title: Effects of risperidone on cytokine profile in drug-naïve first-episode psychosis.
abstract: BACKGROUND
  There is robust evidence that schizophrenia is characterized by immune-inflammatory abnormalities, including variations on cytokine levels. The results of previous studies, however, are heterogeneous due to several confounding factors, such as the effects of antipsychotic drugs. Therefore, research on drug-naïve first-episode psychosis (FEP) patients is essential to elucidate the role of immune processes in that disorder.
  
  
  METHODS
  The aim of this study is to compare cytokine levels (IL-2, IL-10, IL-4, IL-6, IFN-γ, TNF-α, and IL-17) in drug-naïve FEP patients both before and after treatment with risperidone for 10 weeks, and to investigate possible associations between cytokine levels and clinical responses to treatment and presence of depressive symptoms. It this study, we included 55 drug-naïve FEP patients who had repeated measurements of cytokine levels and 57 healthy controls.
  
  
  RESULTS
  We found that FEP patients had significantly higher IL-6, IL-10 and TNF-α levels than healthy controls. After risperidone treatment, these three cytokines and additionally IL-4 decreased significantly. No significant difference was found between the post-treatment cytokine levels in FEP patients and in healthy controls, suggesting that these alterations in cytokine profiles are a state marker of FEP. No significant association was found between risperidone-induced changes in cytokines and the clinical response to treatment or the presence of depression. There was a significant inverse association between the risperidone-induced changes in IL-10 and the negative symptoms.
  
