Plasma antioxidant enzyme imbalance in childhood- and adolescent-onset schizophrenia: clinical correlates and diagnostic utility.

چکیده اصلی

Chronic oxidative stress (OS) is strongly implicated in the pathobiology of adult-onset schizophrenia, while contributions to childhood- and adolescent-onset schizophrenia (CAOS) have not been extensively investigated. Here we examined abnormalities in peripheral OS markers and associations with symptoms in a large CAOS cohort. Total superoxide dismutase (T-SOD), Mn-SOD, CuZn-SOD, glutathione peroxidase (GSH-Px), thioredoxin peroxidase (TPx), and catalase (CAT) activities as well as the Mn-SOD/T-SOD ratio were measured in plasma samples from 120 CAOS cases and 40 healthy controls (HCs). Psychopathological symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) and cognitive function using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Marker diagnostic performance was assessed by receiver operating characteristic analysis. Patients exhibited significantly lower T-SOD (Cohen's d = 0.56, P = 0.002), Mn-SOD (Cohen's d = 0.67, P < 0.001), and GSH-Px (Cohen's d = 0.55, P = 0.003), reduced Mn-SOD/T-SOD (Cohen's d = 0.36, P = 0.005), and elevated TPx (Cohen's d = 1.00, P < 0.001) versus HCs. Elevated TPx activity was associated with higher PANSS negative symptom score (β=0.220, P = 0.016) and total PANSS score (β=0.220, P = 0.010); a five-factor PANSS analysis further linked TPx to the thought disturbance/disorganization dimension. Unexpectedly, higher TPx was also associated with improved RBANS attention index (β=0.218, P = 0.013) and total score (β=0.192, P = 0.011). Plasma TPx was the strongest diagnostic marker (AUC=0.711), while a combined antioxidant enzyme index (CAEI) improved diagnostic performance (AUC=0.756, sensitivity 83.3%, specificity 60.0%). CAOS patients demonstrated multiple antioxidant enzyme activity abnormalities; TPx correlated with greater negative symptoms but better attention performance. Future studies are warranted to confirm the diagnostic utility of our CAEI.

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