Anti-inflammatory Strategies for Schizophrenia: A Review of Evidence for Therapeutic Applications and Drug Repurposing

Hong, Jonghee; Bang, Minji

doi:10.9758/cpn.2020.18.1.10

Cited by 57 publications

(34 citation statements)

References 134 publications

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“…Taking schizophrenia as a brief example, supplementary treatment of schizophrenia with anti-inflammatory drugs like aspirin, statins, and minocycline has largely proven to be effective in reducing clinical schizophrenic symptoms, as compared to sole treatment with antipsychotics. Schizophrenia patients have been shown to have high levels of inflammatory cytokines, such as TNF-α, IL-1β, and IL-6, as well as high microglial activation throughout the brain as shown by PET scans and postmortem biopsies ( Hong and Bang, 2020 ). Furthermore, there are many forms of evidence suggesting a role for adaptive immunity in schizophrenia patients.…”

Section: Neuroinflammation In Neurological Disordersmentioning

confidence: 99%

Repurposing Immunomodulatory Imide Drugs (IMiDs) in Neuropsychiatric and Neurodegenerative Disorders

et al. 2021

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Neuroinflammation represents a common trait in the pathology and progression of the major psychiatric and neurodegenerative disorders. Neuropsychiatric disorders have emerged as a global crisis, affecting 1 in 4 people, while neurological disorders are the second leading cause of death in the elderly population worldwide (WHO, 2001; GBD 2016 Neurology Collaborators, 2019). However, there remains an immense deficit in availability of effective drug treatments for most neurological disorders. In fact, for disorders such as depression, placebos and behavioral therapies have equal effectiveness as antidepressants. For neurodegenerative diseases such as Parkinson’s disease and Alzheimer’s disease, drugs that can prevent, slow, or cure the disease have yet to be found. Several non-traditional avenues of drug target identification have emerged with ongoing neurological disease research to meet the need for novel and efficacious treatments. Of these novel avenues is that of neuroinflammation, which has been found to be involved in the progression and pathology of many of the leading neurological disorders. Neuroinflammation is characterized by glial inflammatory factors in certain stages of neurological disorders. Although the meta-analyses have provided evidence of genetic/proteomic upregulation of inflammatory factors in certain stages of neurological disorders. Although the mechanisms underpinning the connections between neuroinflammation and neurological disorders are unclear, and meta-analysis results have shown high sensitivity to factors such as disorder severity and sample type, there is significant evidence of neuroinflammation associations across neurological disorders. In this review, we summarize the role of neuroinflammation in psychiatric disorders such as major depressive disorder, generalized anxiety disorder, post-traumatic stress disorder, and bipolar disorder, as well as in neurodegenerative disorders, such as Parkinson’s disease and Alzheimer’s disease, and introduce current research on the potential of immunomodulatory imide drugs (IMiDs) as a new treatment strategy for these disorders.

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Section: Neuroinflammation In Neurological Disordersmentioning

confidence: 99%

Repurposing Immunomodulatory Imide Drugs (IMiDs) in Neuropsychiatric and Neurodegenerative Disorders

et al. 2021

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“…With global use of CPZ, reports have shown that patients receiving CPZ had a lower incidence of bacterial infections (Kristiansen and Amaral, 1997). There is also growing evidence to suggest that inflammation, infection, oxidative stress, changes in the glutamatergic system, and neurotrophins are involved in schizophrenia (Hong and Bang, 2020). CPZ also has antimicrobial activity against Staphylococcus aureus in vitro, at concentrations greatly exceeding those achieved clinically (Ordway et al, 2002;Amaral and Molnar, 2012).…”

Section: Chlorpromazine and Microbial Infectionsmentioning

confidence: 99%

The Large Action of Chlorpromazine: Translational and Transdisciplinary Considerations in the Face of COVID-19

