题名

Protective Effects of Quetiapine on Metabolic and Inflammatory Abnormalities in Schizophrenic Patients during Exacerbated Stage

DOI

10.4077/CJP.2016.BAE370

作者

Yu-Chen Kao;Chih-Yuan Ko;Sheng-Chiang Wang;Yia-Ping Liu

关键词

cytokines ; inflammation ; metabolic abnormalities ; quetiapine ; schizophrenia

期刊名称

The Chinese Journal of Physiology

卷期/出版年月

59卷2期(2016 / 04 / 30)

页次

69 - 77

内容语文

英文

英文摘要

Inflammation has been considered important in the pathogenesis of schizophrenia. Increasing evidence reveals that patients with schizophrenia have abnormal expression of cytokines, which are related to development of metabolic abnormalities. Metabolic abnormality has become a critical issue, though its longitudinal relationship with the disorder, such as the antipsychotics influence, is unclear. We aimed to investigate whether abnormalities of metabolic parameters and cytokine levels in acute exacerbated schizophrenic patients existed, and whether intervention of antipsychotic could help. The present study analyzed peripheral cytokines and metabolic/hemodynamic parameters in healthy controls and acute exacerbated schizophrenic patients hospitalized for three weeks under the unique treatment of quetiapine, a well-known second-generation antipsychotic. Our results showed that patients with schizophrenia were predisposed to metabolic abnormalities in acute exacerbation, including body mass index (BMI) and waist circumference (WC). The patients were also prone to dysglycemia, lower high-density lipoprotein cholesterol (HDL-c) levels, and higher blood pressure with concomitant of elevation of interleukin (IL)-2, IL-6 and IL-10 in which IL-6 was associated with BMI. After quetiapine treatment, IL-2, IL-6 and IL-10 remained higher than the controls, but IL-10 was significantly decreased in follow-up comparison. Glycemic-related indexes, HDL-c and IL-10 levels were significantly changed by variance analysis. Results of the present study imply that acute exacerbated schizophrenic patients with metabolism abnormalities may involve disruption of expression of cytokines, and that quetiapine may have therapeutic effects. Nonetheless, metabolism parameters of patients undergoing treatment with quetiapine should be closely monitored.

