Psychosis Could Be Linked to Blood-Brain Barrier Disruption By: SUSAN BIRK

CHICAGO – The inflammatory theory of schizophrenia first put forth more than 100 years ago has scientific validity, a study of 30 psychotic pediatric patients indicates.

The study found significantly elevated serum levels of several inflammatory markers implicated in disruption of the blood-brain barrier (BBB) in psychotic children, compared with controls. The finding provides evidence for a relationship between psychosis, inflammation, and BBB disruption, reported Dr. Tatiana Falcone and the cerebrovascular research team led by Dr. Damir Janigro of Cleveland Clinic in a poster at the annual meeting of the American Academy of Child and Adolescent Psychiatry.

“If our hypothesis is correct, and a causal link between inflammation and psychosis exists, new treatment modalities may be identified to add as a coadjuvant treatment for schizophrenia,” Dr. Falcone said in an interview.

“Although there are some studies evaluating anti-inflammatory medications in patients with schizophrenia, the results are confounding. We believe this might be related to the timing of the intervention, with more hope for effectiveness in first-episode psychosis and/or early-onset schizophrenia,” she said.

Patients had a diagnosis of acute psychosis on admission to the child and adolescent psychiatric unit at Cleveland Clinic. In the control group, a preliminary interview ruled out psychosis, neurodegenerative disorders, fever, current infection, and current use of antibiotics.

Blood samples were taken from the psychotic children on admission. All subjects underwent serum analysis for several inflammatory markers, including S100-β, a neurotrophic protein; tumor necrosis factor (TNF)–α; interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, and IL-10; and C-reactive protein.

The S100-β levels in 85% of the psychotic children exceeded the recognized normal range. The psychiatric patients also had significantly higher levels of IL-1β, TNF-α, IL-5, IL-6, and IL-10 than did controls. “These inflammatory mediators are often directly involved in BBB disruption,” Dr. Falcone said.


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