Abstract
Background: Accumulating studies have shown that the pathophysiology of schizophrenia may be associated with aberrant lysophospolipid metabolism in the early stage of brain development. Recent evidence demonstrates that antipsychotic medication can regulate the phospholipase activity. However, it remains unclear whether lysophospolipid is associated with the therapeutic response to antipsychotic medication in schizophrenia. This study aimed to investigate the influence of olanzapine monotherapy on lysophosphatidylcholine (LPC) and lysophosphatidylethanolamine (LPE) and the association between symptom improvement and changes of LPC and LPE levels during treatment in antipsychotic-naïve first-episode (ANFE) patients.Materials and Methods: The psychotic symptoms were evaluated by the Positive and Negative Syndrome Scale (PANSS). 25 ANFE patients were treated with olanzapine for 1 mo. The levels of LPC and LPE were determined and psychotic symptoms were assessed at baseline and at 1-mo follow-up.Results: Relative to baseline, the psychotic symptoms were significantly reduced after olanzapine treatment, except for negative symptoms. Moreover, the levels of most LPC and LPE increased after treatment. Interestingly, increased LPC(18:3) and LPC(20:2) levels were positively associated with the reduction rates of PANSS positive subscore. In addition, baseline levels of LPE(20:5), LPE(18:3) and LPE(22:5) were predictors for the reduction of positive symptoms.Conclusion: Our study reveals that the levels of lysophospolipid are associated with the improvement of positive symptoms, indicating that LPC may be a potential therapeutic target for olanzapine in schizophrenia. Moreover, baseline LPE levels were predictive biomarkers for the therapeutic response to olanzapine in the early stage of treatment in ANFE patients.
Highlights
Schizophrenia is a chronic and severe mental disorder affecting approximately 1% of the population (Barnett 2018)
Liquid chromatography tandem mass spectrometry (LC-MS) based metabolomics provided an opportunity to understand the pathological role of metabolites and develop new predictive biomarkers that can monitor the response to antipsychotics (KaddurahDaouk et al, 2008; Paredes et al, 2014; Pickard 2015)
Our previous study by metabolomics method showed that olanzapine treatment for 1 month significantly increased the plasma levels of several types of lysophosphatidylcholine (LPC) and lysophosphatidylethanolamine (LPE) (Liu et al, 2021)
Summary
Schizophrenia is a chronic and severe mental disorder affecting approximately 1% of the population (Barnett 2018). Most of small-molecule metabolites are currently difficult to separate and detect (Rojo et al, 2012). Their roles in the pathophysiology of schizophrenia remain unclear. Accumulating studies have shown that the pathophysiology of schizophrenia may be associated with aberrant lysophospolipid metabolism in the early stage of brain development. Recent evidence demonstrates that antipsychotic medication can regulate the phospholipase activity. It remains unclear whether lysophospolipid is associated with the therapeutic response to antipsychotic medication in schizophrenia. This study aimed to investigate the influence of olanzapine monotherapy on lysophosphatidylcholine (LPC) and lysophosphatidylethanolamine (LPE) and the association between symptom improvement and changes of LPC and LPE levels during treatment in antipsychoticnaïve first-episode (ANFE) patients
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