主题分类 醫藥衛生 > 基礎醫學
参考文献
  1. Abidin, Z.,Davoren, M.,Naughton, L.,Gibbons, O.,Nulty, A.,Kennedy, H.G.(2013).Susceptibility (risk and protective) factors for inpatient violence and self-harm: prospective study of structured professional judgement instruments START and SAPROF, DUNDRUM-3 and DUNDRUM-4 in forensic mental health services.BMC Psychiatry,13,197.
  2. Afsar, B.(2015).Disruption of circadian blood pressure, heart rate and the impact on glycemic control in type 1 diabetes.Diabetes Metab. Syndr.,9,359-363.
  3. Amsen, D.,de Visser, K.E.,Town, T.(2009).Approaches to determine expression of inflammatory cytokines.Methods Mol. Biol.,511,107-142.
  4. Ansell, B.J.(2005).Evidence for a combined approach to the management of hypertension and dyslipidemia.Am. J. Hypertens.,18,1249-1257.
  5. Bautista, L.E.,Vera, L.M.,Arenas, I.A.,Gamarra, G.(2005).Independent association between inflammatory markers (C-reactive protein, interleukin-6, and TNF-α) and essential hypertension.J. Hum. Hypertens.,19,149-154.
  6. Bian, Q.,Kato, T.,Monji, A.,Hashioka, S.,Mizoguchi, Y.,Horikawa, H.,Kanba, S.(2008).The effect of atypical antipsychotics, perospirone, ziprasidone and quetiapine on microglial activation induced by interferon-γ.Prog. Neuropsychopharmacol. Biol. Psychiatry,32,42-48.
  7. Borovcanin, M.,Jovanovic, I.,Radosavljevic, G.,Djukic Dejanovic, S.,Stefanovic, V.,Arsenijevic, N.,Lukic, M.L.(2013).Antipsychotics can modulate the cytokine profile in schizophrenia: attenuation of the type-2 inflammatory response.Schizophr. Res.,147,103-109.
  8. Bresee, L.C.,Majumdar, S.R.,Patten, S.B.,Johnson, J.A.(2010).Prevalence of cardiovascular risk factors and disease in people with schizophrenia: a population-based study.Schizophr. Res.,117,75-82.
  9. Coppieters, K.T.,von Herrath, M.G.(2014).Metabolic syndrome-removing roadblocks to therapy: antigenic immunotherapies.Mol. Metab.,3,275-283.
  10. Cutler, A.,Ball, S.,Stahl, S.M.(2008).Dosing atypical antipsychotics.CNS Spectr.,13,1-16.
  11. de Leon, J.,Susce, M.T.,Johnson, M.,Hardin, M.,Pointer, L.,Ruaño, G.,Windemuth, A.,Diaz, F.J.(2007).A clinical study of the association of antipsychotics with hyperlipidemia.Schizophr. Res.,92,95-102.
  12. Espinosa-Oliva, A.M.,de Pablos, R.M.,Sarmiento, M.,Villarán, R.F.,Carrillo-Jiménez, A.,Santiago, M.,Venero, J.L.,Herrera, A.J.,Cano, J.,Machado, A.(2014).Role of dopamine in the recruitment of immune cells to the nigro-striatal dopaminergic structures.Neurotoxicology,41,89-101.
  13. Ferrante, A.W. Jr.(2007).Obesity-induced inflammation: a metabolic dialogue in the language of inflammation.J. Intern. Med.,262,408-414.
  14. Fineberg, A.M.,Ellman, L.M.(2013).Inflammatory cytokines and neurological and neurocognitive alterations in the course of schizophrenia.Biol. Psychiatry,73,951-966.
  15. Gao, L.,Li, Z.,Chang, S.,Wang, J.(2014).Association of interleukin-10 polymorphisms with schizophrenia: a meta-analysis.PLoS One,9,e90407.
  16. Gupta, S.,Masand, P.S.,Virk, S.,Schwartz, T.,Hameed, A.,Frank, B.L.,Lockwood, K.(2004).Weight decline in patients switching from olanzapine to quetiapine.Schizophr. Res.,70,57-62.
  17. Hara, K.,Horikoshi, M.,Yamauchi, T.,Yago, H.,Miyazaki, O.,Ebinuma, H.,Imai, Y.,Nagai, R.,Kadowaki, T.(2006).Measurement of the high-molecular weight form of adiponectin in plasma is useful for the prediction of insulin resistance and metabolic syndrome.Diabetes Care,29,1357-1362.
  18. Himmerich, H.,Schönherr, J.,Fulda, S.,Sheldrick, A.J.,Bauer, K.,Sack, U.(2011).Impact of antipsychotics on cytokine production invitro.J. Psychiatr. Res.,45,1358-1365.
  19. Keller, W.R.,Fischer, B.A.,McMahon, R.P.,Meyer, W.,Buchanan, R.W.(2013).Open-label salsalate for the treatment of prediabetes in people with schizophrenia.Schizophr. Res.,147,408-409.
