精神分裂症患者治疗前血清MCP-1水平预测利培酮疗效

背景:精神分裂症是一种慢性致残性疾病,其发病及治疗可能与炎性细胞因子有关.目前细胞因子预测抗精神病药物疗效的研究尚少.目的:研究细胞因子对抗精神病药物疗效的预测作用.方法:采用横断面与自然观察随访相结合的方法,(1)对比精神分裂症患者组(n=64)基线期和正常对照组(n=53)血清IL-1β、TNF-α和MCP-1水平;(2)探索基线期细胞因子水平对奥氮平或利培酮单药治疗效果的影响.结果:(1)精神分裂症患者治疗前血清MCP-1水平明显高于健康对照组(t=2.62,p=0.010),IL-1β(t=1.43,p=0.154)、TNF-α(t=0.79,p=0.434)未见变化;(2)精神分裂症患者治疗前MCP-1水平与利培酮单药治疗4周后PANSS量表一般病理评分的减少量呈显著负相关(r=-0.658;p﹤0.001),但在奥氮平组中则未发现(r=-0.031;p=0.855);(3)纳入性别、年龄、受教育年限和BMI后等影响因素后,多元线性回归分析发现,基线血清MCP-1水平可作为利培酮单药治疗效果的独立预测因子(校正R2=0.409,β=-0.658,p﹤0.001).结论:MCP-1可能参与精神分裂症的发生,治疗前血清MCP-1水平可能是利培酮疗效预测的生物标记物.

Pretreatment Serum MCP-1 Level Predicts Response to Risperidone in Schizophrenia

Background: Schizophrenia is a chronic debilitating disease. The pathogenesis and treatment may be associated with inflammatory cytokines. There are few studies focusing on the prediction of cytokines in response to antipsychotics. Aim: To investigate whether cytokines would predict response to antipsychotics. Methods: Cross-sectional and natural observational cohort studies were applied to:(1) compare the baseline levels of serum IL-1β, TNF-α and MCP-1 between schizophrenia (n=64) and healthy controls (n=53); (2) To investigate the impact of baseline cytokines to psychopathology following olanzapine and risperidone monotherapy. Results: (1) Baseline MCP-1 level of patients with schizophrenia was significantly higher than healthy controls (t=2.62, p=0.010), while no significance was found in IL-1β (t=1.43, p=0.154) and TNF-α (t=0.79, p=0.434); (2) Pretreatment level of MCP-1 significantly correlated with PANSS-G reduction following 4 weeks' of risperidone monotherapy (r =-0.658; p<0.001) but not olanzapine monotherapy (r =-0.031; p=0.855); (3) Further stepwise multiple linear regression analysis indicated that higher MCP-1 level prior to treatment was a significant predictor of less PANSS-G reduction in schizophrenia patients following risperidone monotherapy (adjusted R2= 0.409, β = -0.658, p <0.001), but not in the olanzapine group. Conclusion: MCP-1 may play a role in the pathogenesis of schizophrenia. Pretreatment level of MCP-1 may serve as a biomarker indicating response to risperidone treatment.