A meta-analysis of blood and salivary cortisol levels in first-episode psychosis and high-risk individuals.

Dysregulated cortisol responses and glucose metabolism have been reported in psychosis. We performed a random-effects meta-analysis of cortisol responses in first-episode psychosis (FEP) and psychosis risk states, taking into consideration glucose metabolism. A total of 47 studies were included. Unstimulated blood cortisol levels were significantly higher (g = 0.48, 95 %CI: 0.25-0.70, p < 0.001) in FEP, but not in psychosis risk states (g = 0.39, 95 %CI: -0.42-1.21, p = 0.342), compared to controls. Cortisol awakening response (CAR) was attenuated in FEP (g = -0.40, 95 %CI: -0.68 - -0.12, p = 0.006), but not in psychosis risk states (p = 0.433). Glucose and insulin levels were positively correlated with unstimulated blood cortisol levels in FEP. Our meta-analysis supports previous findings of elevated blood cortisol levels and attenuated CAR in FEP. Future research should focus on identifying the common denominators for alterations in stress hormones and glucose metabolism.

Markers of Regenerative Processes in Patients with Bipolar Disorder: A Case-control Study.

Progress in medical science has allowed the discovery of many factors affecting the pathogenesis of bipolar disorder, and among the most recent research directions are found regenerative and inflammatory processes. The role of regenerative processes remains particularly poorly explored, but available data encourage further research, which may explain the pathogenesis of bipolar disorder (BD). The aim of this study was to evaluate the mobilization of stem cells into peripheral blood, in patients with bipolar disorder during stable phase, not treated with lithium salts. The study included 30 unrelated individuals with the diagnosis of bipolar disorder, with disease duration of at least 10 years, not treated with lithium salts for at least five years prior to the study. The control group consisted of 30 healthy subjects, matched for age, sex, body mass index (BMI), origin, socio-demographic factors and nicotine use. Blood samples underwent cytometric analyses to assess concentrations of: Very Small Embryonic Like (VSEL) CD34+, VSEL AC133+, HSC CD34+, HSC AC133+. There were no significant differences in stem cell levels between patients with BD and healthy controls. However, the level of VSEL cells AC133 + was significantly higher in type I BD patients compared to healthy controls. Our results indicate a disturbance in regenerative processes in patients with bipolar disorder.

Assessment of Appetite-Regulating Hormones Provides Further Evidence of Altered Adipoinsular Axis in Early Psychosis.

It has been found that antipsychotic-naïve patients with first-episode psychosis (FEP) present with impaired hormonal regulation of appetite in terms of low leptin and high insulin levels (the adipoinsular axis). These findings imply that certain intrinsic mechanisms might play a role in the development of metabolic dysregulation in early psychosis. However, clinical correlates of this phenomenon remain unknown. Moreover, these alterations have not been tested in individuals at familial high risk of psychosis (FHR-P). In this study we aimed to assess the levels of adiponectin, insulin, leptin, glucose, total cholesterol, lipoproteins and triglycerides in FEP patients, unaffected offspring of schizophrenia patients (FHR-P individuals) and healthy controls (HCs) with respect to cognitive performance and psychopathological manifestation. Participants were 35 FEP patients, 33 FHR-P individuals, and 32 HCs. Cognitive performance was assessed using the Repeatable Battery for Assessment of Neuropsychological Status (RBANS). The levels of leptin and high-density lipoproteins (HDL) were significantly lower (leptin: 10.7 ± 15.7 vs. 12.6 ± 10.1, p = 0.046, and HDL: 48.0 ± 16.9 vs. 59.8 ± 17.5 mg/dl, p = 0.007), while the levels of triglycerides and insulin were significantly higher (triglycerides: 137.4 ± 58.8 vs. 77.5 ± 33.2 mg/dl, p < 0.001, and insulin: 15.2 ± 13.1 vs. 9.6 ± 5.0 µIU/ml, p = 0.023) in FEP patients compared to HCs. These differences were significant after controlling for the effects of potential confounding factors. No significant differences in the levels of serum markers between FHR-P individuals and HCs were found. There was a significant negative correlation between the level of leptin and the RBANS language score after covarying for potential confounding factors in FEP patients (B = -0.226, p = 0.006) but not in other subgroups of participants. Our findings confirm impairment of adipoinsular axis in early psychosis. However, results of our study do not support the hypothesis that familial liability to psychosis might be associated with metabolic dysregulation. Leptin levels might be associated with cognitive deficits in FEP patients. Longitudinal studies of individuals at risk of psychosis are needed to provide insights into causal mechanisms underlying our results.

Assessment of Complement Cascade Components in Patients With Bipolar Disorder.

Introduction: The immune system is undoubtedly involved in the pathogenesis of various psychiatric disorders, such as schizophrenia, bipolar disorder, or depression. Although its role is not fully understood, it appears that this area of research can help to understand the etiology of mental illness. One of the components of the human immune system is the complement system, which forms a part of the innate immune response. Physiologically, except for its essential protective role, it is a vital element in the regeneration processes, including neurogenesis. To date, few studies have tried to clarify the role of the complement cascade in mental disorders. Materials and Methods: We evaluated concentrations of C3a, C5a, and C5b-9 complement cascade components in the peripheral blood of 30 patients suffering from bipolar disorder (BD) for at least 10 years, in euthymia, who were not treated with lithium salts. In addition, we divided our study sample into BD type I (BD-I, 22 persons), and BD type II (BD-II, 8 patients). The control group consisted of 30 healthy volunteers matched for age, sex, BMI, and smoking habits. Results: Compared to healthy controls, BD patients had elevated concentrations of all the investigated components. Furthermore, in patients with BD-II, we observed higher concentrations of C5b-9 as compared to patients with BD-I. However, there was a significant effect of BD diagnosis only on the levels of C3a and C5a but not on the level of C5b-9 after adjustment for potential confounding factors. Conclusions: Increased concentrations of components C3a and C5a of the complement system in the investigated group as compared to healthy controls suggest involvement of the complement cascade in the pathogenesis of BD, and provides further evidence of immune system dysregulation in BD patients.

Mobilization of Peripheral Blood Stem Cells and Changes in the Concentration of Plasma Factors Influencing their Movement in Patients with Panic Disorder.

In this paper we examined whether stem cells and factors responsible for their movement may serve as new biological markers of anxiety disorders. The study was carried out on a group of 30 patients diagnosed with panic disorder (examined before and after treatment), compared to 30 healthy individuals forming the control group. We examined the number of circulating HSCs (hematopoetic stem cells) (Lin-/CD45 +/CD34 +) and HSCs (Lin-/CD45 +/AC133 +), the number of circulating VSELs (very small embryonic-like stem cells) (Lin-/CD45-/CD34 +) and VSELs (Lin-/CD45-/AC133 +), as well as the concentration of complement components: C3a, C5a and C5b-9, SDF-1 (stromal derived factor) and S1P (sphingosine-1-phosphate). Significantly lower levels of HSCs (Lin-/CD45 +/AC133 +) have been demonstrated in the patient group compared to the control group both before and after treatment. The level of VSELs (Lin-/CD45-/CD133 +) was significantly lower in the patient group before treatment as compared to the patient group after treatment.The levels of factors responsible for stem cell movement were significantly lower in the patient group compared to the control group before and after treatment. It was concluded that the study of stem cells and factors associated with their movement can be useful in the diagnostics of panic disorder, as well as differentiating between psychotic and anxiety disorders.