et al. 2020

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Coronavirus disease 2019 (COVID-19) is a severe acute respiratory syndrome (SARS) in humans that is caused by SARS-associated coronavirus type 2 (SARS-CoV-2). In the context of COVID-19, several aspects of the relations between psychiatry and the pandemic due to the coronavirus have been described. Some drugs used as antiviral medication have neuropsychiatric side effects, and conversely some psychotropic drugs have antiviral properties. Chlorpromazine (CPZ, Largactil®) is a well-established antipsychotic medication that has recently been proposed to have antiviral activity against SARS-CoV-2. This review aims to 1) inform health care professionals and scientists about the history of CPZ use in psychiatry and its potential anti- SARS-CoV-2 activities 2) inform psychiatrists about its potential anti-SARS-CoV-2 activities, and 3) propose a research protocol for investigating the use of CPZ in the treatment of COVID-19 during the potential second wave. The history of CPZ’s discovery and development is described in addition to the review of literature from published studies within the discipline of virology related to CPZ. The early stages of infection with coronavirus are critical events in the course of the viral cycle. In particular, viral entry is the first step in the interaction between the virus and the cell that can initiate, maintain, and spread the infection. The possible mechanism of action of CPZ is related to virus cell entry via clathrin-mediated endocytosis. Therefore, CPZ could be useful to treat COVID-19 patients provided that its efficacy is evaluated in adequate and well-conducted clinical trials. Interestingly, clinical trials of very good quality are in progress. However, more information is still needed about the appropriate dosage regimen. In short, CPZ repositioning is defined as a new use beyond the field of psychiatry.

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“…These present possible pre-natal targets for reducing susceptibility for developing schizophrenia. Treatment targets include neuroprotection and functional enhancement to prevent abnormal structural and functional changes in the brain, reduction of oxidative stress and toxicity, reduction of pro-inflammatory cytokines, increase in anti-inflammatory cytokines, modulation of microglia function, and reduction of environmental stressors (Hong & Bang, 2020).…”

Section: Anti-inflammatory and Immunomodulating Agentsmentioning

confidence: 99%

“…It is also possible that optimal use of antipsychotic medication could help reduce inflammation. 4 Also, targeting immune and anti-inflammatory therapies to specific bio-markers and specific clinical sub-groups could provide a more personalized, and hopefully, more effective approach to treating schizophrenia (Hong & Bang, 2020;Krogmann et al, 2019;Pandurangi & Buckley, 2020;Sommer et al, 2012).…”

Section: Anti-inflammatory and Immunomodulating Agentsmentioning

confidence: 99%

Schizophrenia: Epidemiology, Causes, Neurobiology, Pathophysiology, and Treatment

Volkan¹

2020

jhms

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Schizophrenia is a severe mental illness that has devastating consequences for those who suffer from the disorder. The epidemiology of schizophrenia indicates that it occurs relatively often, in many different contexts, and in conjunction with other disorders, decreasing quality of life and causing premature death. There has been an enormous amount of research into the causes of schizophrenia and there is now have a much better understanding of the genetic, environmental, and psychological factors that contribute to the disease. While there are numerous ways to understand and conceptualize schizophrenia, a unified picture of the neurobiology, changes in brain structure, cognitive and social-cognitive impairments related to the disorder has yet to emerge. Convulsive therapies and psychosurgery were used unsuccessfully, indiscriminately and without scientific validation in the past to treat schizophrenia. Medical advances including advanced imaging technology have now provided the ability to perform specifically focused neuromodulation and psychosurgery in severe and treatment resistant cases of schizophrenia. While still at a preliminary stage, these approaches have the potential to yield effective treatments in the future. For the last 70 years antipsychotic medication has become the prevailing treatment for schizophrenia. However, many people suffering from the disorder have trouble with side-effects and adhering to a regimen of antipsychotic medication. Newer pharmacological agents are being developed and include not only novel antipsychotic drugs, but anti-inflammatory and immunomodulating agents as well. These new agents, used either alone or in combination, have the potential to improve outcomes for people suffering from schizophrenia. Nevertheless, conclusively better pharmacotherapies will likely not arise until there is better understanding of the pathophysiology underlying schizophrenia. After the development of antipsychotic medication, psychotherapeutic methods for treating schizophrenia fell out of favor, but there is currently some reversal of this trend. The use of newer psychotherapies and modified forms of older therapeutic treatments are not only targeting the symptoms of schizophrenia but are also now focusing on recovery from the disorder. These newer approaches as well as efforts at preventing schizophrenia show promise in reducing the suffering caused by this disease.

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Anti-inflammatory Strategies for Schizophrenia: A Review of Evidence for Therapeutic Applications and Drug Repurposing

Cited by 57 publications

References 134 publications

Repurposing Immunomodulatory Imide Drugs (IMiDs) in Neuropsychiatric and Neurodegenerative Disorders

Repurposing Immunomodulatory Imide Drugs (IMiDs) in Neuropsychiatric and Neurodegenerative Disorders

The Large Action of Chlorpromazine: Translational and Transdisciplinary Considerations in the Face of COVID-19

Schizophrenia: Epidemiology, Causes, Neurobiology, Pathophysiology, and Treatment

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