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Selected metabolites of kynurenine pathway and response to antipsychotic treatment in schizophrenia

Published online by Cambridge University Press:  23 March 2020

K. Szymona*
Affiliation:
Medical University of Lublin, Mental Health Outpatient Clinic- Children's University Hospital, Lublin, Poland
H. Karakuła-Juchnowicz
Affiliation:
Medical University of Lublin, Department of Clinical Neuropsychiatry Department of Psychiatry- Psychotherapy and Early Intervention, Lublin, Poland
M. Flis
Affiliation:
Medical University of Lublin, Department of Psychiatry- Psychotherapy and Early Intervention, Lublin, Poland
T. Kocki
Affiliation:
Medical University of Lublin, Laboratory of Cellular and Molecular Pharmacology- Department of Experimental and Clinical Pharmacology, Lublin, Poland
A. Urbanska
Affiliation:
Medical University of Lublin, Department of Psychiatry and Psychiatry Rehabilitation, Lublin, Poland
R. Kloc
Affiliation:
Medical University of Lublin, Laboratory of Cellular and Molecular Pharmacology- Department of Experimental and Clinical Pharmacology, Lublin, Poland
Z. Szymona
Affiliation:
PZ Cormay SA, Orphee Group, Lomianki, Poland
W. Rosa
Affiliation:
Lublin University of Technology, Faculty of Fundamentals of Technology- Department of Applied Mathematics, Lublin, Poland
E.M. Urbańska
Affiliation:
Medical University of Lublin, Laboratory of Cellular and Molecular Pharmacology- Department of Experimental and Clinical Pharmacology, Lublin, Poland
*
*Corresponding author.

Abstract

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Introduction

Deficit of glutamatergic transmission and aberrant function of kynurenine pathway, with disturbed synthesis of glutamate receptors antagonist, kynurenic acid (KYNA) and neurotoxic metabolite of kynurenine, 3-hydroxykynurenine (3-OH-KYN) have been implicated in the pathogenesis of schizophrenia.

Objectives

Demonstrated by others higher level of KYNA in the brain may cause relative deficiency of glutamate-mediate transmission with resulting behavioural and cognitive changes.

Aims

Search for predictors of satisfactory response to antipsychotic treatment based on the analysis of KYNA and 3-OH-KYN serum levels.

Methods

Fifty-three patients with chronic schizophrenia and 46 healthy individuals were enrolled in the study. Quantitative analyses of KYNA and 3-OH-KYN were performed using high-pressure liquid chromatography (HPLC) and electrochemical detection, respectively. Clinical assessments (PANSS, SANS, SAPS) and blood analyses were conducted at 3 time-points: during the active phase of disease, after 4 weeks of modified pharmacotherapy, and after reaching remission.

Results

In schizophrenia group, lower levels of KYNA (P = 0.002) and non-altered levels of 3-OH-KYN (p = 0.195), as compared to control, were detected during active phase of disease. Despite clinical improvement, no significant changes in the level of studied metabolites were observed later on. The initial level of 3-OH-KYN correlated negatively (r = –0.368; Spearman's rank) with clinical improvement (negative symptoms) (P < 0.05).

Conclusions

1. The peripheral dysregulation of kynurenine pathway metabolites in chronic schizophrenia manifests as relative increase in the ratio between neurotoxic 3-OH-KYN and neuroprotective KYNA. 2. The higher serum level of 3-OH-KYN during relapse of schizophrenia seems to predict poor response to antipsychotic treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
EW559
Copyright
Copyright © European Psychiatric Association 2014
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