INTERLEUKIN-18 LEVELS IN SCHIZOPHRENIA PATIENTS RECEIVING ANTI-PSYCHOTIC THERAPY AT THE PSYCHIATRIC POLYCLINIC OF SITI RAHMAH ISLAMIC HOSPITAL
Main Article Content
The use of antipsychotic therapy is effective in managing symptoms and has become a cornerstone in the treatment of patients with schizophrenia. However, antipsychotics have side effects on the immune system, particularly affecting Interleukin 18 (IL-18) levels. Therefore, it is important to assess IL-18 levels in schizophrenic patients receiving antipsychotic therapy. Objective: To determine IL-18 levels in schizophrenic patients undergoing antipsychotic therapy and receiving outpatient care at the RSI Siti Rahmah Padang clinic. This descriptive study recruited 25 schizophrenic patients receiving antipsychotic therapy who voluntarily participated. IL-18 levels were measured using the ELISA method from patient serum. Results: In 25 schizophrenia patients who received antipsychotic therapy, IL 18 levels were obtained as much as 483.7 SD ± 27.3 ng/ml. The subjects were aged 36-45 years (60%), 88% were male, and 64% were using atypical antipsychotics. Schizophrenic patients receiving antipsychotic therapy at RSI Siti Rahmah Padang showed elevated IL-18 levels.
Keywords:
Schizophrenia
Antipsychotic
Interleukin-18
1. D. Surya Yudhantara R. Synopsis of Schizophrenia (Definition of Schizophrenia). e.book [Internet]. 2018; Available from: https://books.google.com/books?hl=id&lr=&id=ZOJqDwAAQBAJ&oi=fnd&pg=PR5&dq=schizophrenia&ots=tvu4eT2GAy&sig=s91VZIZYVDs7weGEfD_ArQeZ35Y
2. Putri, IA (2022). Schizophrenia: A literature study. Journal of Public Health and Medical Studies, 1(1), 1-12.
3. Chrisanto EY, Furqoni PD, Zulkandri R. The Relationship between Family Information Support and Relapse in Schizophrenia Patients at the Aulia Rahma Foundation, Bandar Lampung. Malahayati Nursing Journal . 2022 May 1;4(5):1169–76.
4. He H, Liu Q, Li N, Guo L, Gao F, Bai L, et al. Trends in the incidence and DALYs of schizophrenia at the global, regional and national levels: Results from the Global Burden of Disease Study 2017. Epidemiol Psychiatr Sci. 2019;
5. Charlson FJ, Ferrari AJ, Santomauro DF, Diminic S, Stockings E, Scott JG, et al. Global epidemiology and burden of schizophrenia: Findings from the global burden of disease study 2016. Schizophr Bull. 2018 Oct 17;44(6):1195–203.
6. Zhang Z, Sun K, Jatchavala C, Koh J, Chia Y, Bose J, et al. Overview of stigma against psychiatric illnesses and advances of anti-stigma activities in six asian societies. Int J Environ Res Public Health. 2020 Jan 1;17(1).
7. Chan KY, Zhao FF, Meng S, Demaio AR, Reed C, Theodoratou E, et al. Prevalence of schizophrenia in China between 1990 and 2010. J Glob Health. 2015;5(1).
8. Murwasuminar B, Munro I, Recoche K. Mental health recovery for people with schizophrenia in Southeast Asia: A systematic review. Vol. 30, Journal of Psychiatric and Mental Health Nursing. John Wiley and Sons Inc; 2023. p. 620–36.
9. Herawati, N., & Afconneri, Y. (2020). Self-care of schizophrenia patients with hallucinations. Journal of Mental Health Nursing, 8(1), 9-20.
10. West Sumatra Riskesdas Report 2018.
11. Afconneri Y, Lim K, Erwina I, Nursing J, Padang K. Relapse Factors in Schizophrenia Clients at the Polyclinic of Prof. Dr. Hb Sa'TM anin Mental Hospital Padang . Endurance Journal: Scientific Study of Health Problems [Internet]. 2020 Jun 29 [cited 2023 Jun 6];5(2):321–30. Available from: http://ejournal.lldikti10.id/index.php/endurance/article/view/v5i2-3885
12. Fitrikasari A, Kartikasari L. Textbook of Schizophrenia. Kuntardjo N, editor. Vol. 1. Undip Press Semarang; 2022. 15–17 p.
