背景:阴性症状影响精神病患者的生活质量,目前阴性症状的治疗方案效果有限。以前的研究表明,补体和凝血途径蛋白水平与后来的精神病经历有关,精神病,和功能。然而,补体和凝血蛋白与阴性症状之间的预后关系尚不明确.
方法:在北美前驱体纵向研究2和3中,使用精神病风险症状量表在2年内多次就诊时测量了431名临床精神病高风险个体(平均年龄:18.2,SD3.6;42.5%女性)的阴性症状。使用质谱法在基线处定量血浆蛋白。衍生了四个因子来代表参与补体或凝血系统的激活或调节的蛋白质的水平。使用广义最小二乘回归对标准化蛋白质组因素与阴性症状随时间的连续测量之间的关系进行建模。分析调整基线候选预后因素:阴性症状,阳性症状,功能,抑郁症状,自杀意念,使用大麻,烟草使用,抗精神病药的使用,抗抑郁药的使用,年龄,和性爱。
结果:随访阴性症状的临床和人口统计学预后因素包括阴性,积极的,和抑郁症状,功能,和年龄。调整所有候选预后因素,补体调节因子组和凝血调节因子组是随访阴性症状的预后因素(β:0.501,95%CI:0.160,0.842;β:0.430,95%CI:0.080,0.780。在单独的NAPLS2(β:0.501,95%CI:-0.037,1.039)和单独的NAPLS3中也观察到补体调节因子水平与阴性症状之间的关系,另外调整BMI(β:0.442,95%CI:0.127,0.757)。
结论:结果表明,血浆补体和凝血调节因子水平是阴性症状的预后因素,独立于临床和人口统计学预后因素。这些结果表明,补体和凝血调节剂水平可能在告知有风险的个体的阴性症状的治疗决定方面具有潜在的效用。
BACKGROUND: Negative symptoms impact the quality of life of individuals with psychosis and current treatment options for negative symptoms have limited effectiveness. Previous studies have demonstrated that complement and coagulation pathway protein levels are related to later psychotic experiences, psychotic disorder, and functioning. However, the prognostic relationship between complement and coagulation proteins and negative symptoms is poorly characterised.
METHODS: In the North American Prodrome Longitudinal Studies 2 and 3, negative symptoms in 431 individuals at clinical high-risk for psychosis (mean age: 18.2, SD 3.6; 42.5 % female) were measured at multiple visits over 2 years using the Scale of Psychosis-Risk Symptoms. Plasma proteins were quantified at baseline using mass spectrometry. Four factors were derived to represent levels of proteins involved in the activation or regulation of the complement or coagulation systems. The relationships between standardised protein group factors and serial measurements of negative symptoms over time were modelled using generalised least squares regression. Analyses were adjusted for baseline candidate prognostic factors: negative symptoms, positive symptoms, functioning, depressive symptoms, suicidal ideation, cannabis use, tobacco use, antipsychotic use, antidepressant use, age, and sex.
RESULTS: Clinical and demographic prognostic factors of follow-up negative symptoms included negative, positive, and depressive symptoms, functioning, and age. Adjusting for all candidate prognostic factors, the complement regulators group and the coagulation regulators group were identified as prognostic factors of follow-up negative symptoms (β: 0.501, 95 % CI: 0.160, 0.842; β: 0.430, 95 % CI: 0.080, 0.780 respectively. The relationship between complement regulator levels and negative symptoms was also observed in NAPLS2 alone (β: 0.501, 95 % CI: -0.037, 1.039) and NAPLS3 alone, additionally adjusting for BMI (β: 0.442, 95 % CI: 0.127, 0.757).
CONCLUSIONS: The results indicate that plasma complement and coagulation regulator levels are prognostic factors of negative symptoms, independent of clinical and demographic prognostic factors. These results suggest complement and coagulation regulator levels could have potential utility in informing treatment decisions for negative symptoms in individuals at risk.