA水平。治疗前后使用标准化量表评估精神病症状。以简明精神病评定量表（BPRS）评分降低超过40%作为治疗反应的指标。35名健康志愿者作为对照组。FEP患者基线时血浆苏氨酸（Thr）、蛋氨酸（Met）、亮氨酸（Leu）、赖氨酸（Lys）、组氨酸（His）和酪氨酸（Tyr）水平高于健康对照组。治疗10周后，Leu、His和Tyr进一步升高，主要见于治疗有反应的患者。相反，缬氨酸（Val）水平在基线时低于对照组且治疗后保持不变。EAA水平升高与阳性症状量表得分较低（症状较轻）相关。治疗无反应者的酪氨酸/大中性氨基酸（LNAA）比值持续较低。治疗后酪氨酸/LNAA比值升高，特别是在治疗有反应者中。治疗后两组有反应者和无反应者的苯丙氨酸/酪氨酸比值均降低。FEP患者EAA水平升高可能表明对神经递质或能量生理需求增加的代偿反应。将特定的EAA补充剂与抗精神病药物治疗相结合可能会增强这些患者的治疗反应。