  
  CONCLUSIONS
  In conclusion, our results show a specific cytokine profile in FEP patients (monocytic and regulatory T-cell activation) and suggest immunoregulatory effects of risperidone treatment, characterized by suppressant effects on monocytic, Th2, and T-regulatory functions.
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Noto, Rizzo, Cordeiro, Bressan, Gadelha, and Brietzke); First Episode Psychosis Program, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil (Drs Noto, Gouveia, Honda, and Cordeiro); Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo, São Paulo, Brazil (Drs Ota, Gouveia, Spindola, and Belangero); Department of Psychiatry, Deakin University, Geelong, Vic., Australia (Dr Maes); Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand (Dr Maes).
authors.forename: Cristiano
authors.initials: C
authors.lastname: Noto
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Noto, Rizzo, Cordeiro, Bressan, Gadelha, and Brietzke); First Episode Psychosis Program, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil (Drs Noto, Gouveia, Honda, and Cordeiro); Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo, São Paulo, Brazil (Drs Ota, Gouveia, Spindola, and Belangero); Department of Psychiatry, Deakin University, Geelong, Vic., Australia (Dr Maes); Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand (Dr Maes).
authors.forename: Vanessa Kiyomi
authors.initials: VK
authors.lastname: Ota
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Noto, Rizzo, Cordeiro, Bressan, Gadelha, and Brietzke); First Episode Psychosis Program, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil (Drs Noto, Gouveia, Honda, and Cordeiro); Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo, São Paulo, Brazil (Drs Ota, Gouveia, Spindola, and Belangero); Department of Psychiatry, Deakin University, Geelong, Vic., Australia (Dr Maes); Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand (Dr Maes).
authors.forename: Eduardo S
authors.initials: ES
authors.lastname: Gouvea
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Noto, Rizzo, Cordeiro, Bressan, Gadelha, and Brietzke); First Episode Psychosis Program, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil (Drs Noto, Gouveia, Honda, and Cordeiro); Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo, São Paulo, Brazil (Drs Ota, Gouveia, Spindola, and Belangero); Department of Psychiatry, Deakin University, Geelong, Vic., Australia (Dr Maes); Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand (Dr Maes).
authors.forename: Lucas B
authors.initials: LB
authors.lastname: Rizzo
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Noto, Rizzo, Cordeiro, Bressan, Gadelha, and Brietzke); First Episode Psychosis Program, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil (Drs Noto, Gouveia, Honda, and Cordeiro); Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo, São Paulo, Brazil (Drs Ota, Gouveia, Spindola, and Belangero); Department of Psychiatry, Deakin University, Geelong, Vic., Australia (Dr Maes); Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand (Dr Maes).
authors.forename: Leticia M N
authors.initials: LM
authors.lastname: Spindola
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Noto, Rizzo, Cordeiro, Bressan, Gadelha, and Brietzke); First Episode Psychosis Program, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil (Drs Noto, Gouveia, Honda, and Cordeiro); Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo, São Paulo, Brazil (Drs Ota, Gouveia, Spindola, and Belangero); Department of Psychiatry, Deakin University, Geelong, Vic., Australia (Dr Maes); Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand (Dr Maes).
authors.forename: Pedro H S
authors.initials: PH
authors.lastname: Honda
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Noto, Rizzo, Cordeiro, Bressan, Gadelha, and Brietzke); First Episode Psychosis Program, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil (Drs Noto, Gouveia, Honda, and Cordeiro); Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo, São Paulo, Brazil (Drs Ota, Gouveia, Spindola, and Belangero); Department of Psychiatry, Deakin University, Geelong, Vic., Australia (Dr Maes); Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand (Dr Maes).
authors.forename: Quirino
authors.initials: Q
authors.lastname: Cordeiro
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Noto, Rizzo, Cordeiro, Bressan, Gadelha, and Brietzke); First Episode Psychosis Program, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil (Drs Noto, Gouveia, Honda, and Cordeiro); Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo, São Paulo, Brazil (Drs Ota, Gouveia, Spindola, and Belangero); Department of Psychiatry, Deakin University, Geelong, Vic., Australia (Dr Maes); Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand (Dr Maes).
authors.forename: Sintia Iole
authors.initials: SI
authors.lastname: Belangero
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Noto, Rizzo, Cordeiro, Bressan, Gadelha, and Brietzke); First Episode Psychosis Program, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil (Drs Noto, Gouveia, Honda, and Cordeiro); Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo, São Paulo, Brazil (Drs Ota, Gouveia, Spindola, and Belangero); Department of Psychiatry, Deakin University, Geelong, Vic., Australia (Dr Maes); Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand (Dr Maes).
authors.forename: Rodrigo Affonseca
authors.initials: RA
authors.lastname: Bressan
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Noto, Rizzo, Cordeiro, Bressan, Gadelha, and Brietzke); First Episode Psychosis Program, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil (Drs Noto, Gouveia, Honda, and Cordeiro); Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo, São Paulo, Brazil (Drs Ota, Gouveia, Spindola, and Belangero); Department of Psychiatry, Deakin University, Geelong, Vic., Australia (Dr Maes); Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand (Dr Maes).
authors.forename: Ary
authors.initials: A
authors.lastname: Gadelha
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Noto, Rizzo, Cordeiro, Bressan, Gadelha, and Brietzke); First Episode Psychosis Program, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil (Drs Noto, Gouveia, Honda, and Cordeiro); Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo, São Paulo, Brazil (Drs Ota, Gouveia, Spindola, and Belangero); Department of Psychiatry, Deakin University, Geelong, Vic., Australia (Dr Maes); Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand (Dr Maes).
authors.forename: Michael
authors.initials: M
authors.lastname: Maes
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil (Drs Noto, Rizzo, Cordeiro, Bressan, Gadelha, and Brietzke); First Episode Psychosis Program, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil (Drs Noto, Gouveia, Honda, and Cordeiro); Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo, São Paulo, Brazil (Drs Ota, Gouveia, Spindola, and Belangero); Department of Psychiatry, Deakin University, Geelong, Vic., Australia (Dr Maes); Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand (Dr Maes). elisabrietzke@hotmail.com.
authors.forename: Elisa
authors.initials: E
authors.lastname: Brietzke
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D016207:Cytokines / Q000378:metabolism*; D003863:Depression / Q000097:blood / Q000150:complications / Q000188:drug therapy; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000097:blood* / Q000150:complications / Q000188:drug therapy*; D018967:Risperidone / Q000627:therapeutic use*; D061665:Time-to-Treatment; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D016207:Cytokines; D018967:Risperidone
keywords: FEP; antipsychotic; cytokines; drug-naïve; immunology; inflammation; risperidone; schizophrenia