Could CRP be a differential biomarker of illness stages in schizophrenia? A systematic review and meta-analysis

Lestra, Valentine; Roméo, Bruno; Martelli, Catherine; Benyamina, Aminé; Hamdani, Nora

doi:10.1016/j.schres.2022.06.026

Cited by 23 publications

(14 citation statements)

References 111 publications

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“…A converging and expanding literature supports an association between elevated peripheral blood levels of CRP and cognitive dysfunction in patients with SP. 5,[18][19][20][21][22] Moreover, associations were found between declining "personal social performance," reduced processing speed, and higher CRP levels in a crosssectional study of patients with SP. 19 These data are consistent with our current findings.…”

Section: Discussionmentioning

confidence: 90%

“…4 High-sensitivity (hs) CRP is an acute phase protein and sensitive marker of subclinical inflammation that is associated with cognitive dysfunction and may contribute to the pathogenesis of SP. 5 It has been defined that CRP is associated with cognitive dysfunction. 6,7 Homocysteine (Hcy) is a nonprotein amino acid containing sulfhydryl derived from methionine and is a homolog of cysteine.…”

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confidence: 99%

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Correlation of Serum High-Sensitivity C-Reactive Protein, Homocysteine, and Macrophage Migration Inhibitory Factor Levels With Symptom Severity and Cognitive Function in Patients With Schizophrenia

Weng,

Zheng,

Lin

2024

Clin Neuropharm

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Objective This trial analyzed high-sensitivity C-reactive protein (hs-CRP), homocysteine (Hcy), and macrophage migration inhibitory factor (MIF) level in serum and their correlation with symptom severity and cognitive function in patients with schizophrenia (SP). Methods Sixty-eight SP patients were enrolled in the SP group, and 68 healthy volunteers were in the control (CN) group. Serum hs-CRP, Hcy, and MIF were measured, and symptom severity was assessed with the Positive and Negative Symptom Scale (PANSS). Cognitive function was determined with the MATRICS Consensus Cognitive Battery (MCCB). The SP group was divided into high PANSS score (PANSS ≥70 points) and low PANSS score (PANSS <70 points), or the mild cognitive dysfunction group and severe cognitive dysfunction group according to the median MCCB score. The correlation between serum hs-CRP, Hcy, and MIF levels and PANSS and MCCB scores in SP patients was examined by Pearson correlation analysis. Results SP patients had higher serum hs-CRP, Hcy, and MIF levels and showed higher PANSS scores and lower MCCB total score. Serum hs-CRP, Hcy, and MIF levels in the high PANSS group were higher than those in the low PANSS group and in the severe cognitive dysfunction group than in the mild cognitive dysfunction group. Serum hs-CRP, Hcy, and MIF levels in SP patients were positively correlated with PANSS total score and negatively correlated with MCCB total score. Conclusion High serum hs-CRP, Hcy, and MIF levels in SP patients are correlated with symptom severity and cognitive dysfunction.

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Section: Discussionmentioning

confidence: 90%

mentioning

confidence: 99%

Correlation of Serum High-Sensitivity C-Reactive Protein, Homocysteine, and Macrophage Migration Inhibitory Factor Levels With Symptom Severity and Cognitive Function in Patients With Schizophrenia

Weng,

Zheng,

Lin

2024

Clin Neuropharm

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“…CRP levels fluctuate in response to change in inflammatory status and may be used to infer whether low-grade systemic inflammation is associated with cognitive impairment. In fact, increased levels of CRP have been consistently reported in SZ and BD relative to healthy controls, and previously found to be modestly associated with clinical-and cognitive characteristics (Fernandes et al, 2016;Fond et al, 2018;Halstead et al, 2023;Jacomb et al, 2018;Johnsen et al, 2016;Lestra et al, 2022;Millett et al, 2021;Misiak et al, 2018;Patlola et al, 2023).…”

Section: Introductionmentioning

confidence: 93%

Longitudinal course of inflammatory-cognitive subgroups across first treatment severe mental illness and healthy controls

