title: Does Systemic Inflammation Play a Role in Pediatric Psychosis?
abstract: BACKGROUND
  Human and animal studies have suggested an underlying inflammatory mechanism for a variety of neuropsychiatric disorders, including schizophrenia. To date, most available reports focused on adult patients.
  
  
  OBJECTIVE
  We wished to test the hypothesis that the first psychotic episode in youth is associated with inflammation.
  
  
  METHODS
  We studied patients admitted to a pediatric inpatient psychiatric unit. Patients (n=80) had new-onset psychosis diagnosed using DSM-IV TR criteria for Psychosis NOS, Schizophreniform Disorder or Schizoaffective Disorder. Patients were matched for age, race and gender with inpatient controls without psychosis within the same unit (n=66). We also compared these values to normal pediatric hematologic values. To study the role of inflammation in youth with psychosis, we collected serum samples of 28 children presenting with first-episode psychosis and compared their serum cytokine and S100B levels to eight healthy controls.
  
  
  METHODS
  In this study, we measured serum markers of systemic inflammation.
  
  
  RESULTS
  Leukocyte counts revealed a statistically significant increase in absolute monocytes compared to patients without psychosis (0.61 ± 0.282 k/ml vs. 0.496 ± 0.14 k/ml; p<0.01) and lymphocytes (2.51 ± 0.84 k/ml vs. 2.24 ± 0.72 k/ml; p<0.05) in patients with psychosis. All other hematologic values were similar between the groups. In addition, psychosis was characterized by increased serum levels of S100B, a peripheral marker of blood-brain barrier (BBB) damage. Several inflammatory mediators (e.g., TNF-α, IL-1β, IL-6, IL-5, IL-10, and IFN-γ) were elevated in children with psychosis.
  
  
  CONCLUSIONS
  These results strongly support a link between systemic inflammation, blood-brain barrier disruption and first-episode psychosis in pediatric patients.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Falcone
authors.forename: Erin
authors.initials: E
authors.lastname: Carlton
authors.forename: Catherine
authors.initials: C
authors.lastname: Lee
authors.forename: Mattia
authors.initials: M
authors.lastname: Janigro
authors.forename: Vince
authors.initials: V
authors.lastname: Fazio
authors.forename: Fernando Espi
authors.initials: FE
authors.lastname: Forcen
authors.forename: Kathleen
authors.initials: K
authors.lastname: Franco
authors.forename: Damir
authors.initials: D
authors.lastname: Janigro
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D011618:Psychotic Disorders / Q000097:blood*; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood*; D012559:Schizophrenia / Q000097:blood*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood*
chemical_list: D015415:Biomarkers; D016207:Cytokines; D064568:S100 Calcium Binding Protein beta Subunit; C579160:S100B protein, human
keywords: Blood-Brain Barrier; Markers; Pediatric; Psychosis; Schizophrenia