Peripheral immune and kynurenine profiles are associated with cognitive change during early treatment of first-episode schizophrenia
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By
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March 25, 2026
Objective:
To delineate the longitudinal relationships among peripheral inflammation, kynurenine pathway dysregulation, immune-cell redistribution, and cognitive performance in antipsychotic-naïve first-episode schizophrenia, highlighting the significance of these relationships for treatment strategies.
Key Findings:
- FES showed significant cognitive impairment at baseline with improvement by week 6 and month 6, with p-values indicating statistical significance.
- Baseline KP profile in FES indicated a neurotoxic shift with elevated inflammatory markers and monocyte redistribution, suggesting a need for targeted interventions.
- Cognitive performance was associated with stable between-person immuno-KP differences rather than broad inflammatory changes, emphasizing the role of individual variability.
Interpretation:
Cognitive improvement in FES is linked to shifts in the kynurenine pathway and inflammatory markers, suggesting potential biomarkers for treatment response that could guide personalized therapy.
Limitations:
- Study design may not fully capture the complexity of immune and cognitive interactions over time, potentially limiting the understanding of causality.
- Sample size may limit generalizability of findings, necessitating further research with larger cohorts.
Conclusion:
Antipsychotic-naïve FES exhibits cognitive impairment associated with inflammation and kynurenine pathway dysregulation, with cognitive improvement tracking KP remodeling, indicating potential avenues for therapeutic intervention.