13. Stahl SM. Stahl's essential psychopharmacology: Neuroscientific basis and practical applications, 4th ed. Stahl's essential psychopharmacology: Neuroscientific basis and practical applications, 4th ed. New York, NY, US: Cambridge University Press; 2013. 608, xv, 608–xv p.
14. Komang I, Landra G, Devi K, Anggelina I. Paranoid Schizophrenia. Ganesha Medicina [Internet]. 2022 Jun 5 [cited 2023 Feb 18];2(1):66–71. Available from: https://ejournal.undiksha.ac.id/index.php/GM/article/view/46314
15. Maylani RY, Fadraersada J, Ramadhan AM. Study of Antipsychotic Administration for Several Types of Schizophrenia at Atma Husada Mahakam Mental Hospital, Samarinda. Proceeding of Mulawarman Pharmaceuticals Conferences. 2018 Dec 31;8:267–75.
16. Romeo B, Brunet-Lecomte M, Martelli C, Benyamina A. Kinetics of cytokine levels during antipsychotic treatment in schizophrenia: A meta-Analysis. International Journal of Neuropsychopharmacology. 2018;21(9):828–36.
17. Borovcanin MM, Jovanovic I, Radosavljevic G, Pantic J, Janicijevic SM, Arsenijevic N, et al. Interleukin-6 in schizophrenia-Is there a therapeutic relevance? Vol. 8, Frontiers in Psychiatry. Frontiers Media SA; 2017.
18. Giridharan V, Scaini G, Colpo GD, Doifode T, F. Pinjari O, Teixeira AL, et al. Clozapine Prevents Poly (I:C) Induced Inflammation by Modulating NLRP3 Pathway in Microglial Cells. Cells [Internet]. 2020 Feb 28;9(3):577. Available.from: https://www.mdpi.com/2073-4409/9/3/577
19. Lejeune JA, Northrop A, Kurtz MM. A Meta-analysis of Cognitive Remediation for Schizophrenia: Efficacy and the Role of Participant and Treatment Factors. Schizophr Bull. 2021 Jul 1;47(4):997–1006.
20. Rony F, Yuliyanda PC. Cost Of Illness Analysis in Schizophrenia Patients at the Psychiatric Polyclinic of the Lampung Provincial Mental Hospital Cost Of Illness Analysis in Schizophrenia Patients at the Psychiatric Polyclinic of the Lampung Provincial Mental Hospital.2023
21. Sri Yulianti T, Ariasti D. Kosala. Vol. 8, Journal of Health Sciences. 2020.
2 2. Wulandari L, Mitra Husada Karanganyar Stik. Analysis of the Incidence of Readmission Cases of Schizophrenia.2021
23. Lodha P, Karia S. Testosterone and Schizophrenia: A Clinical Review. Annals of Indian Psychiatry [Internet]. 2019;3(2). Available from: https://journals.lww.com/aips/fulltext/2019/03020/testosterone_and_schizophrenia__a_clinical_review.4.aspx
24. Leung MD DrA, Chue MRC Psych. DrP. Sex differences in schizophrenia, a review of the literature. Acta Psychiatr Scand [Internet]. 2000;101(401):3–38. Available.from: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.0065-1591.2000.0ap25.x
25. Grigoriadis S, Seeman M V. The role of estrogen in schizophrenia: Implications for schizophrenia practice guidelines for women. Canadian Journal of Psychiatry. 2002;47(5):437–42.
26. Fibriana AI, Article I. Risk Factors for Schizophrenia (Case Study in the Working Area of Pati II Health Center) [Internet]. Vol. 1, Public Health Perspective Journal. 2016. Available from: http://journal.unnes.ac. id/sju/index.php/phpj
27. Hasni D, Sagala ICA, Anissa M, Eldrian F. Profile of Leptin Levels in Schizophrenic Patients Receiving Antipsychotic Therapy in Prof. Dr. HB Saanin Hospital Padang. Brawijaya Medical Journal. 2020 Oct 1;31(2):105–10.
