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Chronic low-grade peripheral inflammation is associated with severe nicotine dependence in schizophrenia: results from the national multicentric FACE-SZ cohort

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Abstract

Chronic peripheral inflammation (CPI) has been associated with cognitive impairment in schizophrenia (SZ). However, its sources remain unclear, more specifically it is not known whether tobacco smoking is a source of inflammation or not in SZ subjects. Moreover, nicotine (NIC), the major psychoactive compound of tobacco, shows strong anti-inflammatory properties in vitro, as well as inducing a severe biological dependence when administered repeatedly. The objective of the present study was to determine if CPI was associated with tobacco smoking and/or NIC dependence in schizophrenia. Three hundred and forty five stabilized community-dwelling SZ subjects aged 16 years or older (mean age = 32 years, 73% male) were consecutively included in the network of the FondaMental Expert Centers for Schizophrenia and assessed with validated scales. CPI was defined by a highly sensitive C-reactive protein (hsCRP) ≥3 mg/L. Current tobacco status was self-declared. Severe NIC dependence was defined by a Fagerstrom Test for Nicotine Dependence score ≥7. Overall, 159 (46.1%) were non-smokers, 117 (33.9%) and 69 (20%) were current tobacco smokers with, respectively, low and severe nicotine dependence. In a multivariate model, CPI remained associated with severe NIC dependence (29 vs 15%, OR = 2.8, p = 0.003) and body mass index (OR = 1.1, p < 0.0001), independently of socio-demographic characteristics and antidepressant intake. No association of CPI with low to moderate tobacco smoking dependence, number of daily smoked cigarettes, cannabis use, alcohol use or illness characteristics was found (all p > 0.05). CPI was associated with severe NIC dependence but not with tobacco smoking with low to moderate NIC dependence in SZ, independently of socio-demographic variables, body mass index, alcohol consumption and antidepressant intake. This result highlights the potential CPI consequences of the high prevalence of heavy tobacco smoking in SZ, indicating the importance of new therapeutic strategies for tobacco cessation in SZ.

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Acknowledgements

This work was funded by AP-HP (Assistance Publique des Hôpitaux de Paris), Fondation FondaMental (RTRS Santé Mentale), by the Investissements d’Avenir program managed by the ANR under reference ANR-11-IDEX-0004-02 and ANR-10-COHO-10-01, and by INSERM (Institut National de la Santé et de la Recherche Médicale). We express all our thanks to the nurses, and to the patients who were included in the present study. We thank Hakim Laouamri, and his team (Stéphane Beaufort, Seif Ben Salem, Karmène Souyris, Victor Barteau and Mohamed Laaidi) for the development of the FACE-SZ computer interface, data management, quality control and regulatory aspects.

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Authors and Affiliations

  1. Fondation FondaMental, Créteil, France

    G. Fond, F. Berna, M. Andrianarisoa, O. Godin, M. Leboyer, L. Brunel, B. Aouizerate, D. Capdevielle, I. Chereau, T. D’Amato, H. Denizot, C. Dubertret, J. Dubreucq, C. Faget, F. Gabayet, P. M. Llorca, J. Mallet, D. Misdrahi, C. Passerieux, R. Richieri, R. Rey, A. Schandrin, M. Urbach, P. Vidailhet, L. Boyer & F. Schürhoff

  2. INSERM U955, équipe de psychiatrie translationnelle, Créteil, France

    M. Andrianarisoa, M. Leboyer, L. Brunel & F. Schürhoff

  3. Université Paris-Est Créteil, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France

    M. Andrianarisoa, M. Leboyer, L. Brunel & F. Schürhoff

  4. Pôle psychiatrie universitaire, CHU Sainte-Marguerite, 13274, Marseille cedex 09, France

    L. Boyer

  5. Centre Hospitalier Charles Perrens, Université de Bordeaux, 33076, Bordeaux, France

    B. Aouizerate & D. Misdrahi

  6. Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France

    F. Berna & P. Vidailhet

  7. Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm, 1061, Montpellier, France

    D. Capdevielle & A. Schandrin

  8. CMP B, CHU, EA 7280 Faculté de Médecine, Université d’Auvergne, BP 69 63003, Clermont-Ferrand Cedex 1, France

    I. Chereau, H. Denizot & P. M. Llorca

  9. INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678, Bron Cedex, France

    T. D’Amato & R. Rey

  10. AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, Colombes, France

    C. Dubertret & J. Mallet

  11. Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France

    J. Dubreucq & F. Gabayet

  12. Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France

    C. Faget & R. Richieri

  13. Service de psychiatrie d’adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France

    C. Passerieux & M. Urbach

  14. Bordeaux Sleep Clinique, Pellegrin University Hospital, Bordeaux University, USR CNRS 3413 SANPSY, Research Unit, 33000, Bordeaux, France

    B. Aouizerate

  15. Inserm, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, 33000, Bordeaux, France

    B. Aouizerate

  16. CNRS UMR 5287-INCIA, Bordeaux, France

    D. Misdrahi

  17. Clinique Jeanne d’Arc-Hôpital Privé Parisien, Saint-Mandé, France

    G. Fond

  18. CHU Carémeau, Nîmes, France

    G. Fond

  19. UPMC University Paris 06, UMRS 943, 75013, Paris, France

    O. Godin

  20. INSERM, UMRS 943, 75013, Paris, France

    O. Godin

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  1. G. Fond
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  2. F. Berna
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The FACE-SZ (FondaMental Academic Centers of Expertise for Schizophrenia) group

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Fond, G., Berna, F., Andrianarisoa, M. et al. Chronic low-grade peripheral inflammation is associated with severe nicotine dependence in schizophrenia: results from the national multicentric FACE-SZ cohort. Eur Arch Psychiatry Clin Neurosci 267, 465–472 (2017). https://doi.org/10.1007/s00406-017-0771-4

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