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Cortisol and Inflammatory Biomarkers Predict Poor Treatment Response in First Episode Psychosis

Title: Cortisol and Inflammatory Biomarkers Predict Poor Treatment Response in First Episode Psychosis
Author(s): Mondelli, V
Ciufolini, S
Belvederi Murri, M
Bonaccorso, S
Di Forti, M
Giordano, A
Marques, TR
Zunszain, PA
Morgan, C
Murray, RM
Pariante, CM
Dazzan, P
Item Type: Journal Article
Abstract: BACKGROUND: Cortisol and inflammatory markers have been increasingly reported as abnormal at psychosis onset. The main aim of our study was to investigate the ability of these biomarkers to predict treatment response at 12 weeks follow-up in first episode psychosis. METHODS: In a longitudinal study, we collected saliva and blood samples in 68 first episode psychosis patients (and 57 controls) at baseline and assessed response to clinician-led antipsychotic treatment after 12 weeks. Moreover, we repeated biological measurements in 39 patients at the same time we assessed the response. Saliva samples were collected at multiple time points during the day to measure diurnal cortisol levels and cortisol awakening response (CAR); interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor-α, and interferon-γ (IFN-γ) levels were analyzed from serum samples. Patients were divided into Non-Responders (n = 38) and Responders (n = 30) according to the Remission symptom criteria of the Schizophrenia Working Group Consensus. RESULTS: At first onset, Non-Responders had markedly lower CAR (d = 0.6, P = .03) and higher IL-6 and IFN-γ levels (respectively, d = 1.0, P = .003 and d = 0.9, P = .02) when compared with Responders. After 12 weeks, Non-Responders show persistent lower CAR (P = .01), and higher IL-6 (P = .04) and IFN-γ (P = .05) when compared with Responders. Comparison with controls show that these abnormalities are present in both patients groups, but are more evident in Non-Responders. CONCLUSIONS: Cortisol and inflammatory biomarkers at the onset of psychosis should be considered as possible predictors of treatment response, as well as potential targets for the development of novel therapeutic agents.
Publication Date: 31-Mar-2015
Date of Acceptance: 31-Mar-2015
URI: http://hdl.handle.net/10044/1/40539
DOI: http://dx.doi.org/10.1093/schbul/sbv028
ISSN: 1745-1701
Publisher: Oxford University Press
Start Page: 1162
End Page: 1170
Journal / Book Title: Schizophrenia Bulletin
Volume: 41
Issue: 5
Copyright Statement: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: HPA axis
cytokine
inflammation
outcome
schizophrenia
stress
Adult
Antipsychotic Agents
Biomarkers
Cytokines
Female
Follow-Up Studies
Humans
Hydrocortisone
Inflammation
Male
Prognosis
Psychotic Disorders
Treatment Outcome
Humans
Inflammation
Hydrocortisone
Antipsychotic Agents
Cytokines
Prognosis
Treatment Outcome
Follow-Up Studies
Psychotic Disorders
Adult
Female
Male
Biomarkers
Psychiatry
11 Medical And Health Sciences
17 Psychology And Cognitive Sciences
Publication Status: Published
Appears in Collections:Clinical Sciences
Imaging Sciences
Faculty of Medicine



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