  20. Kim, H.,Bang, J.,Chang, H.W.,Kim, J.Y.,Park, K.U.,Kim, S.H.,Lee, K.J.,Cho, C.H.,Hwang, I.,Park, S.D.,Ha, E.,Jung, S.W.(2012).Anti-inflammatory effect of quetiapine on collagen-induced arthritis of mouse.Eur. J. Pharmacol.,678,55-60.
  21. Klemettilä, J.P.,Kampman, O.,Seppälä, N.,Viikki, M.,Hämäläinen, M.,Moilanen, E.,Leinonen, E.(2014).Cytokine and adipokine alterations in patients with schizophrenia treated with clozapine.Psychiatry Res.,218,277-283.
  22. Ko, C.Y.,Liu, Y.P.(2015).Isolation rearing impaired sensorimotor gating but increased pro-inflammatory cytokines and disrupted metabolic parameters in both sexes of rats.Psychoneuroendocrinology,55,173-183.
  23. Kunz, M.,Ceresér, K.M.,Goi, P.D.,Fries, G.R.,Teixeira, A.L.,Fernandes, B.S.,Belmonte-de-Abreu, P.S.,Kauer-Sant'Anna, M.,Kapczinski, F.,Gama, C.S.(2011).Serum levels of IL-6, IL-10 and TNF-α in patients with bipolar disorder and schizophrenia: differences in pro- and anti-inflammatory balance.Rev. Bras. Psiquiatr.,33,268-274.
  24. Kuo, S.M.,Halpern, M.M.(2011).Lack of association between body mass index and plasma adiponectin levels in healthy adults.Int. J. Obes.,35,1487-1494.
  25. Lee, S.Y.,Park, M.H.,Patkar, A.A.,Pae, C.U.(2011).A retrospective comparison of BMI changes and the potential risk factors among schizophrenic inpatients treated with aripiprazole, olanzapine, quetiapine or risperidone.Prog. Neuropsychopharmacol. Biol. Psychiatry,35,490-496.
  26. Lofgren, P.,van Harmelen, V.,Reynisdottir, S.,Näslund, E.,Rydén, M.,Rössner, S.,Arner, P.(2000).Secretion of tumor necrosis factor-α shows a strong relationship to insulin-stimulated glucose transport in human adipose tissue.Diabetes,49,688-692.
  27. López-Muñoz, F.,Alamo, C.(2013).Active metabolites as antidepressant drugs: the role of norquetiapine in the mechanism of action of quetiapine in the treatment of mood disorders.Front. Psychiatry,4,102.
  28. McAllister, C.G.,van Kammen, D.P.,Rehn, T.J.,Miller, A.L.,Gurklis, J.,Kelley, M.E.,Yao, J.,Peters, J.L.(1995).Increases in CSF levels of interleukin-2 in schizophrenia: effects of recurrence of psychosis and medication status.Am. J. Psychiatry,152,1291-1297.
  29. McGrath, J.,Saha, S.,Chant, D.,Welham, J.(2008).Schizophrenia: a concise overview of incidence, prevalence, and mortality.Epidemiol. Rev.,30,67-76.
  30. Meshkani, R.,Adeli, K.(2009).Hepatic insulin resistance, metabolic syndrome and cardiovascular disease.Clin. Biochem.,42,1331-1346.
  31. Mikkola, I.,Keinänen-Kiukaanniemi, S.,Laakso, M.,Jokelainen, J.,Härkönen, P.,Meyer-Rochow, V.B.,Juuti, A.K.,Peitso, A.,Timonen, M.(2007).Metabolic syndrome in connection with BMI in young finnish male adults.Diabetes Res. Clin. Pract.,76,404-409.
  32. Miller, B.J.,Buckley, P.,Seabolt, W.,Mellor, A.,Kirkpatrick, B.(2011).Meta-analysis of cytokine alterations in schizophrenia: clinical status and antipsychotic effects.Biol. Psychiatry,70,663-671.
  33. Miranda, P.J.,DeFronzo, R.A.,Califf, R.M.,Guyton, J.R.(2005).Metabolic syndrome: definition, pathophysiology, and mechanisms.Am. Heart J.,149,33-45.
  34. Mitchell, A.J.,Vancampfort, D.,De Herdt, A.,Yu, W.,De Hert, M.(2013).Is the prevalence of metabolic syndrome and metabolic abnormalities increased in early schizophrenia? A comparative metaanalysis of first episode, untreated and treated patients.Schizophr. Bull.,39,295-305.
  35. Mitchell, A.J.,Vancampfort, D.,Sweers, K.,van Winkel, R.,Yu, W.,De Hert, M.(2013).Prevalence of metabolic syndrome and metabolic abnormalities in schizophrenia and related disorders-a systematic review and meta-analysis.Schizophr. Bull.,39,306-318.
