Changes in inflammatory balance correlates with conversion to psychosis among individuals at clinical high-risk: A prospective cohort study

• Published in: Psychiatry research 2022-12, Vol.318, p.114938-114938, Article 114938
• Main Authors: Zhang, TianHong, Zeng, JiaHui, Wei, YanYan, Ye, JiaYi, Tang, XiaoChen, Xu, LiHua, Hu, YeGang, Cui, HuiRu, Xie, YuOu, Tang, YingYing, Liu, XiaoHua, Liu, HaiChun, Chen, Tao, Li, ChunBo, Wang, JiJun
• Format: Article
• Language: English
• Subjects: Biomarker; Case-Control Studies; Cross-Sectional Studies; Cytokine; Cytokines; Humans; Interleukin-6; Prediction; Prodromal Symptoms; Prospective Studies; Psychosis; Psychotic Disorders; Transition; Ultra high risk
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2022.114938

•The baseline interleukin (IL)-1β/IL-6 ratio changes in individuals with clinical high risk who convert to full psychosis.•A specific CD4-expressing T helper cell type 1 (Th1) and type 2 (Th2) cytokine imbalance is associated with an increased risk of developing psychosis.•The interleukin (IL)-1β/IL-6 ratio is a significant predictor of the subsequent conversion to psychosis. Previous studies have revealed that the imbalance between Th1 cytokines and Th2 cytokines plays a role in disturbance of cellular responses in the brain during psychosis. Cross-sectional studies have implied that inflammatory cytokine changes emerge in early psychosis, even at the at-risk stage. This study aimed to test the hypothesis that inflammatory imbalance in clinical high-risk (CHR) individuals is associated with an increased risk of future psychosis. A prospective case-control study was performed to assess the Th1(interleukin (IL)-1β)/Th2(IL-6) balance in 84 CHR individuals and 65 age- and sex-matched healthy controls (HC). Serum IL-1β and IL-6 levels were measured by enzyme-linked immunosorbent assay at baseline and 1-year after the completion of the clinical assessment. Sixteen (19.0%) CHR participants converted to full psychosis during the 1-year follow-up period. At baseline, serum IL-1β level was significantly lower in the CHR-converter group - resulting in decreased IL-1β/IL-6 ratios – compared to those of the CHR-non-converter and HC groups. At the 1-year follow-up, IL-1β level had decreased, and IL-1β/IL-6 ratios had decreased in the CHR-non-converter group, such that these were comparable to values in the CHR-converter at this time point. Analysis of the changes in IL-1β/IL-6 ratio between the baseline and 1-year follow-up measurements identified different trajectories in the CHR-converter and CHR-non-converter groups. Our findings demonstrate that a specific pattern of Th1/Th2 imbalance (decreased IL-1β/IL-6 ratios with lower serum IL-1β level) is associated with an increased risk of developing psychosis. Such specific pattern has potential for predicting conversion outcomes and selecting a distinct subgroup of CHR with immune-imbalanced-phenotype, that relevance in precise prevention.