Inflammatory evidence for the psychosis continuum model.

Abstract

BACKGROUND:

Inflammation and immune activation have been implicated in the pathophysiology of severe mental disorders. Previous studies of inflammatory markers, however, have been limited with somewhat inconsistent results.

AIMS:

We aimed to determine the effect sizes of inflammatory marker alterations across diagnostic groups of the psychosis continuum and investigate association to antipsychotic medications.

METHODS:

Plasma levels of soluble tumor necrosis factor receptor 1 (sTNF-R1), interleukin 1 receptor antagonist (IL-1Ra), osteoprotegerin (OPG), and von Willebrand factor (vWf) were measured in patients (n=992) with schizophrenia spectrum (SCZ, n=584), schizoaffective disorder (SA, n=93), affective spectrum disorders (AFF, n=315), and healthy controls (HC, n=638).

RESULTS:

Levels of sTNF-R1 (p=1.8×10(-8), d=0.23) and IL-1Ra (p=0.002, d=0.16) were increased in patients compared to HC. The SCZ group had higher levels of sTNF-R1 (p=8.5×10(-8), d=0.27) and IL-1Ra (p=5.9×10(-5), d=0.25) compared to HC, and for sTNF-R1 this was also seen in the SA group (p=0.01, d=0.3) and in the AFF group (p=0.002, d=0.12). Further, IL-1Ra (p=0.004, d=0.25) and vWf (p=0.02, d=0.21) were increased in the SCZ compared to the AFF group. There was no significant association between inflammatory markers and use of antipsychotic medication.

CONCLUSION:

We demonstrate a small increase in sTNF-R1 and IL-1Ra in patients with severe mental disorders supporting a role of inflammatory mechanisms in disease pathophysiology. The increase was more pronounced in SCZ compared to AFF supporting a continuum psychosis model related to immune factors.

• Authors: Ragni H Mørch, Ingrid Dieset, Ann Færden, Sigrun Hope, Monica Aas, Mari Nerhus, Erlend S Gardsjord, Inge Joa, Gunnar Morken, Ingrid Agartz, Pål Aukrust, Srdjan Djurovic, Ingrid Melle, Thor Ueland, Ole A Andreassen
• Journal: Psychoneuroendocrinology (Psychoneuroendocrinology) Vol. 67 Pg. 189-97 (May 2016) ISSN: 1873-3360 [Electronic] England
• PMID: 26923849 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 Elsevier Ltd. All rights reserved.

Chemical References

• Antipsychotic Agents
• Biomarkers
• Interleukin 1 Receptor Antagonist Protein
• Osteoprotegerin
• Psychotropic Drugs
• Receptors, Tumor Necrosis Factor, Type I
• von Willebrand Factor

Topics

• Adult
• Antipsychotic Agents (blood, therapeutic use)
• Biomarkers (blood)
• Case-Control Studies
• Female
• Humans
• Inflammation (blood, complications)
• Interleukin 1 Receptor Antagonist Protein (blood)
• Male
• Models, Psychological
• Mood Disorders (blood, complications, drug therapy)
• Osteoprotegerin (blood)
• Psychotic Disorders (blood, complications, drug therapy)
• Psychotropic Drugs (therapeutic use)
• Receptors, Tumor Necrosis Factor, Type I (blood)
• Schizophrenia (blood, complications, drug therapy)
• Young Adult
• von Willebrand Factor (metabolism)