  36. Moncrieff, J.(2006).Does antipsychotic withdrawal provoke psychosis? Review of the literature on rapid onset psychosis (supersensitivity psychosis) and withdrawal-related relapse.Acta Psychiatr. Scand.,114,3-13.
  37. Na, K.S.,Jung, H.Y.,Kim, Y.K.(2014).The role of pro-inflammatory cytokines in the neuroinflammation and neurogenesis of schizophrenia.Prog. Neuropsychopharmacol. Biol. Psychiatry,48,277-286.
  38. Na, K.S.,Kim, Y.K.(2007).Monocytic, Th1 and Th2 cytokine alterations in the pathophysiology of schizophrenia.Neuropsychobiology,56,55-63.
  39. Osburg, B.,Peiser, C.,Domling, D.,Schomburg, L.,Ko, Y.T.,Voigt, K.,Bickel, U.(2002).Effect of endotoxin on expression of TNF receptors and transport of TNF-α at the blood-brain barrier of the rat.Am. J. Physiol. Endocrinol. Metab.,283,899-908.
  40. Ozaki, K.,Leonard, W.J.(2002).Cytokine and cytokine receptor pleiotropy and redundancy.J. Biol. Chem.,277,29355-29358.
  41. Park, H.S.,Park, J.Y.,Yu, R.(2005).Relationship of obesity and visceral adiposity with serum concentrations of CRP, TNF-α and IL-6.Diabetes Res. Clin. Pract.,69,29-35.
  42. Prasad, K.,Dhar, I.(2014).Oxidative stress as a mechanism of added sugar-induced cardiovascular disease.Int. J. Angiol.,23,217-226.
  43. Quagliarello, V.J.,Wispelwey, B.,Long, Jr. W.J.,Scheld, W.M.(1991).Recombinant human interleukin-1 induces meningitis and bloodbrain barrier injury in the rat. Characterization and comparison with tumor necrosis factor.J. Clin. Invest.,87,1360-1366.
  44. Richard, M.D.,Brahm, N.C.(2012).Schizophrenia and the immune system: pathophysiology, prevention, and treatment.Am. J. Health Syst. Pharm.,69,757-766.
  45. Ryan, M.C.,Collins, P.,Thakore, J.H.(2003).Impaired fasting glucose tolerance in first-episode, drug-naive patients with schizophrenia.Am. J. Psychiatry,160,284-289.
  46. Saddichha, S.,Manjunatha, N.,Ameen, S.,Akhtar, S.(2008).Metabolic syndrome in first episode schizophrenia - a randomized double-blind controlled, short-term prospective study.Schizophr. Res.,101,266-272.
  47. Sobiś, J.,Rykaczewska-Czerwińska, M.,Świętochowska, E.,Gorczyca, P.(2015).Therapeutic effect of aripiprazole in chronic schizophrenia is accompanied by anti-inflammatory activity.Pharmacol. Rep.,67,353-359.
  48. Steiner, J.,Bernstein, H.G.,Schiltz, K.,Müller, U.J.,Westphal, S.,Drexhage, H.A.,Bogerts, B.(2014).Immune system and glucose metabolism interaction in schizophrenia: a chicken-egg dilemma.Prog. Neuropsychopharmacol. Biol. Psychiatry,48,287-294.
  49. Strous, R.D.,Shoenfeld, Y.(2006).Schizophrenia, autoimmunity and immune system dysregulation: a comprehensive model updated and revisited.J. Autoimmun.,27,71-80.
  50. Suvisaari, J.,Loo, B.M.,Saarni, S.E.,Haukka, J.,Perälä, J.,Saarni, S.I.,Viertiö, S.,Partti, K.,Lönnqvist, J.,Jula, A.(2011).Inflammation in psychotic disorders: a population-based study.Psychiatry Res.,189,305-311.
  51. Tschoner, A.,Engl, J.,Laimer, M.,Kaser, S.,Rettenbacher, M.,Fleischhacker, W.W.,Patsch, J.R.,Ebenbichler, C.F.(2007).Metabolic side effects of antipsychotic medication.Int. J. Clin. Pract.,61,356-1370.
  52. Wellen, K.E.,Hotamisligil, G.S.(2005).Inflammation, stress, and diabetes.J. Clin. Invest.,115,1111-1119.
  53. Woodroofe, M.N.(1995).Cytokine production in the central nervous system.Neurology,45,6-10.
  54. Xiu, M.H.,Yang, G.G.,Tan, Y.L.,Chen, D.C.,Tan, S.P.,Wang, Z.R.,Yang, F.D.,Okusaga, O.,Soares, J.C.,Zhang, X.Y.(2014).Decreased interleukin-10 serum levels in first-episode drug-naïve schizophrenia: relationship to psychopathology.Schizophr. Res.,156,9-14.
  55. Zhang, X.Y.,Zhou, D.F.,Cao, L.Y.,Zhang, P.Y.,Wu, G.Y.,Shen, Y.C.(2004).Changes in serum interleukin-2, -6, and -8 levels before and during treatment with risperidone and haloperidol: relationship to outcome in schizophrenia.J. Clin. Psychiatry,65,940-947.