Serum metabolic signatures of schizophrenia patients complicated with hepatitis B virus infection: A 1H NMR-based metabolomics study

Caigui Lin; Qing Hu; Jiyang Dong; Zhiliang Wei; Jie Li; Zhong Chen

doi:10.3389/fpsyt.2022.998709

Serum metabolic signatures of schizophrenia patients complicated with hepatitis B virus infection: A ¹H NMR-based metabolomics study

Front Psychiatry. 2022 Dec 21:13:998709. doi: 10.3389/fpsyt.2022.998709. eCollection 2022.

Authors

Caigui Lin^{1

2}, Qing Hu³, Jiyang Dong¹, Zhiliang Wei⁴, Jie Li⁵, Zhong Chen¹

Affiliations

¹ Fujian Provincial Key Laboratory for Plasma and Magnetic Resonance, Department of Electronic Science, Xiamen University, Xiamen, Fujian, China.
² National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, Fujian, China.
³ Xiamen Xianyue Hospital, Xiamen, Fujian, China.
⁴ Department of Radiology, Johns Hopkins University, Baltimore, MD, United States.
⁵ Department of Hepatobiliary Surgery, Zhongshan Hospital of Xiamen University, Xiamen, Fujian, China.

Abstract

Introduction: Schizophrenia (SZ) is a severe chronic mental disorder with increased risk of hepatitis B virus (HBV) infection, which is incurable currently and induces various negative emotions and psychological pressures in patients to exacerbate mental disorders. To facilitate the therapeutic design for SZ patients complicated with HBV infection (SZ + HBV), it is helpful to first elucidate the metabolic perturbations in SZ + HBV patients.

Methods: In this study, metabolic profiles of the serum samples from four groups of participants comprising healthy controls (HC, n = 72), HBV infection (n = 52), SZ patients (n = 37), and SZ + HBV (n = 41) patients were investigated using a high-resolution ¹H NMR-based metabolomics approach.

Results and discussion: Distinguishable metabolic profiles were found in the four groups. In comparison with HC, HBV infection induced increased levels of citrate and succinate to perturbate the tricarboxylic acid cycle and succinate-related pathways. Similar to SZ cases, SZ + HBV patients exhibited decreased glucose but increased citrate, pyruvate, and lactate, suggesting the occurrence of disturbance in glucose metabolism. Moreover, in comparison with HC, several serum amino acid levels in SZ + HBV patients were significantly altered. Our findings suggest that Warburg effect, energy metabolism disorders, neurotransmitter metabolism abnormalities, mitochondrial dysfunction and several disturbed pathways in relation to tyrosine and choline appear to play specific and central roles in the pathophysiology of SZ + HBV. Apart from replicating metabolic alterations induced by SZ and HBV separately (e.g., in energy metabolism and Warburg effect), the specific metabolic abnormalities in the SZ + HBV group (e.g., several tyrosine- and choline-related pathways) highlighted the existence of a synergistic action between SZ and HBV pathologies. Current study revealed the metabolic alterations specific to the interaction between SZ and HBV pathologies, and may open important perspectives for designing precise therapies for SZ + HBV patients beyond the simple combination of two individual treatments.

Keywords: NMR; hepatitis B virus; metabolomics; schizophrenia; synergistic action.