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정신분열병 환자에서 항정신병약물 치료가 혈청 VEGF, sVEGFR-1 및 sVEGFR-2의 농도에 미치는 영향- 예비 연구 -

The effect of antipsychotic drug treatment on serum VEGF, sVEGFR-1, and sVEGFR-2 level in schizophrenia- A preliminary study -

이상규|김도훈|손봉기|김태현|정전섭
대한생물정신의학회 (The Korean Society Of Biological Psychiatry)|2007.11|생물정신의학 (Journal of Korean Society of Biological Psychiatry)|제14권 제4호|pp. 232-240

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주제분류정신과학

초록

목적 : Cytokine 중의 하나인 vascular endothelial growth factor (VEGF)와 VEGF 수용체들은 다양한 생체내 조절 및 질병 상태와 연관이 있음이 알려져 있다. 본 연구는 정신분열병 환자에서 항정신병약물 치료에 따른 혈청내 자유 (free) VEGF와 가용성 VEGFR-1, 가용성 VEGFR-2의 변화를 보기 위한 것이었다. 방법 : 각 환자들은 DSM-IV 진단기준에 의해 정신분열병으로 진단을 받았고, 약물투여 시작일을 기준으로 4주째 및 8주째에 추적 관찰하였다. 모두 13명이 환자군에 포함되었으며 항정신병약물 투여전과 투여후 4주째, 8주째에 각각 PANSS에 의한 상태 평가와 함께 자유 VEGF, sVEGFR-1, sVEGFR-2의 농도를 측정하였다. 13명의 정상 대조군을 환자군의 나이와 성별에 맞춰 선정하였다. 결과 : 정신분열병 환자군의 혈청 자유 VEGF (295.2±43.7 pg/ml)와 sVEGFR-2 (8259±336.7)의 농도는 정상 대조군 (199.0±28.8 및 8481±371.9)과 비교하였을 때 의미있는 차이를 보이지 않았다. 그러나 sVEGFR-1의 농도 (86.2±10.3, p<0.05)는 정신분열병 환자군에서 대조군 (59.0±6.4)에 비해 의미있게 상승하였다. 정신분열병 환자군에서 항정신병약물 투여 후 자유 VEGF 농도는 4주째 (338.9±56.5)와 8주째 (309.5±58.7) 모두 투여 전과 비교하여 차이가 없었다. 그러나 sVEGFR-1 농도는 약물 치료후 8주째 (57.3±6.3, p<0.05)에 측정한 결과에서 유의하게 감소하였다. sVEGFR-2의 농도도 치료전과 비교하였을때 약물 치료후 4주째 (7761±403.0, p<0.05)와 8주째 (7435±333.5, p<0.05) 모두 유의하게 감소하였다.

Abstract

Object : Vascular endothelial growth factor (VEGF), one of a potent cytokines, and its receptors were related with various biological functions and pathological conditions. The purpose of this study was to investigate the changes of serum levels of free VEGF, soluble VEGFR-1, and soluble VEGFR-2 after treatment with atypical antipsychotic drugs in schizophrenia.Method : The schizophrenic patients were diagnosed with DSM-IV and were prospectively followed up for 4 and 8 weeks. Thirteen schizophrenic patients were evaluated their clinical assessment with serum level of free VEGF, sVEGFR-1, sVEGFR-2, and positive and negative symptom scale (PANSS) at baseline, 4 weeks, and 8 weeks after treatment with atypical antipsychotic drugs. Thirteen normal control subjects were recruited and matched with patient group by age and sex.Result : The serum level of free VEGF (295.2±43.7 pg/ml)and sVEGFR-2 (8259±336.7) at baseline (before treatment) in schizophrenic patients were not significantly different compared with control group (199.0±28.8 and 8481±371.9) respectively. However, the serum level of sVEGFR-1 (86.2±10.3, p<0.05) was significantly increased in schizophrenia patients compared with control group (59.0±6.4). After treatment with antipsychotic drug, the serum level of free VEGF at 4 weeks (338.9±56.5) and 8 weeks (309.5±58.7) were not significantly different compared with baseline. But the serum level of sVEGFR-1 were significantly decreased at 8 weeks (57.3±6.3, p<0.05) after antipsychotic drug treatment. The serum level of sVEGFR-2 were decreased at 4 weeks (7761±403.0, p<0.05) and 8 weeks (7435±333.5, p<0.05) compared with baseline. Conclusion : The decreased serum level of sVEGFR-1 and sVEGFR-2 might be affected by dopaminergic system which was influenced by antipsychotic drugs.

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