Total and differential white blood cell counts and hemodynamic parameters in first-episode psychosis

Moody, Grant; Miller, Brian J.

doi:10.1016/j.psychres.2017.11.086

Cited by 41 publications

(28 citation statements)

References 41 publications

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“…Unlike Núñez and colleagues 9 who only found alterations in neutrophil counts, we observed additional diagnosis-dependent aberrations of other leukocyte populations. Monocyte counts were elevated in FEP and Sz patients at baseline, as described previously, 6 , 26 but this was not reflected by diagnosis-dependent differences regarding the percentage of subjects with counts above the reference range. However, MLRs were increased in FEP and Sz, consistent with a recent meta-analysis.…”

Section: Discussionsupporting

confidence: 70%

Innate Immune Cells and C-Reactive Protein in Acute First-Episode Psychosis and Schizophrenia: Relationship to Psychopathology and Treatment

Steiner

Frodl

Schiltz

et al. 2019

Schizophrenia Bulletin

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Innate immunity has been linked to initiation of Alzheimer’s disease and multiple sclerosis. Moreover, risk of first-episode psychosis (FEP) and schizophrenia (Sz) is increased after various infections in predisposed individuals. Thus, we hypothesized an analogous role of innate immunity with increased C-reactive protein (CRP) in non-affective psychosis. Differential blood count, CRP, neutrophil and monocyte–macrophage activation markers, cortisol and psychotic symptoms (Positive and Negative Syndrome Scale [PANSS]) were assessed in controls (n = 294) and acutely ill unmedicated FEP (n = 129) and Sz (n = 124) patients at baseline and after 6 weeks treatment. Neutrophils, monocytes, and CRP were increased in patients vs controls at baseline (P < .001), and neutrophil and monocyte counts correlated positively with activation markers. Eosinophils were lower at baseline in FEP (P < .001) and Sz (P = .021) vs controls. Differences in neutrophils (P = .023), eosinophils (P < .001), and CRP (P < .001) were also present when controlling for smoking and cortisol, and partially remitted after antipsychotic treatment. FEP patients with high neutrophils (P = .048) or monocytes (P = .021) had higher PANSS-P scores at baseline but similar disease course. CRP correlated with PANSS-P at baseline (ρ = 0.204, P = .012). Improvement of positive symptoms after treatment correlated with declining neutrophils (ρ = 0.186, P = .015) or CRP (ρ = 0.237, P = .002) and rising eosinophils (ρ = −0.161, P = .036). In FEP, normalization of neutrophils (ρ = −0.231, P = .029) and eosinophils (ρ = 0.209, P = .048) correlated with drug dosage. In conclusion, innate immune system activation correlated with PANSS-P, supporting the immune hypothesis of psychosis. Neutrophil and monocyte counts and CRP levels may be useful markers of disease acuity, severity, and treatment response.

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Section: Discussionsupporting

confidence: 70%

Innate Immune Cells and C-Reactive Protein in Acute First-Episode Psychosis and Schizophrenia: Relationship to Psychopathology and Treatment

Steiner

Frodl

Schiltz

et al. 2019

Schizophrenia Bulletin

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show abstract

“…Of note, because we can only derive proportion of cell types from whole blood DNA methylation data, and not actual counts, an increase in one or more cell types must be balanced by a decrease in one or more other cell types and an apparrent change in the proportion of one specific cell type does not mean that the actual abundance of that cell type is altered. Despite this, the results from DNA methylation-derived cell proportions are consistent with previous studies based on empirical cell abundance measures which have reported increased monocyte counts 67,68 , increased neutrophil counts 69,70 , increased monocyte to lymphocyte ratio 71,72 and increased neutrophil to lymphocyte ratio 71,73 in both schizophrenia and FEP patients compared to controls. Studies have also shown that higher neutrophil counts in schizophrenia patients correlate with a greater burden of positive symptoms 69 suggesting that variations in the number of neutrophils is a potential marker of disease severity 72 .…”

Section: Discussionsupporting

confidence: 88%

Large-scale analysis of DNA methylation identifies cellular alterations in blood from psychosis patients and molecular biomarkers of treatment-resistant schizophrenia

Hannon

Dempster

Mansell

et al. 2020

Preprint

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Objective:Psychosis -a complex and heterogeneous neuropsychiatric condition characterized by hallucinations and delusions -is a common feature of schizophrenia. There is evidence for altered DNA methylation (DNAm) associated with schizophrenia in both brain and peripheral tissues. We aimed to undertake a systematic analysis of variable DNAm associated with psychosis, schizophrenia, and treatmentresistant schizophrenia, also exploring measures of biological ageing, smoking, and blood cell composition derived from DNAm data to identify molecular biomarkers of disease. Methods:We quantified DNAm across the genome in blood samples from 4,483 participants from seven casecontrol cohorts including patients with schizophrenia or first-episode psychosis. Measures of biological age, cellular composition and smoking status were derived from DNAm data using established algorithms. DNAm and derived measures were analyzed within each cohort and the results combined by meta-analysis. Results:Psychosis cases were characterized by significant differences in measures of blood cell proportions and elevated smoking exposure derived from the DNAm data, with the largest differences seen in treatment-resistant schizophrenia patients. DNAm at 95 CpG sites was significantly different between psychosis cases and controls, with 1,048 differentially methylated positions (DMPs) identified between schizophrenia cases and controls. Schizophrenia-associated DMPs colocalize to regions identified in genetic association studies, with genes annotated to these sites enriched for pathways relevant to disease. Finally, a number of the schizophrenia associated differences were only present in the treatment-resistant schizophrenia subgroup. Conclusions:We show that DNAm data can be leveraged to derive measures of blood cell counts and smoking that are strongly associated with psychosis. Our DNAm meta-analysis identified multiple DMPs associated with both psychosis and a more refined diagnosis of schizophrenia, with evidence for differential methylation associated with treatment-resistant schizophrenia that potentially reflects exposure to clozapine.

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“…Elevations of the NLR have been associated with an increase in cytokines such as IL-6 and IL-8 ( Karageorgiou et al., 2019 ). In a study carried out in patients experiencing a first episode of psychosis, a mean NLR of 2.7 ± 1.9 has been documented ( Moody and Miller, 2018 ). In the three cases reported here, we have found an elevation of the NLR (2.8, 3.7, and 4.76), which may suggest a generalized inflammatory state.…”

Section: Discussionmentioning

confidence: 99%

Psychotic symptoms in COVID-19 infection: A case series from Lima, Peru

Huarcaya-Victoria

Meneses-Saco

Luna-Cuadros

2020

Psychiatry Research

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Total and differential white blood cell counts and hemodynamic parameters in first-episode psychosis

Cited by 41 publications

References 41 publications

Innate Immune Cells and C-Reactive Protein in Acute First-Episode Psychosis and Schizophrenia: Relationship to Psychopathology and Treatment

Innate Immune Cells and C-Reactive Protein in Acute First-Episode Psychosis and Schizophrenia: Relationship to Psychopathology and Treatment

Large-scale analysis of DNA methylation identifies cellular alterations in blood from psychosis patients and molecular biomarkers of treatment-resistant schizophrenia

Psychotic symptoms in COVID-19 infection: A case series from Lima, Peru

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