Angiogenic and immune signatures in plasma of young relatives at familial high-risk for psychosis and first-episode patients: A preliminary study

AbstractEarly identification and treatment significantly improve clinical outcomes of psychotic disorders. Recent studies identified protein components of the complement and coagulation systems as key pathways implicated in psychosis. These specific protein alterations are integral to the inflammatory response and can begin years before the onset of clinical symptoms of psychotic disorder. Critically, they have recently been shown to predict the transition from clinical high risk to first-episode psychosis, enabling stratification of individuals who are most likely to transition to psychotic disorder from those who are not. This reinforces the concept that the psychosis spectrum is likely a central nervous system manifestation of systemic changes and highlights the need to investigate plasma proteins as diagnostic or prognostic biomarkers and pathophysiological mediators. In this review, we integrate evidence of alterations in proteins belonging to the complement and coagulation protein systems, including the coagulation, anticoagulation, and fibrinolytic pathways and their dysregulation in psychosis, into a consolidated mechanism that could be integral to the progression and manifestation of psychosis. We consolidate the findings of altered blood proteins relevant for progression to psychotic disorders, using data from longitudinal studies of the general population in addition to clinical high-risk (CHR) individuals transitioning to psychotic disorder. These are compared to markers identified from first-episode psychosis and schizophrenia as well as other psychosis spectrum disorders. We propose the novel hypothesis that altered complement and coagulation plasma levels enhance their pathways’ activating capacities, while low levels observed in key regulatory components contribute to excessive activation observed in patients. This hypothesis will require future testing through a range of experimental paradigms, and if upheld, complement and coagulation pathways or specific proteins could be useful diagnostic or prognostic tools and targets for early intervention and preventive strategies.

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Identification of high-risk Dukes B colorectal cancer by microRNA expression profiling: a preliminary study

Colorectal Disease ◽

10.1111/codi.12886 ◽

2015 ◽

Vol 17 (7) ◽

pp. 578-588 ◽

Cited By ~ 5

Author(s):

M. I. Aslam ◽

J. Venkatesh ◽

J. S. Jameson ◽

K. West ◽

J. H. Pringle ◽

...

Keyword(s):

Colorectal Cancer ◽

High Risk ◽

Expression Profiling ◽

Microrna Expression ◽

Preliminary Study

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White matter microstructure in ultra-high risk and first episode schizophrenia: A prospective study

Psychiatry Research Neuroimaging ◽

10.1016/j.pscychresns.2015.11.003 ◽

2016 ◽

Vol 247 ◽

pp. 42-48 ◽

Cited By ~ 14

Author(s):

Silvia Rigucci ◽

Giulia Santi ◽

Valentina Corigliano ◽

Annamaria Imola ◽

Camilla Rossi-Espagnet ◽

...

Keyword(s):

White Matter ◽

High Risk ◽

Prospective Study ◽

First Episode ◽

White Matter Microstructure ◽

Ultra High Risk ◽

A Prospective Study ◽

First Episode Schizophrenia

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Programma 2000: Celebrating 10 Years of Activity of an Italian Pilot Programme on Early Intervention in Psychosis

Australian & New Zealand Journal of Psychiatry ◽

10.1080/00048670802512032 ◽

2008 ◽

Vol 42 (12) ◽

pp. 1003-1012 ◽

Cited By ~ 39

Author(s):

Angelo Cocchi ◽

Anna Meneghelli ◽

Antonio Preti

Keyword(s):

Early Intervention ◽

High Risk ◽

Rating Scale ◽

Young Patients ◽

Skills Training ◽

First Episode ◽

Global Functioning ◽

Adult Intelligence Scale ◽

Cognitive Behavioural ◽

Early Intervention In Psychosis

Objective: This paper describes the structure and the organization of the single Italian programme specifically targeted at the early detection of and interventions for subjects at onset of or at high risk of psychosis, Programma 2000. Methods: Programma 2000 is a comprehensive multi-modal protocol of early intervention in psychosis, set up in Milan in 1999. The service has been very active since its opening, and at the time of writing (spring (April) 2008), more than 300 young patients have been evaluated through a detailed protocol that embraces Health of the Nation Outcome Scale (HoNOS), Brief Psychiatric Rating Scale (BPRS), Cognitive Behavioural Assessment 2.0, Disability Assessment Schedule, Camberwell Family Interview, Wechsler Adult Intelligence Scale and the Early Recognition Inventory Retrospective Assessment of Symptoms. The treatment includes psychoeducation, cognitive behavioural therapy (CBT), both structured and unstructured psychosocial interventions and pharmacotherapy, when necessary. Results: The programme focuses on young people aged 17–30 years: to date, a total of 132 subjects with definite psychosis or within the high-risk category have been enrolled in treatment after assessment. Patients with first-episode psychosis were, on average and expectedly, more severe than those in the at-risk group, and were more likely to be prescribed antipsychotic drugs. A large majority of patients in both groups received tailored CBT; individual sessions of skills training were provided to two-thirds of patients. In both groups, improvement was found in both the BPRS and HoNOS, and in the level of global functioning as assessed on Global Assessment of Functioning at 6 month and 1 year follow up. Global functioning was more sensitive to change than symptom severity, reflecting the intensive and personalized efforts to improve social and role functioning in patients. Conclusions: Programma 2000 is still in development but it has already gained the support of therapists and other relevant people involved in the life of subjects at onset, or at high risk of psychosis.

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