title: An exploratory study of immune markers in acute and transient psychosis.
abstract: The aim of this study was to look into the balance of pro-inflammatory (TNF-α, IL-6) and anti-inflammatory (TGF-β) cytokines and their association with stress, alterations in HPA axis activity and the disease severity in acute psychosis. Socio-demographic and clinical details were collected from 41 in-patients with a diagnosis of Acute and Transient Psychotic Disorder. Holmes and Rahe Stress Scale for stress in the preceding year, and Brief Psychiatric Rating Scale at baseline and follow up (4-12 weeks) for psychopathology were applied. IL-6, TNF-α (pro-inflammatory), TGF-β (anti-inflammatory) and Cortisol (morning and afternoon values) were measured at baseline and follow up. A total of 30 out of 41 cases recruited had follow up data available. The levels of IL-6 (p<0.001), TNF-α (p<0.001) and TGF-β (p<0.001) at baseline were all found to be significantly elevated compared to 42 age and gender matched healthy controls. There was a significant increase in the levels of TNF-α (p=0.020) and morning levels of cortisol (p=0.009) and a significant decrease in the levels of TGF-β (p=0.004) and afternoon levels of cortisol (p=0.043) from baseline to follow up. This study showed that there was an increased level of both pro and anti-inflammatory cytokines at baseline and a prolonged pro - inflammatory compared to anti - inflammatory response which warrants larger prospective studies and comparative studies to patients with schizophrenia and bipolar disorders.
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India. Electronic address: jayantmahadevan@gmail.com.
authors.forename: Jayant
authors.initials: J
authors.lastname: Mahadevan
authors.affiliation: Department of Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
authors.forename: Aparna
authors.initials: A
authors.lastname: Sundaresh
authors.affiliation: Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
authors.forename: Ravi Philip
authors.initials: RP
authors.lastname: Rajkumar
authors.affiliation: Department of Psychiatry, Sri Manakula Vinayagar Medical College Hospital, Puducherry, India.
authors.forename: A
authors.initials: A
authors.lastname: Muthuramalingam
authors.affiliation: Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Menon
authors.affiliation: Department of Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
authors.forename: V S
authors.initials: VS
authors.lastname: Negi
authors.affiliation: Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
authors.forename: M G
authors.initials: MG
authors.lastname: Sridhar
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007297:Inpatients; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011618:Psychotic Disorders / Q000097:blood* / Q000503:physiopathology*; D016212:Transforming Growth Factor beta / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D055815:Young Adult
chemical_list: C508600:IL6 protein, human; D015850:Interleukin-6; C439524:TNF protein, human; D016212:Transforming Growth Factor beta; D014409:Tumor Necrosis Factor-alpha; D006854:Hydrocortisone
keywords: Acute and transient psychotic disorders; Brief psychiatric rating scale; Cortisol; Hypothalamic-pituitary-adrenal (HPA) axis; Interleukin (IL)-6; Stress; Transforming Growth Factor (TGF)-β; Tumour Necrosis Factor (TNF)-α