Abstract
Individuals at clinical high risk (CHR) for psychosis have been found to have altered cytokine levels, but whether these changes are related to clinical outcomes remains unclear. We addressed this issue by measuring serum levels of 20 immune markers in 325 participants (n = 269 CHR, n = 56 healthy controls) using multiplex immunoassays, and then followed up the CHR sample to determine their clinical outcomes. Among 269 CHR individuals, 50 (18.6 %) developed psychosis by two years. Univariate and machine learning techniques were used to compare levels of inflammatory markers in CHR subjects and healthy controls, and in CHR subjects who had (CHR-t), or had not (CHR-nt) transitioned to psychosis. An ANCOVA identified significant group differences (CHR-t, CHR-nt and controls) and post-hoc tests indicated that VEGF levels and the IL-10/IL-6 ratio were significantly higher in CHR-t than CHR-nt, after adjusting for multiple comparisons. Using a penalised logistic regression classifier, CHR participants were distinguished from controls with an area-under the curve (AUC) of 0.82, with IL-6 and IL-4 levels the most important discriminating features. Transition to psychosis was predicted with an AUC of 0.57, with higher VEGF level and IL-10/IL-6 ratio the most important discriminating features. These data suggest that alterations in the levels of peripheral immune markers are associated with the subsequent onset of psychosis. The association with increased VEGF levels could reflect altered blood–brain-barrier (BBB) permeability, while the link with an elevated IL-10/IL-6 ratio points to an imbalance between anti- and pro-inflammatory cytokines.
Original language | English |
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Pages (from-to) | 290-296 |
Number of pages | 7 |
Journal | Brain, Behavior, and Immunity |
Volume | 110 |
Early online date | 20 Mar 2023 |
DOIs | |
Publication status | Published - May 2023 |
Bibliographical note
Funding Information:The European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) Project is funded by grant agreement HEALTH-F2-2010-241909 (Project EU-GEI) from the European Community’s Seventh Framework Programme. Additional support was provided by a Medical Research Council Fellowship to M Kempton (grant MR/J008915/1). Prof Mondelli, Dr Blackman, Dr Kempton, Prof Valmaggia, and Prof McGuire receive funding support from the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the authors and not necessarily those of the NIHR, or the Department of Health and Social Care. Prof Mondelli is also funded by MQ: Transforming Mental Health (Grant: MQBF/1 and MQBF/4) and the Medical Research Foundation (Grant: MRF-160-0005-ELP-MONDE). Dr Barrantes-Vidal was supported by the Ministerio de Ciencia, Innovación e Universidades (PSI2017-87512-C2-1-R) and the Generalitat de Catalunya (2017SGR1612 and ICREA Academia Award).
Funding Information:
The European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) Project is funded by grant agreement HEALTH-F2-2010-241909 (Project EU-GEI) from the European Community's Seventh Framework Programme. Additional support was provided by a Medical Research Council Fellowship to M Kempton (grant MR/J008915/1). Prof Mondelli, Dr Blackman, Dr Kempton, Prof Valmaggia, and Prof McGuire receive funding support from the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the authors and not necessarily those of the NIHR, or the Department of Health and Social Care. Prof Mondelli is also funded by MQ: Transforming Mental Health (Grant: MQBF/1 and MQBF/4) and the Medical Research Foundation (Grant: MRF-160-0005-ELP-MONDE). Dr Barrantes-Vidal was supported by the Ministerio de Ciencia, Innovación e Universidades (PSI2017-87512-C2-1-R) and the Generalitat de Catalunya (2017SGR1612 and ICREA Academia Award).
Publisher Copyright:
© 2023 The Author(s)
Funding
The European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) Project is funded by grant agreement HEALTH-F2-2010-241909 (Project EU-GEI) from the European Community’s Seventh Framework Programme. Additional support was provided by a Medical Research Council Fellowship to M Kempton (grant MR/J008915/1). Prof Mondelli, Dr Blackman, Dr Kempton, Prof Valmaggia, and Prof McGuire receive funding support from the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the authors and not necessarily those of the NIHR, or the Department of Health and Social Care. Prof Mondelli is also funded by MQ: Transforming Mental Health (Grant: MQBF/1 and MQBF/4) and the Medical Research Foundation (Grant: MRF-160-0005-ELP-MONDE). Dr Barrantes-Vidal was supported by the Ministerio de Ciencia, Innovación e Universidades (PSI2017-87512-C2-1-R) and the Generalitat de Catalunya (2017SGR1612 and ICREA Academia Award). The European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) Project is funded by grant agreement HEALTH-F2-2010-241909 (Project EU-GEI) from the European Community's Seventh Framework Programme. Additional support was provided by a Medical Research Council Fellowship to M Kempton (grant MR/J008915/1). Prof Mondelli, Dr Blackman, Dr Kempton, Prof Valmaggia, and Prof McGuire receive funding support from the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the authors and not necessarily those of the NIHR, or the Department of Health and Social Care. Prof Mondelli is also funded by MQ: Transforming Mental Health (Grant: MQBF/1 and MQBF/4) and the Medical Research Foundation (Grant: MRF-160-0005-ELP-MONDE). Dr Barrantes-Vidal was supported by the Ministerio de Ciencia, Innovación e Universidades (PSI2017-87512-C2-1-R) and the Generalitat de Catalunya (2017SGR1612 and ICREA Academia Award).
Funders | Funder number |
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European Network of National Schizophrenia Networks Studying Gene-Environment Interactions | HEALTH-F2-2010-241909 |
Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust | |
King’s College London | MQBF/1, MQBF/4 |
King’s College London | |
Seventh Framework Programme | |
Ministerio de Ciencia, Innovación y Universidades | PSI2017-87512-C2-1-R |
Ministerio de Ciencia, Innovación y Universidades | |
Medical Research Council | MR/J008915/1 |
Medical Research Council | |
National Institute for Health and Care Research | |
King's College London | |
Generalitat de Catalunya | 2017SGR1612 |
Generalitat de Catalunya | |
Institució Catalana de Recerca i Estudis Avançats | |
Seventh Framework Programme | |
Medical Research Foundation | MRF-160-0005-ELP-MONDE |
Medical Research Foundation |
Keywords
- Clinical high risk
- Cytokines
- Immune markers
- Inflammation
- Interleukin-6
- Psychosis
- Transition
- VEGF