The clinical and biological studies indicate the involvement of inflammation in the pathogenesis of endogenous mental disorders. The inflammation markers leukocyte elastase, α1-proteinase inhibitor, and autoantibodies to neuroantigens reflect the severity of the pathological process in the brain. Systemic endotoxemia is a pathological process caused by an excess of endotoxins in the systemic circulation, can be considered as one of the components of the inflammatory process in endogenous psychosis.

To evaluate the association between systemic inflammation markers and indicators of systemic endotoxemia in patients with endogenous psychosis.

The study included 25 patients aged 23-49 with endogenous psychoses (F20, F25) and 25 healthy people. The severity of symptoms was assessed using PANSS. We detected the activity of leukocyte elastase and a1-proteinase inhibitor, antibodies to neuroantigens, endotoxin (ET) concentration, and antibodies to endotoxin (aEТ) in serum.

In 24% of cases, an increase of inflammation markers activity, ET concentration, and aET deficiency were observed (p<0.05), which is an unfavorable factor that aggravates the clinical course of the disease. In 76% of cases, ET concentration remained within control values (p>0.05) but associated with different levels of aET, which is likely to be a consequence of previous endotoxin aggression. There were correlations between ET concentration and antibodies to neuroantigens S-100B and MBP. We also revealed the association between the activity of the inflammatory marker with the severity of clinical symptoms in patients.

Results suggest the relationship between systemic inflammation markers and indicators of systemic endotoxemia and their involvement in the pathogenesis of endogenous psychosis.

No significant relationships.

Inflammation is an important factor in the pathogenesis of endogenous psychosis. An inducer of inflammatory reactions can be endotoxin aggression of intestinal origin.

To determine the level of inflammation markers and indicators of systemic endotoxinemia in blood of patients with endogenous psychosis in relation to assessment of the treatment effectiveness.

25 patients with endogenous psychosis (F20, F25) were examined before and after treatment. The control group consisted of 25 healthy people. The activity of inflammatory markers - leukocyte elastase, α1-antitrypsin, antibodies to S-100B, and indicators of systemic endotoxinemia – endotoxin concentration and antiendotoxin immunity activity were measured in blood serum. The treatment effectiveness was assessed by the dynamics of inflammatory markers.

Based on the results of determining the studied parameters before treatment, all patients were divided into two groups. In the 1st group (6 patients, 24%), an increase of inflammatory markers activity and high concentration of endotoxin in the blood serum were revealed (p<0,001, p<0,05, respectively). In the 2nd group (19 patients, 76%), only activation of inflammatory reactions (p<0,001) was detected. After therapy in the 1st group of patients, there was no positive dynamics of all studied markers, which indicated an active course of the pathological process. In the 2nd group, the normalization of inflammatory markers was shown (p<0,05), which corresponded to the formation of remission.

The results indicate that endotoxic aggression contributes to reduction of the effectiveness of endogenous psychosis therapy and can be considered as an additional therapeutic target.