title: Pro-/anti-inflammatory dysregulation in patients with first episode of psychosis: toward an integrative inflammatory hypothesis of schizophrenia.
abstract: BACKGROUND
  Schizophrenia is a chronic syndrome of unknown etiology, predominantly defined by signs of psychosis. The onset of the disorder occurs typically in late adolescence or early adulthood. Efforts to study pathophysiological mechanisms in early stages of the disease are crucial in order to prompt intervention.
  
  
  METHODS
  Case-control study of first-episode psychotic (FEP) patients and matched controls. We recruited 117 patients during the first year after their FEP according to the DSM-IV criteria and recruited 106 gender-, race-, and age-matched controls between September 2010 and June 2011.
  
  
  RESULTS
  Biochemical studies carried out in peripheral mononuclear blood cells (PMBC) and plasma evidence a significant increase in intracellular components of a main proinflammatory pathway, along with a significant decrease in the anti-inflammatory ones. Multivariate logistic regression analyses identified the expression of inducible isoforms of nitric oxide synthase and cyclooxygenase in PMBC and homocysteine plasma levels as the most reliable potential risk factors and the inhibitor of the inflammatory transcription factor NFκB, IκBα, and the anti-inflammatory prostaglandin 15d-PGJ2 as potential protection factors.
  
  
  CONCLUSIONS
  Taken as a whole, the results of this study indicate robust phenotypical differences at the cellular machinery level in PMBC of patients with FEP. Although more scientific evidence is needed, the determination of multiple components of pro- and anti-inflammatory cellular pathways including the activity of nuclear receptors has interesting potential as biological markers and potential risk/protective factors for FEP. Due to its soluble nature, a notable finding in this study is that the anti-inflammatory mediator 15d-PGJ2 might be used as plasmatic biomarker for first episodes of psychosis.
authors.affiliation: These authors contributed equally to this work.
authors.forename: Borja
authors.initials: B
authors.lastname: García-Bueno
authors.forename: Miquel
authors.initials: M
authors.lastname: Bioque
authors.forename: Karina S
authors.initials: KS
authors.lastname: Mac-Dowell
authors.forename: M Fe
authors.initials: MF
authors.lastname: Barcones
authors.forename: Monica
authors.initials: M
authors.lastname: Martínez-Cengotitabengoa
authors.forename: Laura
authors.initials: L
authors.lastname: Pina-Camacho
authors.forename: Roberto
authors.initials: R
authors.lastname: Rodríguez-Jiménez
authors.forename: Pilar A
authors.initials: PA
authors.lastname: Sáiz
authors.forename: Carmen
authors.initials: C
authors.lastname: Castro
authors.forename: Amalia
authors.initials: A
authors.lastname: Lafuente
authors.forename: Javier
authors.initials: J
authors.lastname: Santabárbara
authors.forename: Ana
authors.initials: A
authors.lastname: González-Pinto
authors.forename: Mara
authors.initials: M
authors.lastname: Parellada
authors.forename: Gabriel
authors.initials: G
authors.lastname: Rubio
authors.forename: M Paz
authors.initials: MP
authors.lastname: García-Portilla
authors.forename: Juan A
authors.initials: JA
authors.lastname: Micó
authors.forename: Miguel
authors.initials: M
authors.lastname: Bernardo
authors.forename: Juan C
authors.initials: JC
authors.lastname: Leza
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology; D007249:Inflammation / Q000097:blood / Q000150:complications / Q000276:immunology*; D008297:Male; D010641:Phenotype; D015230:Prostaglandin D2 / Q000031:analogs & derivatives / Q000097:blood; D011618:Psychotic Disorders / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000276:immunology*; D012307:Risk Factors; D012559:Schizophrenia / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000276:immunology*; D013997:Time Factors; D055815:Young Adult
chemical_list: C477819:15-deoxyprostaglandin J2; D015415:Biomarkers; D015230:Prostaglandin D2
keywords: biomarker; first-episode psychosis; inflammatory balance; schizophrenia