Endorphins in schizophrenia: hemodialysis/hemoperfusion are ineffective in clearing beta-Leu5-endorphin and beta-endorphin from human plasma.

Beta-Leu5-endorphin, a relative of "normal" beta-endorphin in which leucine is substituted for methionine at position 5 of the latter, has previously been found in high concentrations in the dialysate of schizophrenics. Its removal from plasma by means of hemodialysis has been claimed to relive the symptoms of schizophrenia. Using a highly sensitive radioimmunoassay of equal sensitivity to beta-endorphin and beta-leu5-endorphin, we have compared the plasma immunoreactivity of three schizophrenic patients befofe and after performance of their first session of membrane hemoperfusion. As compared to normal subjects, plasma beta-endorphin-like immunoreactivity was not greatly elevated in the schizophrenic patients before hemoperfusion.However, instead of the expected decrease, a consistent increase in the plasma levels of immunoreactive beta-endorphin was detected after hemoperfusion. In vitro experiments in which two different membranes and hemodialysis as well as hemoperfusion were used, revealed that synthetic beta-leu5-endorphin (and beta-endorphin) from human plasma was not cleared with any of these methods. This finding is inconsistent with the hypothesis that the claimed therapeutic effects of hemodialysis in schizophrenics are due to the removal of a beta-endorphin-like material from the plasma. Consequently, it seems to be unprobable that high concentrations of beta-leu5-endorphin occur in the dialysate or ultrafiltrate of schizophrenics.