The Correlation Research Of Elevated Plasma HsCRP,IL-6 Levels And Aggressive Behavior In Schizophrenia Patients

ObjectiveTo investigate whether plasma inflammatory markers levels were altered in schizophrenia patients with and without aggressive behavior compared with healthy controls,whether there was a correlation between plasma inflammatory markers levels and aggression,whether inflammatory markers by influencing the 5-HT synthesis and eventually led to aggressive behavior.MethodsPlasma hsCRP,IL-6,IFN-?,TNF-?and IL-10 levels were examined by enzyme-linked immunosorbent assay(ELISA)from 49 schizophrenia patients with aggressive behavior,51 schizophrenia patients without aggressive behavior,and 40 healthy controls.Plasma levels of 5-HT and 5-HIAA were measured by high performance liquid chromatography.The severity of psychotic symptoms were assessed by Positive and negative syndrome scale(PANSS).Modified overt aggression scale(MOAS)was used to measure the severity of aggressive behavior,and trait aggression was assessed by Chinese version of Buss&Perry Aggression Questionnaire.Results1.Schizophrenia patients with aggressive behavior had significantly higher levels of hsCRP than the patients without aggressive behavior and heathy controls,(Bonferroni corrected P=0.034,Bonferroni corrected P=0.006,respectively).IL-6levels were significantly higher in schizophrenia patients with aggressive behavior and without aggressive behavior than in normal controls(Bonferroni corrected P<0.001,Bonferroni corrected P<0.001,respectively).However,there were no significant differences in IL-6 between patients with aggressive behavior and without aggressive behavior(Bonferroni corrected P=0.407).2.Plasma hsCRP and IL-6 levels were positively correlated with total score and aggression against others subscore of MOAS in the whole schizophrenia patients(hsCRP:r_s=0.242,P=0.015;r_s=0.228,P=0.023;IL-6:r_s=0.291,P=0.003;r_s=0.292,P=0.003,respectively).Plasma IL-6 levels were positively correlated with total score and aggression against others subscore of MOAS in schizophrenia patients with aggressive behavior(r_s=0.311,P=0.030;r_s=0.326,P=0.022,respectively).3.Across all participants,IL-6 levels were positively correlated with AQ-CV total score,physical aggression,hostility and self-aggression subscore(r_s=0.228,P=0.013;r_s=0.210,P=0.022;r_s=0.305,P=0.001;r_s=0.218,P=0.017,respectively).IL-10 levels were positively correlated with AQ-CV total score,hostility and self-aggression subscore(r=0.370,P=0.026;r=0.467,P=0.004;r=0.492,P=0.002,respectively),while plasma TNF-?levels were negatively correlated with verbal aggression(r_s=-0.541,P=0.001)in schizophrenia patients with aggressive behavior.4.Plasma 5-HIAA levels were significantly higher in schizophrenia patients with aggressive behavior and without aggressive behavior than in normal controls(Bonferroni corrected P<0.001,Bonferroni corrected P<0.001,respectively).However,there were no significant differences in 5-HIAA between patients with aggressive behavior and without aggressive behavior(Bonferroni corrected P=0.949).5.Across all participants,plasma 5-HT levels were positively correlated with plasma IFN-?levels(r_s=0.182,P=0.031).Plasma 5-HIAA levels were negatively correlated with IFN-?levels(r_s=-0.198,P=0.019)and were positively correlated with plasma IL-6 levels(r_s=0.280,P=0.001).5-HT levels were positively correlated with IFN-?levels(r_s=0.319,P=0.026)in patients with aggressive behavior.ConclusionsPlasma levels of hsCRP and IL-6 were associated with aggressive behavior in schizophrenia patients.Inflammatory markers may play an important role in the pathophysiology of schizophrenia patients with aggressive behavior.Plasma hsCRP?IL-6?TNF-?and IL-10 could be biomarkers of aggression in schizophrenia patients.