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Meta-Analysis
. 2019 Jun 18;45(4):742-751.
doi: 10.1093/schbul/sby125.

Oxidative Stress and Inflammation in First-Episode Psychosis: A Systematic Review and Meta-analysis

David Fraguas  1   2 , Covadonga M Díaz-Caneja  1   2 , Miriam Ayora  1   2 , Fabián Hernández-Álvarez  1 , Alberto Rodríguez-Quiroga  1 , Sandra Recio  1   2 , Juan C Leza  2   3 , Celso Arango  1   2
Affiliations
Meta-Analysis

Oxidative Stress and Inflammation in First-Episode Psychosis: A Systematic Review and Meta-analysis

David Fraguas et al. Schizophr Bull. .

Abstract

Despite mixed findings, increasing evidence suggests that people with first-episode psychosis (FEP) show increased pro-inflammatory and pro-oxidative status. We used the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to conduct a systematic literature search of cross-sectional studies comparing in vivo inflammatory and oxidative blood markers between FEP patients and healthy controls. We analyzed 61 independent samples from 59 publications, including 3002 patients with FEP (ie, patients with FEP, early psychosis, first-episode schizophrenia or early schizophrenia) and 2806 controls. After controlling for multiple comparisons, our meta-analysis showed that total antioxidant status and docosahexaenoic acid levels were significantly lower in FEP patients than in controls, whereas levels of homocysteine, interleukin-6 and tumor necrosis factor alpha were significantly higher in FEP patients than in controls. This suggests that FEP patients had reduced antioxidant status and a pro-inflammatory imbalance, and that these biological processes may be targets for managing FEP.

Keywords: biomarker; cytokine; first-episode psychosis; inflammatory; meta-analysis; oxidation; schizophrenia.

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Figures

Fig. 1.
Fig. 1.
Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram of the systematic literature search strategy. aTwo papers reported results from 2 independent samples each, yielding a final number of 61 independent samples from 59 records.
Fig. 2.
Fig. 2.
Forest plots of significant meta-analyses after Bonferroni-Holm correction. DHA, docosahexaenoic acid; FEP, first-episode psychosis; Hcy, homocysteine; IL-6, interleukin-6; TAS, total antioxidant status; TNF-α, tumor necrosis factor-α.
Fig. 2.
Fig. 2.
Forest plots of significant meta-analyses after Bonferroni-Holm correction. DHA, docosahexaenoic acid; FEP, first-episode psychosis; Hcy, homocysteine; IL-6, interleukin-6; TAS, total antioxidant status; TNF-α, tumor necrosis factor-α.
See this image and copyright information in PMC

References

    1. Kahn RS, Sommer IE, Murray RM, et al. . Schizophrenia. Nat Rev Dis Primers. 2015;1:15067. - PubMed
    1. Kahn RS, Sommer IE. The neurobiology and treatment of first-episode schizophrenia. Mol Psychiatry. 2015;20:84–97. - PMC - PubMed
    1. Leza JC, García-Bueno B, Bioque M, et al. . Inflammation in schizophrenia: a question of balance. Neurosci Biobehav Rev. 2015;55:612–626. - PubMed
    1. Meyer U, Schwarz MJ, Müller N. Inflammatory processes in schizophrenia: a promising neuroimmunological target for the treatment of negative/cognitive symptoms and beyond. Pharmacol Ther. 2011;132:96–110. - PubMed
    1. Camps J, García-Heredia A. Introduction: oxidation and inflammation, a molecular link between non-communicable diseases. Adv Exp Med Biol. 2014;824:1–4. - PubMed

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