Plasma essential amino acid levels in first episode psychosis at baseline and after antipsychotic treatment.

IF 3 Q2 PSYCHIATRY Schizophrenia (Heidelberg, Germany) Pub Date : 2024-11-06 DOI:10.1038/s41537-024-00528-3
Beyazit Garip, Jibran Y Khokhar, Hakan Kayir
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Abstract

This study assessed plasma levels of essential amino acids (EAA) in drug-naïve first episode psychosis (FEP) patients at diagnosis and after 10 weeks of antipsychotic treatment. Forty FEP patients were enrolled at baseline, with blood samples collected before and after a 10-week antipsychotic treatment period. Plasma EAA levels were measured using an LC/MS/MS method. Psychotic symptoms were evaluated using standardized inventories before and after treatment. A decrease in BPRS score of more than 40% was used to indicate treatment response. Thirty-five healthy volunteers served as the control group. Baseline plasma levels of Thr, Met, Leu, Lys, His, and Tyr were higher in FEP patients than in healthy controls. After 10 weeks of treatment, Leu, His, and Tyr increased further, primarily in treatment-responsive patients. Conversely, Val level was lower than controls in patients at baseline and remained unchanged after treatment. Increased EAA levels were correlated with lower (less severe) scores in positive symptom scales. Treatment non-responders had persistently low Tyr/large neutral amino acid (LNAA) ratio. Tyr/LNAA ratio increased after treatment, specifically in treatment-responders. Phe/Tyr ratio decreased post-treatment in both responder and non-responder groups. Elevated EAA levels in FEP patients may signify compensatory responses to increased physiological demand for neurotransmitters or energy. Combining specific EAA supplementation with antipsychotic treatment may enhance treatment response in these patients.

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首次发病的精神病患者在基线和抗精神病治疗后的血浆必需氨基酸水平。
本研究评估了初次发作精神病(FEP)患者在确诊时和接受 10 周抗精神病药物治疗后血浆中必需氨基酸 (EAA) 的水平。40 名首次发病的精神病患者接受了为期 10 周的抗精神病药物治疗,并在治疗前后采集了血样。采用 LC/MS/MS 方法测量血浆 EAA 水平。在治疗前后,使用标准化清单对精神症状进行评估。BPRS 评分下降超过 40% 表示治疗反应。35 名健康志愿者作为对照组。FEP 患者血浆中 Thr、Met、Leu、Lys、His 和 Tyr 的基线水平高于健康对照组。治疗 10 周后,Leu、His 和 Tyr 进一步升高,主要是在治疗有反应的患者中。相反,患者的 Val 水平在基线时低于对照组,治疗后保持不变。EAA 水平的增加与阳性症状量表评分的降低(不太严重)相关。治疗无反应者的 Tyr/大分子中性氨基酸(LNAA)比率持续偏低。治疗后,Tyr/LNAA 比率增加,特别是在治疗应答者中。治疗后,应答组和非应答组的Phe/Tyr比率均有所下降。FEP 患者体内 EAA 水平的升高可能是对神经递质或能量的生理需求增加的代偿反应。将特定的 EAA 补充剂与抗精神病治疗相结合,可能会增强这些患者的治疗反应。
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