title: Acute-phase proteins in relation to neuropsychiatric symptoms and use of psychotropic medication in Huntington's disease.
abstract: Activation of the innate immune system has been postulated in the pathogenesis of Huntington's disease (HD). We studied serum concentrations of C-reactive protein (CRP) and low albumin as positive and negative acute-phase proteins in HD. Multivariate linear and logistic regression was used to study the association between acute-phase protein levels in relation to clinical, neuropsychiatric, cognitive, and psychotropic use characteristics in a cohort consisting of 122 HD mutation carriers and 42 controls at first biomarker measurement, and 85 HD mutation carriers and 32 controls at second biomarker measurement. Significant associations were found between acute-phase protein levels and Total Functioning Capacity (TFC) score, severity of apathy, cognitive impairment, and the use of antipsychotics. Interestingly, all significant results with neuropsychiatric symptoms disappeared after additional adjusting for antipsychotic use. High sensitivity CRP levels were highest and albumin levels were lowest in mutation carriers who continuously used antipsychotics during follow-up versus those that had never used antipsychotics (mean difference for CRP 1.4 SE mg/L; P=0.04; mean difference for albumin 3 SE g/L; P<0.001). The associations found between acute-phase proteins and TFC score, apathy, and cognitive impairment could mainly be attributed to the use of antipsychotics. This study provides evidence that HD mutation carriers who use antipsychotics are prone to develop an acute-phase response.
authors: Department of Psychiatry, Leiden University Medical Center, The Netherlands. Electronic address: J.A.Bouwens@lumc.nl.
authors: J A
authors: JA
authors: Bouwens
authors: Department of Psychiatry, Leiden University Medical Center, The Netherlands.
authors: A A M
authors: AA
authors: Hubers
authors: Department of Psychiatry, Leiden University Medical Center, The Netherlands; Center for Mental Health Care Delfland, Delft, The Netherlands.
authors: E
authors: E
authors: van Duijn
authors: Department of Clinical Chemistry, Leiden University Medical Center, The Netherlands.
authors: C M
authors: CM
authors: Cobbaert
authors: Department of Neurology, Leiden University Medical Center, The Netherlands.
authors: R A C
authors: RA
authors: Roos
authors: Department of Psychiatry, Leiden University Medical Center, The Netherlands.
authors: R C
authors: RC
authors: van der Mast
authors: Department of Psychiatry, Leiden University Medical Center, The Netherlands.
authors: E J
authors: EJ
authors: Giltay
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism*; D000328:Adult; D000418:Albumins / Q000378:metabolism; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism; D003072:Cognition Disorders / Q000188:drug therapy / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000150:complications* / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D018709:Statistics, Nonparametric
chemical_list: D000209:Acute-Phase Proteins; D000418:Albumins; D014150:Antipsychotic Agents; D002097:C-Reactive Protein
keywords: Acute-phase proteins; Antipsychotics; Huntington׳s disease; Neuropsychiatric symptoms; Psychotropics