The effect of clozapine on immune-related biomarkers in schizophrenia patients
Lu Shao, Li Yu, ZhiYao Yuan, XiYu Guo, GuoJi Zeng, J Liu
Abstract
Globally, schizophrenia is one of the main causes of disability. Approximately 1 % of the general population suffers from schizophrenia, and 30 % of cases are unresponsive to therapy. Clozapine is the gold standard for therapy-resistant schizophrenia (TRS), yet it has limited effectiveness and serious adverse events in some patients. Because of the possibility of severe neutropenia, clozapine administration requires monthly hematological monitoring in the first four months. Previous investigations have demonstrated the immune system alteration after clozapine treatment in schizophrenia patients. Besides, it has been proposed that clozapine changes the cytokines profile in schizophrenia patients. These findings highlighted the need to learn more about the disease's etiology and investigate the relationship between peripheral immune system markers and clozapine response to support strategies for better treatment outcomes. The time decision-making to start clozapine could be significantly decreased if some biomarkers were developed to assist physicians in anticipating whether a particular patient will respond to the medication. Therefore, this study aimed to comprehensively review the effect of clozapine on immune-related biomarkers in schizophrenia patients. • Clozapine may lead to severe neutropenia in schizophrenia patients. • Clozapine changes the cytokines profile in schizophrenia patients. • Immune-related biomarkers might be used to predict the symptom before clozapine treatment. • The upregulation in IL-6 after clozapine treatment is evident. • Class-switched B-cells and plasmablasts have been reported to be decreased after clozapine therapy.