Inflammatory disequilibrium and lateral ventricular enlargement in treatment-resistant schizophrenia.

European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology 2023 Jul

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Treatment-resistant schizophrenia (TRS) patient respond poorly to antipsychotics. Inflammatory imbalance involving pro- and anti-inflammatory cytokines may play an important role in the mechanism of antipsychotic-medication response. This study aimed to investigate immune imbalance and how the latter relates to clinical manifestations in patients with TRS. The level of net inflammation was estimated by evaluating the immune-inflammatory response system and compensatory immune-regulatory reflex system (IRS/CIRS) in 52 patients with TRS, 47 with non-TRS, and 56 sex and age matched healthy controls. The immune biomarkers mainly included macrophagic M1, T helper, Th-1, Th-2, Th-17, and T regulatory cytokines and receptors. Plasma cytokine levels were measured using enzyme-linked immunosorbent assay. Psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS). Subcortical volumes were quantified using a 3-T Prisma Magnetic Resonance Imaging scanner. The results showed that (1) patients with TRS were characterized by activated pro-inflammatory cytokines and relatively insufficient anti-inflammatory cytokines, with an elevated IRS/CIRS ratio indicating a new homeostatic immune setpoint; (2) IRS/CIRS ratio was positively correlated with larger lateral ventricle volume and higher PANSS score in patients with TRS. Our findings highlighted the inflammatory disequilibrium as a potential pathophysiological process of TRS. Copyright © 2023 Elsevier B.V. and ECNP. All rights reserved.

Citation

Wenjin Chen, Mengzhuang Gou, Leilei Wang, Na Li, Wei Li, Jinghui Tong, Yanfang Zhou, Ting Xie, Ting Yu, Wei Feng, Yanli Li, Song Chen, Baopeng Tian, Shuping Tan, Zhiren Wang, Shujuan Pan, Xingguang Luo, Ping Zhang, Junchao Huang, Li Tian, Chiang-Shan R Li, Yunlong Tan. Inflammatory disequilibrium and lateral ventricular enlargement in treatment-resistant schizophrenia. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology. 2023 Jul;72:18-29