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Adiponectin, resistin, Interleukine-4, TGF-β2 levels before and after clozapine treatment in a group of first episode, treatment resistant schizophrenia patients

Published online by Cambridge University Press:  19 July 2023

P. Petrikis ,
A. Karampas ,
G. Leondaritis ,
D. Archimandriti ,
P. Spyrou ,
M. Plakoutsis ,
G. Georgiou ,
C. Mantas ,
P. Voulgari  and
T. Hyphantis
P. Petrikis*
Affiliation:
Department of psychiatry, university of ioannina-faculty of medicine, Ioannina-Greece
A. Karampas
Affiliation:
Department of psychiatry
G. Leondaritis
Affiliation:
Department of pharmacology
D. Archimandriti
Affiliation:
Department of rheumatology-immunology
P. Spyrou
Affiliation:
Department of eheumatology-immunology, university of ioannina-faculty of medicine, Ioannina, Greece
M. Plakoutsis
Affiliation:
Department of psychiatry
G. Georgiou
Affiliation:
Department of psychiatry
C. Mantas
Affiliation:
Department of psychiatry
P. Voulgari
Affiliation:
Department of rheumatology-immunology
T. Hyphantis
Affiliation:
Department of psychiatry
*
*Corresponding author.

Abstract

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Introduction

Treatment resistant schizophrenia (TRS) affects at least 15-20% of newly diagnosed patients with schizophrenia. Clozapine treatment for this sub-group of patients should be considered immediately after the failure in response to two antipsychotics (usually risperidone and olanzapine) received in adequate doses and time. Immune changes have been reported in first episode patients with psychosis, although results from various studies remain inconclusive. Very few studies have investigated so far cytokine and adipokine changes in TRS.

Objectives

To measure Interleukin-4 (IL-4), Tumor Growth Factor-β2 (TGF-β2), adiponectin and resistin in a sample of forty first-episode patients with psychosis (FEP) who proved to be treatment resistant (TRS),after treatment with two atypical antipsychotics ( olanzapine and risperidone) and after clozapine treatment.

Methods

Serum levels of adiponectin, resistin, IL-4 and TGF-β2 were measured by enzyme linked immunosorbent assay (ELISA) before and after clozapine treatment. Psychopathology was assessed with the Positive and Negative Syndrome Scale (PANSS) before and after clozapine treatment, BMI was calculated in the days of blood sample collection.

Results

We observed a significant decrease of adiponectin levels after switching from olanzapine/risperidone to clozapine (p<0.0001, Wilcoxon signed rank test W=820.0) and a statistically significant increase of resistin levels after switching to clozapine (p<0.0001, Wicoxon signed rank test W=-658.0). Similarly, a significant increase of TGF-β2 and of IL-4 levels was found after clozapine treatment (p=0.039, Wilcoxon signed rank test test W=-454.0 and p=0.029, Wilcoxon signed rank test W=-386.0, respectively).

Conclusions

Resistin, IL-4 and TGF-β levels increase after clozapine treatment while adiponectin levels significantly decrease. The findings may of importance, since they may reflect specific immune changes to clozapine responders.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 66 , Special Issue S1: Abstracts of the 31st European Congress of Psychiatry , March 2023 , pp. S638
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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