研究临床高危人群中细胞因子与症状簇之间的脱节：迈向全面的跨维度分析

IF 5.3 2区医学 Q1 CLINICAL NEUROLOGY

Progress in Neuro-Psychopharmacology & Biological Psychiatry Pub Date : 2025-04-02 DOI:10.1016/j.pnpbp.2025.111356

TianHong Zhang , LiHua Xu , YanYan Wei , XiaoChen Tang , MingLiang Ju , XiaoHua Liu , Dan Zhang , HaiChun Liu , ZiXuan Wang , Tao Chen , Jin Gao , Qiang Hu , LingYun Zeng , ZhengHui Yi , ChunBo Li , JiJun Wang

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引用次数: 0

摘要

目的精神病临床高危期个体的聚类往往依赖于单一维度，不同维度聚类结果的独立性或重叠性缺乏足够的证据。此外，目前尚不清楚是否结合不同的维度，如生物标记(如：（细胞因子）和症状维度-可以提高预测疗效。方法本研究纳入370例CHR患者，随访3年，其中50例CHR患者转为精神病。参与者接受了全面的症状评估，包括临床症状和认知障碍。获得8种细胞因子的基线测量值。使用潜在类分析（LCA）分别基于症状概况和细胞因子水平构建聚类。生存分析用于探讨不同集群间转换率的差异。结果LCA决定了症状、细胞因子和综合聚类的四聚类溶液的选择。症状组-2表现出最严重的临床症状和认知障碍，而症状组-4表现出最轻的临床症状和认知障碍。细胞因子-簇-1的特征是炎症细胞因子水平最高，不包括血管内皮生长因子，而症状-簇-4表现出最低水平的细胞因子。根据症状和细胞因子确定的群集显示出实质性的不一致。生存率分析结果显示，症状类转化率（χ2 = 6.731, p = 0.081）和细胞因子类转化率（χ2 = 7.139, p = 0.068）差异无统计学意义，但综合类转化率差异有统计学意义（χ2 = 9.234, p = 0.026）。结论本研究强调了症状和细胞因子维度对精神病风险提供的不同视角，提倡在跨模式方法中整合这些维度以提高预测准确性。

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Investigating the disconnection between cytokine and symptom clusters in clinical high risk populations: Towards a comprehensive cross-dimensional analysis

Objective

Clustering individuals at the Clinical High-Risk(CHR) stage of psychosis often relies on single dimensions, and the independence or overlap of clustering results across different dimensions lacks sufficient evidence. Additionally, it remains unclear whether combining different dimensions—such as biological markers(e.g., cytokines) and symptomatic dimensions—can enhance predictive efficacy.

Methods

This study included 370 individuals with CHR and conducted a three-year follow-up, 50 CHR individuals transitioned to psychosis. The participants underwent thorough symptom assessments, encompassing both clinical symptoms and cognitive impairments. Baseline measurements of eight cytokines were obtained. Latent Class Analysis(LCA) was employed to construct clusters based on both symptom profiles and cytokine levels separately. Survival analysis was utilized to explore differences in conversion rates among different clusters.

Results

The LCA determined the selection of the four-cluster solution for symptoms, cytokines, and the integrated clusters. Symptom-Cluster-2 exhibited the most severe clinical symptoms and cognitive impairments, while Symptom-Cluster-4 displayed the mildest clinical symptoms and cognitive impairments. Cytokine-Cluster-1 was characterized by the highest levels of inflammatory cytokines, excluding vascular endothelial growth factor, whereas Symptom-Cluster-4 exhibited the lowest levels of cytokines. The clusters identified based on symptoms and cytokines showed substantial inconsistency. Survival analysis comparing conversion rates across four clusters revealed no significant difference in symptom(χ² = 6.731, p = 0.081) and cytokine(χ² = 7.139, p = 0.068) clusters but was significant in integrated clusters(χ² = 9.234, p = 0.026).

Conclusion

The study emphasizes the distinct perspectives on psychosis risk offered by symptom and cytokine dimensions, advocating for the integration of these dimensions in a cross-modal approach to enhance predictive accuracy.

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来源期刊

Progress in Neuro-Psychopharmacology & Biological Psychiatry 医学-精神病学

CiteScore

12.00

自引率

1.80%

发文量

153

审稿时长

56 days

期刊介绍： Progress in Neuro-Psychopharmacology & Biological Psychiatry is an international and multidisciplinary journal which aims to ensure the rapid publication of authoritative reviews and research papers dealing with experimental and clinical aspects of neuro-psychopharmacology and biological psychiatry. Issues of the journal are regularly devoted wholly in or in part to a topical subject. Progress in Neuro-Psychopharmacology & Biological Psychiatry does not publish work on the actions of biological extracts unless the pharmacological active molecular substrate and/or specific receptor binding properties of the extract compounds are elucidated.