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Inflammatory markers and indicators of systemic endotoxemia in patients with treatment-resistant schizophrenia

Published online by Cambridge University Press:  19 July 2023

S. A. Zozulya ,
I. N. Otman ,
I. A. Anikhovskaya ,
D. V. Tikhonov ,
V. G. Kaleda ,
M. Y. Yakovlev  and
T. P. Klyushnik
S. A. Zozulya*
Affiliation:
1Laboratory of Neuroimmunology, Mental Health Research Centre
I. N. Otman
Affiliation:
1Laboratory of Neuroimmunology, Mental Health Research Centre
I. A. Anikhovskaya
Affiliation:
2Laboratory of Systemic Endotoxinemia and Shock, Research Institute of General Pathology and Pathophisiology
D. V. Tikhonov
Affiliation:
3Department of Youth Psychiatry, Mental Health Research Centre, Moscow, Russian Federation
V. G. Kaleda
Affiliation:
3Department of Youth Psychiatry, Mental Health Research Centre, Moscow, Russian Federation
M. Y. Yakovlev
Affiliation:
2Laboratory of Systemic Endotoxinemia and Shock, Research Institute of General Pathology and Pathophisiology
T. P. Klyushnik
Affiliation:
1Laboratory of Neuroimmunology, Mental Health Research Centre
*
*Corresponding author.

Abstract

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Introduction

Elevated levels of lipopolysaccharide (LPS) in circulation support chronic inflammation, which is involved in the pathological process in the brain and may be a contributing factor to treatment resistance in schizophrenia.

Objectives

To compare inflammatory markers and indicators of systemic endotoxemia (SE) in patients with treatment-resistant schizophrenia and in those with a good response to treatment.

Methods

The study involved 34 patients with schizophrenia (27±7,5 years) (F20) in an acute psychotic state: 15 patients with TRS (non-responders), 19 patients responded to treatment with reduced symptoms (responders). The markers of systemic inflammation (leukocyte elastase (LE) and a1-proteinase inhibitor (α1-PI) activity, CRP concentration, antibodies (Abs) to S100B and myelin basic protein) and the indicators of SE (LPS level and Abs to LPS) were determined in the blood of patients.

Results

The responders showed a significant increase in LE and α1-P1 activity (p<0.001), CRP concentration (p<0.05), and Abs to neuroantigens (p<0.05) compared to controls. LPS levels did not differ from control values. In non-responders, a moderate increase in LE and α1-PI activities (p<0.05) and a significant increase in CRP concentration (p=0.01) were accompanied by no significant differences in Abs to neuroantigens. These patients had elevated LPS level and Abs to LPS deficiency compared with both responders (p<0.01) and controls (p<0.05).

Conclusions

The identified spectra of systemic inflammation markers, elevated LPS level, and insufficient anti-endotoxin immunity in patients with treatment-resistant schizophrenia may be related to endotoxin tolerance. Further research in this field can help develop new approaches to overcoming resistance to therapy in patients with schizophrenia.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 66 , Special Issue S1: Abstracts of the 31st European Congress of Psychiatry , March 2023 , pp. S247 - S248
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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