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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
C-reactive protein is increased in schizophrenia but is not altered by antipsychotics: Meta-analysis and implications
Molecular Psychiatry, Volume 21, No. 4, Year 2016
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Description
The inflammatory hypothesis of schizophrenia (SZ) posits that inflammatory processes and neural-immune interactions are involved in its pathogenesis, and may underpin some of its neurobiological correlates. SZ is the psychiatric disorder causing the most severe burden of illness, not just owing to its psychiatric impairment, but also owing to its significant medical comorbidity. C-reactive protein (CRP) is a commonly used biomarker of systemic inflammation worldwide. There are some conflicting results regarding the behaviour of CRP in SZ. The aims of this study were to verify whether peripheral CRP levels are indeed increased in SZ, whether different classes of antipsychotics divergently modulate CRP levels and whether its levels are correlated with positive and negative symptomatology. With that in mind, we performed a meta-analysis of all cross-sectional studies of serum and plasma CRP levels in SZ compared to healthy subjects. In addition, we evaluated longitudinal studies on CRP levels before and after antipsychotic use. Our meta-analyses of CRP in SZ included a total of 26 cross-sectional or longitudinal studies comprising 85 000 participants. CRP levels were moderately increased in persons with SZ regardless of the use of antipsychotics and did not change between the first episode of psychosis and with progression of SZ (g=0.66, 95% confidence interval (95% CI) 0.43 to 0.88, P<0.001, 24 between-group comparisons, n=82 962). The extent of the increase in peripheral CRP levels paralleled the increase in severity of positive symptoms, but was unrelated to the severity of negative symptoms. CRP levels were also aligned with an increased body mass index. Conversely, higher age correlated with a smaller difference in CRP levels between persons with SZ and controls. Furthermore, CRP levels did not increase after initiation of antipsychotic medication notwithstanding whether these were typical or atypical antipsychotics (g=0.01, 95% CI -0.20 to 0.22, P=0.803, 8 within-group comparisons, n=713). In summary, our study provides further evidence of the inflammatory hypothesis of SZ. Whether there is a causal relationship between higher CRP levels and the development of SZ and aggravation of psychotic symptoms, or whether they are solely a marker of systemic low-grade inflammation in SZ, remains to be clarified. © 2016 Macmillan Publishers Limited.
Authors & Co-Authors
Dodd, Seetal M.
Australia, Geelong
Deakin University
Australia, Melbourne
Orygen Youth Health
Dean, Olívia May
Australia, Geelong
Deakin University
Australia, Melbourne
Orygen Youth Health
Gonçalves, Carlos Alberto Saraiva
Brazil, Porto Alegre
Universidade Federal do Rio Grande do Sul
Berk, Michael
Australia, Geelong
Deakin University
Australia, Melbourne
Orygen Youth Health
Statistics
Citations: 234
Authors: 4
Affiliations: 5
Identifiers
Doi:
10.1038/mp.2015.87
ISSN:
13594184
Research Areas
Mental Health
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Systematic review