28. Rizkifani S, Susanti R, Febiani T, Jl Professor Doctor H Hadari Nawawi JH, Laut B, Pontianak Tenggara K, et al. Study of Antidepressant and Antipsychotic Drug Interactions in Schizophrenic Patients at the Bangkong River Mental Hospital Pontianak. Vol. 8, Medical Science: Scientific Journal of Pharmacy. 2023
29. Ayu P, Saraswati I, Ketut N, Diniari S. Prevalence of Obesity in Schizophrenia Patients Receiving Atypical Antipsychotic Therapy at Bali Provincial Mental Hospital [Internet]. Vol. 8, Jurnal Medika. May; 2019. Available from: https://ojs.unud.ac.id/index.php/eum
30. Sri Rejeki NMDP, Kuswardhani RAT. Correlation of serum albumin and serum interleukin-6 (IL-6) in geriatric patients at Sanglah General Hospital, Denpasar, Bali, Indonesia. Medicina (B Aires). 2019 Aug 1;50(2).
31. Girgis RR, Ciarleglio A, Choo T, Haynes G, Bathon JM, Cremers S, et al. A Randomized, Double-Blind, Placebo-Controlled Clinical Trial of Tocilizumab, An Interleukin-6 Receptor Antibody, for Residual Symptoms in Schizophrenia. Neuropsychopharmacology. 2018 May 1;43(6):1317–23.
32. Subbanna M, Shivakumar V, Venugopal D, Narayanaswamy JC, Berk M, Varambally S, et al. Impact of antipsychotic medication on IL-6/STAT3 signaling axis in peripheral blood mononuclear cells of drug-naive schizophrenia patients. 2019; Available from: http://onlinelibrary.wiley.com/doi/10.1111/pcn.12938/full
33. Schwieler L, Larsson MK, Skogh E, Kegel ME, Orhan F, Abdelmoaty S, et al. Increased levels of IL-6 in the cerebrospinal fluid of patients with chronic schizophrenia - Significance for activation of the kynurenine pathway. Journal of Psychiatry and Neuroscience. 2015;40(2):126–33.
34. Glund S, Krook A. Role of interleukin-6 signaling in glucose and lipid metabolism. Acta physiologica. 2008;192(1):37–48.
35. Ripke S, O'Dushlaine C, Chambert K, Moran JL, Kähler AK, Akterin S, et al. Genome-wide association analysis identifies 13 new risk loci for schizophrenia. Nat Genet. 2013;45(10).
36. Stojanovic A, Martorell L, Montalvo I, Ortega L, Monseny R, Vilella E, et al. Increased serum interleukin-6 levels in early stages of psychosis: Associations with at-risk mental states and the severity of psychotic symptoms. Psychoneuroendocrinology [Internet]. 2014;41:23–32. Available from: https://www.sciencedirect.com/science/article/pii/S0306453013004411
2. Putri, IA (2022). Schizophrenia: A literature study. Journal of Public Health and Medical Studies, 1(1), 1-12.
3. Chrisanto EY, Furqoni PD, Zulkandri R. The Relationship between Family Information Support and Relapse in Schizophrenia Patients at the Aulia Rahma Foundation, Bandar Lampung. Malahayati Nursing Journal . 2022 May 1;4(5):1169–76.
4. He H, Liu Q, Li N, Guo L, Gao F, Bai L, et al. Trends in the incidence and DALYs of schizophrenia at the global, regional and national levels: Results from the Global Burden of Disease Study 2017. Epidemiol Psychiatr Sci. 2019;
5. Charlson FJ, Ferrari AJ, Santomauro DF, Diminic S, Stockings E, Scott JG, et al. Global epidemiology and burden of schizophrenia: Findings from the global burden of disease study 2016. Schizophr Bull. 2018 Oct 17;44(6):1195–203.
6. Zhang Z, Sun K, Jatchavala C, Koh J, Chia Y, Bose J, et al. Overview of stigma against psychiatric illnesses and advances of anti-stigma activities in six asian societies. Int J Environ Res Public Health. 2020 Jan 1;17(1).
