Abstract
BackgroundThe influence of antipsychotic drugs on tumor necrosis factor-α (TNF-α) levels is unclear, and there is no consensus on the association between TNF-α and psychotic symptoms. This study aimed to investigate the differences in TNF-α levels and clinical correlations in first-episode drug-naïve (FEDN) patients with schizophrenia before and after treatment and in chronic patients.MethodsA total of 103 (51 FEDN and 52 chronic) patients and 114 healthy controls were recruited. Demographic and clinical data, including TNF-α levels, were recorded. We used the Positive and Negative Syndrome Scale (PANSS) to measure the psychopathology of all patients.ResultsTNF-α levels before treatment were significantly higher in FEDN patients than in chronic patients and healthy controls. No significant sex differences were found in the TNF-α levels of patients with schizophrenia. The TNF-α levels before treatment were significantly positively related to changes in PANSS negative symptoms in FEDN patients. The TNF-α levels in chronic patients were significantly negatively correlated with the general psychopathology subscales and PANSS total scores.ConclusionsIncreased TNF-α levels in FEDN patients and their correlation with psychopathology indicate that inflammatory cytokines may play a crucial role in the etiopathogenesis of schizophrenia, and inflammation-directed therapy may, therefore, improve negative symptoms.
Highlights
The influence of antipsychotic drugs on tumor necrosis factor-α (TNF-α) levels is unclear, and there is no consensus on the association between TNF-α and psychotic symptoms
The age of first-episode drug-naïve (FEDN) patients was significantly lower than that of chronic patients and healthy controls (p < 0.001), whereas there was no significant difference in age between chronic patients and healthy controls (p > 0.05)
The education level of FEDN patients was significantly higher than that of chronic patients and healthy controls (p < 0.05), but there was no significant difference in education level between chronic patients and healthy controls (p > 0.05)
Summary
The influence of antipsychotic drugs on tumor necrosis factor-α (TNF-α) levels is unclear, and there is no consensus on the association between TNF-α and psychotic symptoms. This study aimed to investigate the differences in TNF-α levels and clinical correlations in first-episode drug-naïve (FEDN) patients with schizophrenia before and after treatment and in chronic patients. Genetic studies have shown that the strongest genetic association of schizophrenia at the population level includes the complement component 4 (C4) allele genes. During the development of schizophrenia, excessive complement activity may help to explain the decrease in synaptic numbers in the brains of patients with schizophrenia [10]. These results indicate a strong link between inflammation and schizophrenia
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