Cytokine profile in first-episode psychosis, unaffected siblings and community-based controls: the effects of familial liability and childhood maltreatment

• Published in: Psychological medicine 2020-05, Vol.50 (7), p.1139-1147
• Main Authors: Corsi-Zuelli, Fabiana, Loureiro, Camila Marcelino, Shuhama, Rosana, Fachim, Helene Aparecida, Menezes, Paulo Rossi, Louzada-Junior, Paulo, Mondelli, Valeria, Del-Ben, Cristina Marta
• Format: Article
• Language: English
• Subjects: Abuse; Adolescent; Adult; Body mass index; Brazil - epidemiology; Candidates; Case-Control Studies; Child; Child abuse & neglect; Child Abuse - psychology; Childhood; Children; Cytokines; Cytokines - blood; Drug use; Familial factors; Female; Humans; IL-1β; Immune system; Inflammation; Inflammation - blood; Interleukin 10; Interleukin 4; Interleukin 6; Liability; Male; Mental disorders; Mental health; Middle Aged; Patients; Priming; Protective factors; Psychologists; Psychosis; Psychotic Disorders - blood; Schizophrenia; Sex crimes; Siblings; Stress; Subtypes; Tumor Necrosis Factor-alpha - blood; Tumor necrosis factor-α; Young Adult; γ-Interferon
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/s0033291719001016

Inflammation is a possible biological mechanism underlying the association between childhood maltreatment and psychosis. Previous investigations on this regard were mainly conducted on chronic schizophrenia and lacked control for confounders. We aim to investigate the role of familial liability, childhood maltreatment and recent stress in determining cytokine abnormalities at the onset of psychosis. We recruited 114 first-episode psychosis (FEP) patients, 57 unaffected biological siblings of FEP patients, and 251 community-based controls. Plasma cytokines (IL-1β, IL-6, TNF-α, IFN-γ, IL-4, IL-10 and TGF-β) were measured and differences across the groups analysed after adjusting for potential confounders. FEP had a higher pro- and anti-inflammatory cytokine profile (IL-1β, IL-6, TNF-α, IL-10 and TGF-β), which was not observed in unaffected siblings. Siblings presented decreased IL-1β when compared with patients and controls. Childhood maltreatment was associated with higher levels of TGF-β in both patients and siblings when compared with controls. Physical childhood abuse was associated with increased levels of TGF-β in FEP patients but with decreased levels in controls. Other childhood maltreatment subtypes or recent stressors did not affect cytokine levels in any of the groups. Normal or reduced cytokines in siblings represent possibly a protective factor and suggest that the identified inflammatory profile in FEP can be a real pathophysiological component of psychosis. Experience of childhood maltreatment may contribute as long-term immune priming for the TGF-β pathway, and increased levels of this cytokine in both patients and siblings exposed to childhood maltreatment point to a possible biological candidate of familial risk for psychosis.