Evaluation of Changes in Peripheric Biomarkers Related to Blood Brain Barrier Damage in Patients with Schizophrenia and Their Correlation with Symptoms
Ece Yazla 1*, Huseyin Kayadibi 2, Ihsan Cetin 3, Unsal Aydinoglu 1, Mehmet Emrah Karadere 4
1Department of Psychiatry, Hitit University Faculty of Medicine, Corum, Turkey, 2Department of Biochemistry, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkey, 3Department of Biochemistry, Hitit University Faculty of Medicine, Corum, Turkey, 4Department of Psychiatry, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
Received: March 12, 2021; Revised: May 6, 2021; Accepted: June 18, 2021; Published online: June 18, 2021.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Objective: The aim of the study was to evaluate the levels of peripheric biomarkers that have been associated with blood brain barrier (BBB) damage in healthy controls and two groups of patients with schizophrenia, those who received typical-atypical antipsychotics and those who received only atypical antipsychotics. Additionally, we sought relationships between these biomarkers and schizophrenia symptoms.
Methods: This study was conducted with the inclusion of 41 healthy volunteers and 75 patients with schizophrenia. The biomarkers measured to evaluate BBB injury were as follows: spectrin breakdown product 145 (SBDP145), spectrin breakdown product 150 (SBDP150), ubiquitin carboxy terminal hydrolase L1 (UCHL1), ubiquitin ligase cullin-3 (cullin), occludin and claudin, which were measured via ELISA. Symptoms of patients with schizophrenia were evaluated with the Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS), the Clinical Global Impression Scale (CGI), and the general assessment of functionality (GAF).
Results: Compared to controls, SBDP145 (p=0.022) and cullin (p=0.046) levels were significantly higher in patients with schizophrenia receiving atypical antipsychotic treatment. SBDP150 levels were lower in the combination treatment group compared to the control group (p=0.022). Claudin (p=0.804), occludin (p=0.058) and UCHL1 (p=0.715) levels were similar among groups. In recipients of combination treatment, SBDP145 levels were found to be positively correlated with SAPS-total (r=0.440, p=0.036) and SAPS-delusions (r=0.494, p=0.017) scores.
Conclusion: The relationships demonstrated in this study indicate that more comprehensive research is needed to understand whether BBB defects contribute to clinical characteristics in patients with schizophrenia.
Keywords: Schizophrenia, Blood-Brain Barrier, Spectrin, Occludin, Claudins, Ubiquitin