Inflammatory markers and indicators of systemic endotoxemia in patients with treatment-resistant schizophrenia

Abstract

Introduction Elevated levels of lipopolysaccharide (LPS) in circulation support chronic inflammation, which is involved in the pathological process in the brain and may be a contributing factor to treatment resistance in schizophrenia. Objectives To compare inflammatory markers and indicators of systemic endotoxemia (SE) in patients with treatment-resistant schizophrenia and in those with a good response to treatment. Methods The study involved 34 patients with schizophrenia (27±7,5 years) (F20) in an acute psychotic state: 15 patients with TRS (non-responders), 19 patients responded to treatment with reduced symptoms (responders). The markers of systemic inflammation (leukocyte elastase (LE) and a1-proteinase inhibitor (α1-PI) activity, CRP concentration, antibodies (Abs) to S100B and myelin basic protein) and the indicators of SE (LPS level and Abs to LPS) were determined in the blood of patients. Results The responders showed a significant increase in LE and α1-P1 activity (p<0.001), CRP concentration (p<0.05), and Abs to neuroantigens (p<0.05) compared to controls. LPS levels did not differ from control values. In non-responders, a moderate increase in LE and α1-PI activities (p<0.05) and a significant increase in CRP concentration (p=0.01) were accompanied by no significant differences in Abs to neuroantigens. These patients had elevated LPS level and Abs to LPS deficiency compared with both responders (p<0.01) and controls (p<0.05). Conclusions The identified spectra of systemic inflammation markers, elevated LPS level, and insufficient anti-endotoxin immunity in patients with treatment-resistant schizophrenia may be related to endotoxin tolerance. Further research in this field can help develop new approaches to overcoming resistance to therapy in patients with schizophrenia. Disclosure of Interest None Declared