High serum soluble tumor necrosis factor receptor 1 predicts poor treatment response in acute-stage schizophrenia.
Inflammation may be involved in the pathophysiology of schizophrenia. However, few cross-sectional or longitudinal studies have examined changes in biomarker expression to evaluate diagnostic and prognostic efficacy in acute-stage schizophrenia. We compared serum inflammatory biomarker concentrations in 87 patients with acute-stage schizophrenia on admission to 105 age-, sex-, and body mass index (BMI)-matched healthy controls. The measured biomarkers were soluble tumor necrosis factor receptor 1 (sTNFR1) and adiponectin, which are associated with inflammatory responses, and pigment epithelium-derived factor (PEDF), which has anti-inflammatory properties. We then investigated biomarker concentrations and associations with clinical factors in 213 patients (including 42 medication-free patients) and 110 unmatched healthy controls to model conditions typical of clinical practice. Clinical symptoms were assessed using the Brief Psychiatric Rating Scale and Global Assessment of Function. In 121 patients, biomarker levels and clinical status were evaluated at both admission and discharge. Serum sTNFR1 was significantly higher in patients with acute-stage schizophrenia compared to matched controls while no significant group differences were observed for the other markers. Serum sTNFR1 was also significantly higher in the 213 patients compared to unmatched controls. The 42 unmedicated patients had significantly lower PEDF levels compared to controls. Between admission and discharge, sTNFR1 levels decreased significantly; however, biomarker changes did not correlate with clinical symptoms. The discriminant accuracy of sTNFR1 was 93.2% between controls and patients, showing no symptom improvement during care. Inflammation and a low-level anti-inflammatory state may be involved in both schizophrenia pathogenesis and acute-stage onset. High serum sTNFR1 in the acute stage could be a useful prognostic biomarker for treatment response in clinical practice.
Juntendo University Schizophrenia Projects (JUSP), Department of Psychiatry, Juntendo University, Faculty of Medicine, Tokyo, Japan.
Shohei
S
Nishimon
Juntendo University Schizophrenia Projects (JUSP), Department of Psychiatry, Juntendo University, Faculty of Medicine, Tokyo, Japan. Electronic address: otoru@juntendo.ac.jp.
Tohru
T
Ohnuma
Juntendo University Schizophrenia Projects (JUSP), Department of Psychiatry, Juntendo University, Faculty of Medicine, Tokyo, Japan.
Yuto
Y
Takebayashi
Juntendo University Schizophrenia Projects (JUSP), Department of Psychiatry, Juntendo University, Faculty of Medicine, Tokyo, Japan.
Narimasa
N
Katsuta
Juntendo University Schizophrenia Projects (JUSP), Department of Psychiatry, Juntendo University, Faculty of Medicine, Tokyo, Japan.
Mayu
M
Takeda
Juntendo University Schizophrenia Projects (JUSP), Department of Psychiatry, Juntendo University, Faculty of Medicine, Tokyo, Japan.
Toru
T
Nakamura
Juntendo University Schizophrenia Projects (JUSP), Department of Psychiatry, Juntendo University, Faculty of Medicine, Tokyo, Japan.
Takahiro
T
Sannohe
Juntendo University Schizophrenia Projects (JUSP), Department of Psychiatry, Juntendo University, Faculty of Medicine, Tokyo, Japan.
Ryoko
R
Higashiyama
Juntendo University Schizophrenia Projects (JUSP), Department of Psychiatry, Juntendo University, Faculty of Medicine, Tokyo, Japan.
Ayako
A
Kimoto
Juntendo University Schizophrenia Projects (JUSP), Department of Psychiatry, Juntendo University, Faculty of Medicine, Tokyo, Japan.
Nobuto
N
Shibata
Division of Nephrology, Department of Internal Medicine, Juntendo University, Faculty of Medicine, Tokyo, Japan.
Tomohito
T
Gohda
Division of Nephrology, Department of Internal Medicine, Juntendo University, Faculty of Medicine, Tokyo, Japan.
Yusuke
Y
Suzuki
Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume, Japan.
Sho-Ichi
SI
Yamagishi
Division of Nephrology, Department of Internal Medicine, Juntendo University, Faculty of Medicine, Tokyo, Japan.
Yasuhiko
Y
Tomino
Juntendo University Schizophrenia Projects (JUSP), Department of Psychiatry, Juntendo University, Faculty of Medicine, Tokyo, Japan.
Heii
H
Arai
D000208:Acute Disease; D052242:Adiponectin / Q000097:blood*; D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D005136:Eye Proteins / Q000097:blood*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000150:complications; D008297:Male; D009414:Nerve Growth Factors / Q000097:blood*; D010343:Patient Admission; D010351:Patient Discharge; D011379:Prognosis; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood*; D012559:Schizophrenia / Q000097:blood* / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D015843:Serpins / Q000097:blood*; D016896:Treatment Outcome; D055815:Young Adult; D000099174:Pigment Epithelium-Derived Factor
D052242:Adiponectin; D015415:Biomarkers; D005136:Eye Proteins; D009414:Nerve Growth Factors; D047888:Receptors, Tumor Necrosis Factor, Type I; D015843:Serpins; D000099174:Pigment Epithelium-Derived Factor; C506235:TNFRSF1A protein, human
Adiponectin; Biomarker; Inflammation; Pigment epithelium-derived factor; Schizophrenia; TNFR1