TY - JOUR
T1 - Meta-analysis of oxidative stress in schizophrenia
AU - Flatow, Joshua
AU - Buckley, Peter
AU - Miller, Brian J.
N1 - Funding Information:
Mr. Flatow reports no biomedical financial interests or potential conflicts of interest. Dr. Buckley received grant/research support from the National Institute of Mental Health, Janssen Pharmaceutica, Pfizer, and Sunovion and is a consultant (honorarium/expenses) for the National Institute of Mental Health. In the past 3 years, Dr. Miller has received grant support from the National Institute of Mental Health (1K23MH098014-01), the Georgia Regents University Intramural Scientist Training Program, the GRU Brain & Behavior and Immunotherapy Discovery Institutes, the University of Oulu (Finland), the Thule Institute of the University of Oulu, and Oy H. Lundbeck Ab; research support from the National Institutes of Health Clinical Loan Repayment Program; consultancy fees for surveys from Medefied Europe and Plaza Research, on behalf of Genetech/Roche; speaker fees for grand rounds lectures from the Maryland Psychiatric Research Center and the Texas A&M University and Scott and White Hospital Department of Psychiatry; and payment for a survey from e-Rewards Medical Market Research.
PY - 2013/9/15
Y1 - 2013/9/15
N2 - Background Schizophrenia is associated with impaired antioxidant defense, including abnormal serum, plasma, and red blood cell (RBC) oxidative stress parameters. We performed a meta-analysis of these associations, considering the effect of clinical status and antipsychotic treatment after an acute exacerbation of psychosis. Methods We identified articles by searching PubMed, PsychInfo, and Institute for Scientific Information, and the reference lists of identified studies. Results Forty-four studies met the inclusion criteria. Total antioxidant status seemed to be a state marker, because levels were significantly decreased in cross-sectional studies of serum and plasma in first-episode psychosis (FEP) and significantly increased in longitudinal studies of antipsychotic treatment for acute exacerbations of psychosis (p <.01 for each). The RBC catalase and plasma nitrite seemed to be state-related markers, because levels in cross-sectional studies were significantly decreased in FEP (p <.01) and significantly increased in stable outpatients (p =.01). In contrast, RBC superoxide dismutase seemed to be a trait marker for schizophrenia, because levels in cross-sectional studies were significantly decreased in acutely relapsed inpatients, FEP, and stable outpatients (p <.01 for each). Conclusions Oxidative stress abnormalities in FEP suggest an effect that might be independent of antipsychotic medications. Although some parameters (total antioxidant status, RBC catalase, and plasma nitrite) might be state markers for acute exacerbations of psychosis, others (RBC superoxide dismutase) might be trait markers; however, more longitudinal studies are needed. Our findings suggest that oxidative stress might serve as a potential biomarker in the etiopathophysiology and clinical course of schizophrenia.
AB - Background Schizophrenia is associated with impaired antioxidant defense, including abnormal serum, plasma, and red blood cell (RBC) oxidative stress parameters. We performed a meta-analysis of these associations, considering the effect of clinical status and antipsychotic treatment after an acute exacerbation of psychosis. Methods We identified articles by searching PubMed, PsychInfo, and Institute for Scientific Information, and the reference lists of identified studies. Results Forty-four studies met the inclusion criteria. Total antioxidant status seemed to be a state marker, because levels were significantly decreased in cross-sectional studies of serum and plasma in first-episode psychosis (FEP) and significantly increased in longitudinal studies of antipsychotic treatment for acute exacerbations of psychosis (p <.01 for each). The RBC catalase and plasma nitrite seemed to be state-related markers, because levels in cross-sectional studies were significantly decreased in FEP (p <.01) and significantly increased in stable outpatients (p =.01). In contrast, RBC superoxide dismutase seemed to be a trait marker for schizophrenia, because levels in cross-sectional studies were significantly decreased in acutely relapsed inpatients, FEP, and stable outpatients (p <.01 for each). Conclusions Oxidative stress abnormalities in FEP suggest an effect that might be independent of antipsychotic medications. Although some parameters (total antioxidant status, RBC catalase, and plasma nitrite) might be state markers for acute exacerbations of psychosis, others (RBC superoxide dismutase) might be trait markers; however, more longitudinal studies are needed. Our findings suggest that oxidative stress might serve as a potential biomarker in the etiopathophysiology and clinical course of schizophrenia.
KW - Antioxidants
KW - first-episode psychosis
KW - meta-analysis
KW - oxidative stress
KW - relapse
KW - schizophrenia
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U2 - 10.1016/j.biopsych.2013.03.018
DO - 10.1016/j.biopsych.2013.03.018
M3 - Article
C2 - 23683390
AN - SCOPUS:84882647130
SN - 0006-3223
VL - 74
SP - 400
EP - 409
JO - Biological Psychiatry
JF - Biological Psychiatry
IS - 6
ER -