Abstract

Levels of certain circulating cytokines and related immune system molecules are consistently altered in schizophrenia and related disorders. In addition to absolute analyte levels, we sought analytes in correlation networks that could be prognostic. We analyzed baseline blood plasma samples with a Luminex platform from 72 subjects meeting criteria for a psychosis clinical high-risk syndrome; 32 subjects converted to a diagnosis of psychotic disorder within two years while 40 other subjects did not. Another comparison group included 35 unaffected subjects. Assays of 141 analytes passed early quality control. We then used an unweighted co-expression network analysis to identify highly correlated modules in each group. Overall, there was a striking loss of network complexity going from unaffected subjects to nonconverters and thence to converters (applying standard, graph-theoretic metrics). Graph differences were largely driven by proteins regulating tissue remodeling (e.g. blood-brain barrier). In more detail, certain sets of antithetical proteins were highly correlated in unaffected subjects (e.g. SERPINE1 vs MMP9), as expected in homeostasis. However, for particular protein pairs this trend was reversed in converters (e.g. SERPINE1 vs TIMP1, being synthetical inhibitors of remodeling of extracellular matrix and vasculature). Thus, some correlation signals strongly predict impending conversion to a psychotic disorder and directly suggest pharmaceutical targets.

Highlights

  • Circulating levels of immune system proteins and related signaling agents are consistently altered in schizophrenia

  • Psychosis conversion in high-risk subjects was characterized by marked simplifications of networks of correlated proteins that regulate tissue remodeling; this might be consistent with the hypothesis of blood–brain barrier (BBB) dysregulation in schizophrenia[30]

  • The serine protease inhibitor SERPINE1 is the major inhibitor of the plasminogen activator PLAT; PLAT activates plasminogen to plasmin which in turn degrades fibrin

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Summary

Introduction

Circulating levels of immune system proteins and related signaling agents are consistently altered in schizophrenia This observation includes unmedicated first episode psychosis patients[1,2] and persons at clinical highrisk who subsequently convert to psychosis[3,4,5]. Many of the proteins influence brain function directly, crossing blood–brain barrier (BBB) and signaling glia or other perivascular cells These immune signaling molecules regulate brain function by influencing BBB endothelial cell function and general integrity.

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