In Schizophrenia, the Effects of the IL-6/IL-23/Th17 Axis on Health-Related Quality of Life and Disabilities Are Partly Mediated by Generalized Cognitive Decline and the Symptomatome

Ali Fattah Al-Musawi, Hussein Kadhem Al-Hakeim, Zahraa Abdulrazaq Al-Khfaji, Inas H. Al-Haboby, Abbas F. Almulla, Drozdstoj St. Stoyanov and Michael Maes ()
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Ali Fattah Al-Musawi: Department of Clinical Pharmacy and Laboratory Sciences, College of Pharmacy, University of Al-Kafeel, Kufa 54001, Iraq
Hussein Kadhem Al-Hakeim: Department of Chemistry, College of Science, University of Kufa, Kufa 54002, Iraq
Zahraa Abdulrazaq Al-Khfaji: Department of Pharmacology, Toxicology and Clinical Pharmacy, Al-Zahraa University for Women, Karbala 56001, Iraq
Inas H. Al-Haboby: Al-Diwaniya Teaching Hospital, Al-Diwaniya 58001, Iraq
Abbas F. Almulla: Medical Laboratory Technology Department, College of Medical Technology, The Islamic University, Najaf 54001, Iraq
Drozdstoj St. Stoyanov: Department of Psychiatry, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria
Michael Maes: Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, PathumWan, Bangkok 10330, Thailand

IJERPH, 2022, vol. 19, issue 22, 1-18

Abstract: Schizophrenia patients show increased disabilities and lower quality of life (DisQoL). Nevertheless, there are no data on whether the activation of the interleukin (IL)-6, IL-23, T helper (Th)-17 axis, and lower magnesium and calcium levels impact DisQoL scores. This study recruited 90 patients with schizophrenia (including 40 with deficit schizophrenia) and 40 healthy controls and assessed the World Health Association QoL instrument-Abbreviated version and Sheehan Disability scale, Brief Assessment of Cognition in Schizophrenia (BACS), IL-6, IL-23, IL-17, IL-21, IL-22, tumor necrosis factor (TNF)-α, magnesium and calcium. Regression analyses showed that a large part of the first factor extracted from the physical, psychological, social and environmental HR-QoL and interference with school/work, social life, and home responsibilities was predicted by a generalized cognitive deterioration (G-CoDe) index (a latent vector extracted from BACs scores), and the first vector extracted from various symptom domains (“symptomatome”), whereas the biomarkers had no effects. Partial Least Squares analysis showed that the IL6IL23Th17 axis and magnesium/calcium had highly significant total (indirect + direct) effects on HR-QoL/disabilities, which were mediated by G-CoDe and the symptomatome (a first factor extracted from negative and positive symptoms). The IL6IL23Th17 axis explained 63.1% of the variance in the behavioral-cognitive-psycho-social (BCPS) worsening index a single latent trait extracted from G-CoDe, symptomatome, HR-QoL and disability data. In summary, the BCPS worsening index is partly caused by the neuroimmunotoxic effects of the IL6IL23Th17 axis in subjects with lowered antioxidant defenses (magnesium and calcium), thereby probably damaging the neuronal circuits that may underpin deficit schizophrenia.

Keywords: neuroimmune; inflammation; tryptophan catabolites; deficit schizophrenia; biomarkers; psychiatry (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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