Cited by 89Tryptophan and brain disordersSchizophrenia research and treatmentNeuroinflammation and Neurodegeneration Mechanisms

Anti-inflammatory treatment in schizophrenia

Müller, Norbert, Myint, Aye-Mu, Krause, Daniela, Weidinger, Elif, Schwarz, Markus J.·2013·Progress in Neuro-Psychopharmacology and Biological Psychiatry

Abstract

Antipsychotics, which act predominantly as dopamine D2 receptor antagonists, have several shortcomings. The exact pathophysiological mechanism leading to dopaminergic dysfunction in schizophrenia is still unclear, but inflammation has been postulated to be a key player in the pathophysiology of the disorder. A dysfunction in activation of the type 1 immune response seems to be associated with an imbalance in tryptophan/kynurenine metabolism; the degrading enzymes involved in this metabolism are regulated by cytokines. Kynurenic acid (KYNA), an N-methyl-d-aspartate antagonist, was found to be increased in critical regions of the central nervous system (CNS) in schizophrenia, resulting in reduced glutamatergic neurotransmission. The differential activation of microglial cells and astrocytes as functional carriers of the immune system in the CNS may also contribute to this imbalance. The immunological effects of many existing antipsychotics, however, rebalance in part the immune imbalance and overproduction of KYNA. The immunological imbalance results in an inflammatory state combined with increased prostaglandin E(2) production and increased cyclo-oxygenase-2 (COX-2) expression. Growing evidence from clinical studies with COX-2 inhibitors points to favorable effects of anti-inflammatory therapy in schizophrenia, in particular in an early stage of the disorder. Further options for immunomodulating therapies in schizophrenia will be discussed.

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Crossref · 10.1016/j.pnpbp.2012.11.008

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Authors
Müller, N., Myint, A.-M., Krause, D., Weidinger, E., & Schwarz, M. J.
Affiliations
Ludwig-Maximilians-Universität München (DE)
Corresponding author
Müller, Norbert
Venue
Progress in Neuro-Psychopharmacology and Biological Psychiatry
Publisher
Elsevier BV
Published
2013-04
Volume
42
Pages
146-153
ISSN
0278-5846 (ISSN-L)
OpenAlex
W1982896592
Cited by
89
References
136
Citations by year
2026: 1 · 2025: 4 · 2024: 2 · 2023: 5 · 2022: 2 · 2021: 6 · 2020: 6 · 2019: 11 · 2018: 5 · 2017: 5 · 2016: 16 · 2015: 8 · 2014: 11 · 2013: 6 · 2012: 1
FWCI
0.54
Type
journal article
Language
en
Open access
closed
Locations
  • Progress in Neuro-Psychopharmacology and Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
Keywords
schizophrenia, anti-inflammatory therapy, neuroinflammation, kynurenic acid, tryptophan-kynurenine metabolism, NMDA receptor antagonism, glutamatergic neurotransmission, microglia, astrocytes, cyclooxygenase-2, prostaglandin E2, COX-2 inhibitors, immunomodulation, antipsychotic drugs, dopamine D2 receptor antagonists, cytokines
MeSH terms
Animals, Anti-Inflammatory Agents, Non-Steroidal, Humans, Inflammation, Kynurenic Acid, Schizophrenia, Antipsychotic Agents, Cytokines, Treatment Outcome, Controlled Clinical Trials as Topic, Cyclooxygenase 2 Inhibitors

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