Therapeutic effect of aripiprazole in chronic schizophrenia is accompanied by anti-inflammatory activity

Background: Weight gain and metabolic abnormalities occur in chronic schizophrenia patients treated with atypical antipsychotics. The purpose of the study was to evaluate changes in serum levels of C-reactive protein (CRP), insulin and cytokines (IL-6, TNF-alpha, IL-1 beta, IFN-gamma, sTNF-R1, IL-12, IL-23, IL-1Ra, TGF-beta 1, IL-4, and IL-10) after switching to aripiprazole. Methods: Cytokine, hsCRP and insulin measurements were performed in patients (n = 17) on day 0 and day 28 of the study using standard ELISA assays. The psychopathological status was assessed using PANSS. WC and BMI were measured and calculated, respectively. Results: We observed high clinical efficacy in aripiprazole linked to a 2.7% weight loss. There were statistically significant reductions in PANSS scores and body parameters (p < 0.001). After 28 days we detected a significant reduction in hsCRP (p < 0.001), insulin (p <0.001), IL-1 beta, IL-6, TNF-alpha, sTNF-R1, IL-12, IL-23, IL-1Ra, TGF-beta 1, IL-4 (p <0.001), IFN-gamma (p <0.05) and a significant elevation of IL-10 (p <0.001). There was a significant negative correlation between IL-10 levels and PANSS positive, negative and total scores after the study (p = 0.022, p = 0.003, p = 0.008, respectively). Conclusions: Aripiprazole limits inflammatory processes by enhancing anti-inflammatory signaling. Aripiprazole also reduces the risk of metabolic abnormalities. (C) 2014 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban &Partner Sp. z o.o. All rights reserved.