Zusammenfassung:
Seit einigen Jahren wird der Lipidstoffwechsel schizophrener Patienten anhand von
Enzymanalysen und Bestimmungen von Membransynthese- bzw. -abbaustoffen untersucht.
Bisher wurden hierzu sowohl Messungen an Blutproben als auch an verschiedenen Zellpopulationen
durchgeführt. In Analogie dazu lassen sich mittels neuerer Untersuchungsverfahren,
wie der 31P-Magnetresonanz-Spektroskopie (31P-MRS), auch nichtinvasiv in vivo derartige Membranstoffwechselparameter bestimmen.
Im Rahmen der Membranphospholipid-Hypothese der Schizophrenie werden Arachidonsäuredefizite
peripherer Zellmembranen, Phosphodiesterturnover im Gehirn, Phospholipase A2 (PLA2)-Aktivitätssteigerung im Serum und in Blutzellen, verminderte Niacin-Sensibilität
und Abnormitäten des PLA2-Gens bei Schizophrenen diskutiert. Dennoch sind die Zusammenhänge zwischen diesen
und psychopathologischen Befunden bisher spekulativ. Außerdem ist es notwendig, die
Übertragbarkeit der peripheren Messergebnisse auf den Stoffwechsel im zentralen Nervensystem
(ZNS) selbst zu belegen.
Ausgehend von nicht neuronalen Enzym- und Stoffwechselanalysen anderer Arbeitsgruppen
sollen aktuelle Ergebnisse im Zusammenhang mit eigenen 31P-MR-spektroskopischen Arbeiten zusammenfassend dargestellt werden, um Übereinstimmungen
und Zusammenhänge zwischen zentralen und peripheren Untersuchungstechniken aufzuzeigen
und neue Therapieansätze für die Schizophrenie zu eruieren.
Disturbances of Phospholipidmetabolism - Possible Pathogenic Factors in Schizophrenia.
Survey and Discussion of Current Findings:
During the last few years analyses of the lipidmetabolism have been performed on schizophrenic
patients. Anabolic and katabolic metabolite-concentrations from blood and cell samples
have been measured. By means of new investigation techniques, such as 31P-magnetic-resonance-spectroscopy, it is nowadays even possible to determine membrane
metabolites non-invasively in vivo.
Arachidonic acid deficits in peripheral cell membranes, turnover of phosphodiesters
in the brain, increased phospholipase A2 (PLA2)-activity in serum and blood cells, disturbed niacin-response and abnormalities of
the PLA2-gene are summarised as phospholipid-membrane-hypothesis of schizophrenia. Although
there is some evidence for correlations between those findings and psychotic symptoms,
the connection to the pathogenesis of schizophrenia still has speculative character.
Furthermore it has to be confirmed that peripheral biochemical findings acquired in
schizophrenics are transferable to the metabolism of the central nervous system.
Actual results of enzyme and metabolite measurements reported in literature and current
findings of our own 31P-MR-spectroscopic studies are surveyed and summarised. To point out possible connections
between the phospholipid-metabolism of the central nervous system and of peripheral
blood-cells, systemic approaches are considered.
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Dr. med S Smesny
Klinik für Psychiatrie der FSU Jena
Philosophenweg 3
07740 Jena
Email: E-mail: smesny@landgraf.med.uni-jena.de
