Immunobiological markers of the effectiveness of antipsychotic therapy in patients with schizophrenia

Background. Immunoinflammation plays a significant role in the pathogenesis of schizophrenia. The immunomodu-latory and anti-inflammatory effects of antipsychotics support the role of inflammation in schizophrenia. However, the effects of individual psychotropic medications on the immune system and how this may contribute to their effectiveness remain largely unclear. Proinflammatory and anti-inflammatory cytokines and acute-phase proteins can be used as markers of inflammation in schizophrenia. Predicting individual response to therapy before initiating treatment with atypical antipsychotics is a pressing issue in practical medicine. Objective: to identify immunobiological markers for predicting the effectiveness of antipsychotic therapy in patients with schizophrenia. Materials and Methods. A clinical, psychopathological and immunobiological examination of 40 patients with schizophrenia (F20.00, F20.01, F20.02, F20.3, F20.6 according to ICD-10) aged 20-64 years was conducted. Based on the results of assessing the dynamics of improvement in the state during treatment using the Clinical Global Impression (CGI) scale, two groups were formed: Group 1 (n=32) ‒ with a significant improvement in mental state, Group 2 (n=8) ‒ with an insignificant improvement in mental state. Laboratory testing included determination of the concentration of cytokines interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP) in the blood serum of patients using enzyme-linked immuno-sorbent assay. The findings were analyzed using statistical methods. Results. It was shown that patients with schizo-phrenia at point 1 of the study had higher median levels of IL-6 and TNF-α compared to healthy individuals. The most pronounced features of group 1 of patients (with a significant improvement in mental state) compared to group 2 (with insignificant improvement) before the administration of antipsychotic therapy were statistically significantly higher lev-els of TNF-α (p=0.0006) and CRP (p=0.0156), as well as lower IL-6 values (p=0.0069). These immunity indicators can be considered as markers for predicting the effectiveness of therapy for patients with schizophrenia. Conclusion. New data on the role of inflammatory markers in the pathogenetic mechanisms of schizophrenia have been obtained, allowing for targeted rehabilitation psychopharmacological measures.