7. Chan KY, Zhao FF, Meng S, Demaio AR, Reed C, Theodoratou E, et al. Prevalence of schizophrenia in China between 1990 and 2010. J Glob Health. 2015;5(1).
8. Murwasuminar B, Munro I, Recoche K. Mental health recovery for people with schizophrenia in Southeast Asia: A systematic review. Vol. 30, Journal of Psychiatric and Mental Health Nursing. John Wiley and Sons Inc; 2023. p. 620–36.
9. Herawati, N., & Afconneri, Y. (2020). Self-care of schizophrenia patients with hallucinations. Journal of Mental Health Nursing, 8(1), 9-20.
10. West Sumatra Riskesdas Report 2018.
11. Afconneri Y, Lim K, Erwina I, Nursing J, Padang K. Relapse Factors in Schizophrenia Clients at the Polyclinic of Prof. Dr. Hb Sa'TM anin Mental Hospital Padang . Endurance Journal: Scientific Study of Health Problems [Internet]. 2020 Jun 29 [cited 2023 Jun 6];5(2):321–30. Available from: http://ejournal.lldikti10.id/index.php/endurance/article/view/v5i2-3885
12. Fitrikasari A, Kartikasari L. Textbook of Schizophrenia. Kuntardjo N, editor. Vol. 1. Undip Press Semarang; 2022. 15–17 p.
13. Stahl SM. Stahl's essential psychopharmacology: Neuroscientific basis and practical applications, 4th ed. Stahl's essential psychopharmacology: Neuroscientific basis and practical applications, 4th ed. New York, NY, US: Cambridge University Press; 2013. 608, xv, 608–xv p.
14. Komang I, Landra G, Devi K, Anggelina I. Paranoid Schizophrenia. Ganesha Medicina [Internet]. 2022 Jun 5 [cited 2023 Feb 18];2(1):66–71. Available from: https://ejournal.undiksha.ac.id/index.php/GM/article/view/46314
15. Maylani RY, Fadraersada J, Ramadhan AM. Study of Antipsychotic Administration for Several Types of Schizophrenia at Atma Husada Mahakam Mental Hospital, Samarinda. Proceeding of Mulawarman Pharmaceuticals Conferences. 2018 Dec 31;8:267–75.
16. Romeo B, Brunet-Lecomte M, Martelli C, Benyamina A. Kinetics of cytokine levels during antipsychotic treatment in schizophrenia: A meta-Analysis. International Journal of Neuropsychopharmacology. 2018;21(9):828–36.
17. Borovcanin MM, Jovanovic I, Radosavljevic G, Pantic J, Janicijevic SM, Arsenijevic N, et al. Interleukin-6 in schizophrenia-Is there a therapeutic relevance? Vol. 8, Frontiers in Psychiatry. Frontiers Media SA; 2017.
18. Giridharan V, Scaini G, Colpo GD, Doifode T, F. Pinjari O, Teixeira AL, et al. Clozapine Prevents Poly (I:C) Induced Inflammation by Modulating NLRP3 Pathway in Microglial Cells. Cells [Internet]. 2020 Feb 28;9(3):577. Available.from: https://www.mdpi.com/2073-4409/9/3/577
19. Lejeune JA, Northrop A, Kurtz MM. A Meta-analysis of Cognitive Remediation for Schizophrenia: Efficacy and the Role of Participant and Treatment Factors. Schizophr Bull. 2021 Jul 1;47(4):997–1006.
20. Rony F, Yuliyanda PC. Cost Of Illness Analysis in Schizophrenia Patients at the Psychiatric Polyclinic of the Lampung Provincial Mental Hospital Cost Of Illness Analysis in Schizophrenia Patients at the Psychiatric Polyclinic of the Lampung Provincial Mental Hospital.2023
