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Immune system dysfunction can alter the association between cannabis use and psychosis

Publicado em 17 junho 2021

The presence of pro-inflammatory cytokines in the blood may increase the effectiveness of daily cannabis use and increase the risk of developing psychosis in adulthood. Similar results have been observed with the use of cannabis in adolescence in the presence of cytokines. Psychotic disorders include symptoms such as delirium, loss of reality, hallucinations, auditory hallucinations, cognitive and social disorders.

A study by researchers at the Ribeirao Preto Medical College (FMRP-USP) at the University of Sao Paulo, Brazil, was reported in a journal article. Psychosomatic medicineIndividuals exposed to a combination of these two factors (the presence of pro-inflammatory cytokines in the blood and the use of cannabis (either daily or in adolescence)) may suffer more psychosis than those exposed. For the first time I found that is high in either or only one. According to the authors, this study provides “the first clinical evidence that immunodysregulation alters the link between cannabis and psychosis.”

This study was part of a project carried out by the European Network (EU-GEI) of the National Schizophrenia Network, which is a consortium of research centers in 13 countries, including Brazil, to study gene-environment interactions.Article published in Lancet Psychiatry According to the 2019 Consortium, daily cannabis use has tripled the chances of suffering from psychotic disorders.

In a more recent study, researchers analyzed data from 409 people aged 16-64 years, including patients experiencing the first episode of psychosis and community-based controls. Samples were taken from the population of Ribeirao Preto and 25 other cities in the region. Variables analyzed included frequency of cannabis use (daily, non-daily, or none at all), duration (less than 5 years), and age of onset (after adolescence).

In addition to the cannabis use questionnaire, researchers measured various cytokines in plasma donated by volunteers and calculated scores representing systemic inflammatory profiles. They also collected clinical and socio-demographic data, especially variables known as confounding factors such as age, gender, schooling, ethnicity, obesity index, smoking, and psychotropic drug use. The results obtained were independent of confounding factors.

“Not all people who use cannabis develop psychosis, which suggests that other factors such as biological, genetic, and environmental factors can alter the association. “Fabiana Corsi-Zuelli, the first author of the article, said. “so Previous research We identified the correlation between plasma cytokines and the first psychotic episode, which was conducted as part of my master’s study.Following this finding and a recent publication by the consortium that showed a high incidence of psychosis among subjects who use cannabis on a daily basis, our next step is due to biological factors. [inflammatory profile] It affected the link between cannabis use and psychosis. “

The main conclusion was that such a link did exist. “We found a statistically significant correlation between inflammatory profile and daily or adolescent cannabis use. In summary, the results show that immune system dysfunction alters the association between cannabis use and psychosis. There is a possibility, and the combination of these two factors is the probability of suffering from psychotic disorders. “

Corsi-Zuelli currently holds a PhD. Sao Paulo Research Foundation-Candidate for FMRP-USP Graduate Program in Neurology and Neuroscience with the support of FAPESP.

The lead investigator for this project is Cristina Marta Del-Ben, a professor of neuroscience and behavioral science at FMRP-USP. According to Delben, risk factors for psychosis include biological factors such as genetic predisposition and problems during pregnancy, environmental factors such as traumatic experiences in childhood and adolescence, and exposure to psychotropic drugs, especially cannabis. It may be.

“The mechanism of failure is not well understood,” she said. “Our findings show that frequent current use of cannabis or drug use in adolescence is a risk factor for psychosis. We detect the same correlation as occasional or recreational use. Did not. In multicenter collaborative studies involving various levels of European cities, the types of cannabis availability and users of more potent cannabis strains with a THC content of 10% or higher are at increased risk of psychosis. We also found that THC (Delta-9-Tetrahydrocannabinol) is the major psychoactive ingredient in cannabis or marijuana.

The medical explanation for psychosis is that it is a neuropsychiatric syndrome associated with anatomical and functional changes in the brain and is probably associated with altered action of dopamine, an important neurotransmitter for communication between neurons. It means that it is. Excessive dopamine or direct damage to certain brain regions can lead to hallucinations, delusions, delirium, and chaotic behavior.

Other neurotransmitters, such as glutamate, have also been implicated in the neurobiology of psychosis. What experts now call the neuroimmune link, and how dysregulation of the immune system can cause neurochemical, morphological, and behavioral changes that increase the risk of developing mental illness. We are discussing if there is.

Symptomatology of psychosis can be present in some mental disorders that may or may not be emotional. Recent studies have focused on cases of psychosis in patients infected with SARS-CoV-2. Treatment of mental illness includes a combination of medication, psychotherapy, and family support.

Next step

According to Corsi-Zuelli, the origin of the inflammatory changes associated with psychosis is still unknown, but it can result from a combination of genetic and environmental factors. “The inflammation seen in mental illness is considered to be low and not as serious as in patients with autoimmune disease or sepsis,” she said. “Nevertheless, experimental studies suggest that it is associated with sufficient dysregulation to produce neurochemical and behavioral changes.”

Researchers then plan to study genetic variation associated with the immune system and use neuroimaging data to investigate its association with environmental risk factors. “This focus on the interaction between genetics and the environment helps us understand the neurobiology of psychosis, especially the role that the immune system plays,” she said.

The association between inflammation and psychiatric disorders is highly relevant to clinical practice and is attracting attention. “It’s also important to look for alternative treatments for these disorders and to answer questions that are often overlooked regarding the physical health of people with mental illness,” said Corsi-Zuelli.

According to Del-Ben, the next step pipeline is in partnership with Gerald Busatto Filho, a professor of medicine (FM) on USP’s main campus, where inflammatory markers in the blood cause some brain changes. We are investigating whether it is related to. Patients studied.

This study has been internationally recognized twice. The Biological Psychiatry Society has selected a study for the Predoctoral Scholars Award, which was to be officially presented at SOBP’s 2020 Annual Meeting in New York, but due to the epidemic, the conference will be held online. It was postponed until April 2021. The study was also selected by the International Studies Association for Schizophrenia (SIRS) for presentation at the 2020 conference, also held online.

In addition to the scholarships awarded to Corsi-Zuelli, FAPESP supports research through four grants: 2012 / 05178-0, 2013 / 11167-3, 2017 / 13353-0, and 2018 / 07581-2. did.

The genetic predisposition to schizophrenia may increase the risk of psychosis from cannabis use

For more information:
Fabiana Corsi-Zuelli et al, Independent Combined Effects of Cannabis Use and Systemic Inflammation in the Early Stages of Psychosis: A Study of the Two-Hit Hypothesis, Psychosomatic medicine (2021). DOI: 10.1017 / S0033291721000726

Quote: Immune system dysfunction may alter the association between cannabis use and psychosis (June 16, 2021). Obtained from https: // on June 16, 2021.

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Immune system dysfunction can alter the association between cannabis use and psychosis

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