A Meta-Analysis of the Influence of Antipsychotics on Cytokines Levels in First Episode Psychosis

Background: Cytokines have a major impact on the neurotransmitter networks that are involved in schizophrenia pathophysiology. First Episode Psychosis (FEP) patients exhibit abnormalities in cytokines levels prior to the start of treatment. Previous studies showed that antipsychotic treatment modulates cytokines levels. The aim of this meta-analysis is to further investigate this relationship. Methods: Several online databases were searched. For meta-analysis of selected studies, we analysed variables containing the number of cases, mean and standard deviation of IL-1 beta, IL-2, IL-4, IL-6, IL-10, IL-17, TNF-alpha, IFN-gamma levels before, and after, antipsychotic treatment. Results: 12 studies were included in the meta-analysis. Our main results demonstrate that, in FEP patients, antipsychotic treatment is related to decreased concentrations of pro-inflammatory IL-1 beta, IL-6, IFN-gamma, TNF-alpha and anti-inflammatory IL-4, IL-10 cytokines. On the other hand, levels of pro-inflammatory IL-2 and IL-17 remain unaffected. Conclusions: When compared with other meta-analyses of studies involving FEP individuals, results we obtained are consistent regarding decrease in IL-1 beta, IL-6. Comparing outcomes of our study with meta-analyses of schizophrenic subjects, in general, our results are consistent in IL-1 beta, IL-6, TNF-alpha, IFN-gamma, IL-2. Our meta-analysis is the only one which indicates a decrease in anti-inflammatory IL-10 in FEP patients after antipsychotic treatment.

Automated summary

The study shows that antipsychotic treatment leads to decreased concentrations of certain pro-inflammatory and anti-inflammatory cytokines in FEP patients, while leaving levels of other cytokines unaffected. Comparing with other meta-analyses involving schizophrenic subjects, the results are consistent in some cytokines but indicate a decrease in anti-inflammatory IL-10 in FEP patients after antipsychotic treatment.