Treatment and prevention strategies for schizophrenia require knowledge about the mechanisms involved in the psychotic transition. Increasing evidence suggests a redox imbalance in schizophrenia patients. This narrative review presents an overview of the scientific literature regarding blood oxidative stress markers’ evolution in the early stages of psychosis and chronic patients. Studies investigating peripheral levels of oxidative stress in schizophrenia patients, first episode of psychosis or UHR individuals were considered. A total of 76 peer-reviewed articles published from 1991 to 2022 on PubMed and EMBASE were included. Schizophrenia patients present with increased levels of oxidative damage to lipids in the blood, and decreased levels of non-enzymatic antioxidants. Genetic studies provide evidence for altered antioxidant functions in patients. Antioxidant blood levels are decreased before psychosis onset and blood levels of oxidative stress correlate with symptoms severity in patients. Finally, adjunct treatment of antipsychotics with the antioxidant N-acetyl cysteine appears to be effective in schizophrenia patients. Further studies are required to assess its efficacy as a prevention strategy. Redox imbalance might contribute to the pathophysiology of emerging psychosis and could serve as a therapeutic target for preventive or adjunctive therapies, as well as biomarkers of disease progression.

中文翻译：

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氧化应激和精神病的出现

精神分裂症的治疗和预防策略需要了解精神病转变所涉及的机制。越来越多的证据表明精神分裂症患者存在氧化还原失衡。这篇叙述性综述概述了有关血液氧化应激标志物在精神病和慢性患者早期阶段的演变的科学文献。研究调查了精神分裂症患者、精神病首发或 UHR 个体的外周氧化应激水平。包括 1991 年至 2022 年在 PubMed 和 EMBASE 上发表的共 76 篇同行评议文章。精神分裂症患者表现为血液中脂质的氧化损伤水平升高，非酶抗氧化剂水平降低。基因研究为患者抗氧化功能的改变提供了证据。在精神病发作之前，血液中的抗氧化剂水平会降低，并且血液中的氧化应激水平与患者的症状严重程度相关。最后，用抗氧化剂 N-乙酰半胱氨酸辅助治疗抗精神病药似乎对精神分裂症患者有效。需要进一步的研究来评估其作为预防策略的功效。氧化还原失衡可能有助于新出现的精神病的病理生理学，并可作为预防或辅助治疗的治疗靶点，以及疾病进展的生物标志物。用抗氧化剂 N-乙酰半胱氨酸辅助治疗抗精神病药似乎对精神分裂症患者有效。需要进一步的研究来评估其作为预防策略的功效。氧化还原失衡可能有助于新出现的精神病的病理生理学，并可作为预防或辅助治疗的治疗靶点，以及疾病进展的生物标志物。用抗氧化剂 N-乙酰半胱氨酸辅助治疗抗精神病药似乎对精神分裂症患者有效。需要进一步的研究来评估其作为预防策略的功效。氧化还原失衡可能有助于新出现的精神病的病理生理学，并可作为预防或辅助治疗的治疗靶点，以及疾病进展的生物标志物。