Sæther,

Ueland,

Haatveit

et al. 2024

Preprint

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Background While inflammation is associated with cognitive impairment in severe mental illnesses (SMI), there is substantial heterogeneity and evidence of transdiagnostic subgroups across schizophrenia (SZ) and bipolar (BD) spectrum disorders. There is however, limited knowledge about the longitudinal course of this relationship. Methods Systemic inflammation (C-Reactive Protein, CRP) and cognition (nine cognitive domains) was measured from baseline to 1 year follow-up in first treatment SZ and BD (n=221), and healthy controls (HC, n=220). Linear mixed models were used to evaluate longitudinal changes separately in CRP and cognitive domains specific to diagnostic status (SZ, BD, HC). Hierarchical clustering was applied on the entire sample to investigate the longitudinal course of transdiagnostic inflammatory-cognitive subgroups. Results There were no case-control differences or change in CRP from baseline to follow-up. We confirm previous observations of case-control differences in cognition at both time-points and domain specific stability/improvement over time regardless of diagnostic status. We identified transdiagnostic inflammatory-cognitive subgroups at baseline with differing demographics and clinical severity. Despite improvement in cognition, symptoms and functioning, the higher inflammation-lower cognition subgroup (75% SZ; 48% BD; 38% HC) had sustained inflammation and lower cognition, more symptoms, and lower functioning (SMI only) at follow-up. This was in comparison to a lower inflammation-higher cognition subgroup (25% SZ, 52% BD, 62% HC), where SMI participants showed cognitive functioning at HC level with a positive clinical course. Conclusions Our findings support heterogenous and transdiagnostic inflammatory-cognitive subgroups that are stable over time, and may benefit from targeted interventions.

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“…A dysbalance of the immune system in psychotic disorders has been well investigated (Khandaker et al ., 2015). The vulnerability-stress-inflammation model (Howes & McCutcheon, 2017; Müller, 2018; Lestra et al ., 2022) implies an imbalance of the microglia activation (M1/M2 pathways’ homeostasis) leading to an over-expression of pro-inflammatory cytokines (Howes & McCutcheon, 2017). This imbalance could be due to microglia priming, including perinatal insults, early life stresses or genetic vulnerabilities, which leads to a pro-inflammatory M1 phenotype (Boksa, 2010; Sominsky et al ., 2012; Diz-Chaves et al ., 2013; Hagberg et al ., 2015) (5–8) and an overactivation/unregulated synaptic pruning especially in the prefrontal cortex and hippocampus, which may explain the negative and cognitive symptoms of schizophrenia (Boksa, 2010; Nestor et al ., 2013; Sui et al ., 2015; Howes & McCutcheon, 2017).…”

Section: Introductionmentioning

confidence: 99%

Increased markers of inflammation after cannabis cessation and their association with psychotic symptoms

Roméo

Lestra

Martelli

et al. 2023

Acta Neuropsychiatr.

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Introduction: A dysbalance of the immune system in psychotic disorders has been well investigated. However, despite a higher prevalence of cannabis (THC) consumption in patients with psychosis, few studies have investigated the impact of this use on inflammatory markers. Methods: One hundred and two inpatients were included in this retrospective study. Leukocytic formula, hsCRP, fibrinogen levels and urinary THC were measured, and comparisons were performed at baseline and after 4 weeks of cannabis cessation between cannabis users (THC+) and non-users (THC-). Results: After cannabis cessation, we found a greater increase of leucocyte level (p < 0.01), monocyte level (p = 0.05) and a statistical trend to a highest increase of lymphocyte level (p = 0.06) between baseline and 4 weeks in the THC+ group as compared to the THC- group. At 4 weeks, highest leucocyte (p = 0.03), lymphocyte (p = 0.04) and monocyte (p < 0.01) counts were found in the THC+ group whereas at baseline no difference was found. A positive correlation was found between monocyte count at 4 weeks and baseline PANSS negative subscore (p = 0.045) and between the variation of monocyte count between baseline and 4 weeks and the PANSS total score at 4 weeks (p = 0.05). Conclusion: THC cessation is associated with an increase in inflammatory markers, including white blood cell, lymphocyte, and monocyte levels, which correlates with symptomatology of patients with psychosis.

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Could CRP be a differential biomarker of illness stages in schizophrenia? A systematic review and meta-analysis

Cited by 23 publications

References 111 publications

Correlation of Serum High-Sensitivity C-Reactive Protein, Homocysteine, and Macrophage Migration Inhibitory Factor Levels With Symptom Severity and Cognitive Function in Patients With Schizophrenia

Correlation of Serum High-Sensitivity C-Reactive Protein, Homocysteine, and Macrophage Migration Inhibitory Factor Levels With Symptom Severity and Cognitive Function in Patients With Schizophrenia

Longitudinal course of inflammatory-cognitive subgroups across first treatment severe mental illness and healthy controls

Increased markers of inflammation after cannabis cessation and their association with psychotic symptoms

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