Abstract
BackgroundIncreasing evidence indicates that dysregulated TNF-α and oxidative stress (OxS) contribute to the pathophysiology of schizophrenia. Additionally, previous evidence has demonstrated sex differences in many aspects of schizophrenia including clinical characteristics, cytokines, and OxS markers. However, to the best of our knowledge, there is no study investigating sex differences in the association between TNF-α, the OxS system, and their interaction with clinical symptoms in schizophrenia patients, especially in first-episode drug-naïve (FEDN) patients.MethodsA total of 119 FEDN schizophrenia patients and 135 healthy controls were recruited for this study. Serum TNF-α, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT), and malondialdehyde (MDA) were measured. The Positive and Negative Syndrome Scale (PANSS) was applied to evaluate psychotic symptoms. Two-way ANOVA, partial correlation analysis, and multivariate regression analysis were performed.ResultsA sex difference in MDA levels was demonstrated only in healthy controls (F = 7.06, pBonferroni = 0.045) and not seen in patients. Furthermore, only male patients had higher MDA levels than male controls (F = 8.19, pBonferroni = 0.03). Additionally, sex differences were observed in the association of TNF-α and MDA levels with psychotic symptoms (all pBonferroni < 0.05). The interaction of TNF-α and MDA was only associated with general psychopathology symptom in male patients (B = − 0.07, p = 0.02).ConclusionOur results demonstrate the sex difference in the relationship between TNF-α, MDA, and their interaction with psychopathological symptoms of patients with schizophrenia.
Highlights
Schizophrenia is a chronic and severe mental disorder characterized by psychopathological symptoms
Cadet and Lohr firstly suggested the role of oxidative mechanisms in schizophrenia in the 1980s [13] and noted the role of oxidative stress in brain dopamine (DA) systems, which are involved in the pathogenesis of schizophrenia [14]
An Analysis of variance (ANOVA) showed that male patients had a lower average body mass index (BMI) than female patients (F = 7.22, p = 0.008)
Summary
Schizophrenia is a chronic and severe mental disorder characterized by psychopathological symptoms. Growing evidence suggests that the etiology of schizophrenia may be associated with dysregulated inflammatory pathways and oxidative stress (OxS) [2,3,4]. TNF-α is one of the most important pro-inflammatory cytokines and contributes heavily to the pathophysiological process of schizophrenia [8, 9]. Previous evidence has suggested that spontaneous abnormal involuntary movements, a part of the symptoms of schizophrenia, might be associated with the pathophysiology of the disease itself without exposure to antipsychotics [20, 21]. Increasing evidence indicates that dysregulated TNF-α and oxidative stress (OxS) contribute to the pathophysiology of schizophrenia. To the best of our knowledge, there is no study investigating sex differences in the association between TNF-α, the OxS system, and their interaction with clinical symptoms in schizophrenia patients, especially in first-episode drug-naïve (FEDN) patients
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