21. Sri Yulianti T, Ariasti D. Kosala. Vol. 8, Journal of Health Sciences. 2020.
2 2. Wulandari L, Mitra Husada Karanganyar Stik. Analysis of the Incidence of Readmission Cases of Schizophrenia.2021
23. Lodha P, Karia S. Testosterone and Schizophrenia: A Clinical Review. Annals of Indian Psychiatry [Internet]. 2019;3(2). Available from: https://journals.lww.com/aips/fulltext/2019/03020/testosterone_and_schizophrenia__a_clinical_review.4.aspx
24. Leung MD DrA, Chue MRC Psych. DrP. Sex differences in schizophrenia, a review of the literature. Acta Psychiatr Scand [Internet]. 2000;101(401):3–38. Available.from: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.0065-1591.2000.0ap25.x
25. Grigoriadis S, Seeman M V. The role of estrogen in schizophrenia: Implications for schizophrenia practice guidelines for women. Canadian Journal of Psychiatry. 2002;47(5):437–42.
26. Fibriana AI, Article I. Risk Factors for Schizophrenia (Case Study in the Working Area of Pati II Health Center) [Internet]. Vol. 1, Public Health Perspective Journal. 2016. Available from: http://journal.unnes.ac. id/sju/index.php/phpj
27. Hasni D, Sagala ICA, Anissa M, Eldrian F. Profile of Leptin Levels in Schizophrenic Patients Receiving Antipsychotic Therapy in Prof. Dr. HB Saanin Hospital Padang. Brawijaya Medical Journal. 2020 Oct 1;31(2):105–10.
28. Rizkifani S, Susanti R, Febiani T, Jl Professor Doctor H Hadari Nawawi JH, Laut B, Pontianak Tenggara K, et al. Study of Antidepressant and Antipsychotic Drug Interactions in Schizophrenic Patients at the Bangkong River Mental Hospital Pontianak. Vol. 8, Medical Science: Scientific Journal of Pharmacy. 2023
29. Ayu P, Saraswati I, Ketut N, Diniari S. Prevalence of Obesity in Schizophrenia Patients Receiving Atypical Antipsychotic Therapy at Bali Provincial Mental Hospital [Internet]. Vol. 8, Jurnal Medika. May; 2019. Available from: https://ojs.unud.ac.id/index.php/eum
30. Sri Rejeki NMDP, Kuswardhani RAT. Correlation of serum albumin and serum interleukin-6 (IL-6) in geriatric patients at Sanglah General Hospital, Denpasar, Bali, Indonesia. Medicina (B Aires). 2019 Aug 1;50(2).
31. Girgis RR, Ciarleglio A, Choo T, Haynes G, Bathon JM, Cremers S, et al. A Randomized, Double-Blind, Placebo-Controlled Clinical Trial of Tocilizumab, An Interleukin-6 Receptor Antibody, for Residual Symptoms in Schizophrenia. Neuropsychopharmacology. 2018 May 1;43(6):1317–23.
32. Subbanna M, Shivakumar V, Venugopal D, Narayanaswamy JC, Berk M, Varambally S, et al. Impact of antipsychotic medication on IL-6/STAT3 signaling axis in peripheral blood mononuclear cells of drug-naive schizophrenia patients. 2019; Available from: http://onlinelibrary.wiley.com/doi/10.1111/pcn.12938/full
33. Schwieler L, Larsson MK, Skogh E, Kegel ME, Orhan F, Abdelmoaty S, et al. Increased levels of IL-6 in the cerebrospinal fluid of patients with chronic schizophrenia - Significance for activation of the kynurenine pathway. Journal of Psychiatry and Neuroscience. 2015;40(2):126–33.
34. Glund S, Krook A. Role of interleukin-6 signaling in glucose and lipid metabolism. Acta physiologica. 2008;192(1):37–48.
35. Ripke S, O'Dushlaine C, Chambert K, Moran JL, Kähler AK, Akterin S, et al. Genome-wide association analysis identifies 13 new risk loci for schizophrenia. Nat Genet. 2013;45(10).
36. Stojanovic A, Martorell L, Montalvo I, Ortega L, Monseny R, Vilella E, et al. Increased serum interleukin-6 levels in early stages of psychosis: Associations with at-risk mental states and the severity of psychotic symptoms. Psychoneuroendocrinology [Internet]. 2014;41:23–32. Available from: https://www.sciencedirect.com/science/article/pii/S0306453013004411
