Electroconvulsive therapy alters serum cytokine levels and correlates with symptom improvement in patients with acute schizophrenia

Figure 1 Interleukin-8 [chemokine (C-X-C motif) ligand 8] inflammatory pathway in schizophrenia. This diagram illustrates the inflammatory mechanism of interleukin (IL)-8 in schizophrenia pathophysiology. Activation factors (lipopolysaccharide, tumor necrosis factor-alpha, IL-1) stimulate macrophages and microglia to produce IL-8 [chemokine (C-X-C motif) ligand 8], which recruits neutrophils to inflammatory sites. These activated neutrophils release inflammatory mediators including reactive oxygen species and proteases, contributing to neuroinflammation and schizophrenia symptoms. This pathway highlights the role of IL-8 as a key chemokine linking innate immune responses to neuropsychiatric manifestations in schizophrenia. CXCL8: Chemokine (C-X-C motif) ligand 8; IL: Interleukin-8; LPS: Lipopolysaccharide; ROS: Reactive oxygen species; TNF-α: Tumor necrosis factor-alpha.

Figure 2 Serum tumor necrosis factor-alpha, interleukin-8, and interleukin-18 concentrations in healthy controls and acute schizophrenia patients before and after electroconvulsive therapy. A: Tumor necrosis factor-alpha levels; B: Interleukin-8 levels (log-transformed); C: Interleukin-18 levels (log-transformed). This compared among three groups: (1) Before electroconvulsive therapy; (2) After electroconvulsive therapy; and (3) Healthy controls. ECT: Electroconvulsive therapy; IL: Interleukin-8; TNF-α: Tumor necrosis factor-alpha.

Figure 3 Serum tumor necrosis factor-alpha, interleukin-8, and interleukin-18 concentrations before after electroconvulsive therapy in responders and non-responders. A: Tumor necrosis factor-alpha levels; B: Interleukin-8 levels (log-transformed); C: Interleukin-18 levels (log-transformed). They were compared between responders and non-responders before (white bars) and after (gray bars) electroconvulsive therapy treatment. ECT: Electroconvulsive therapy; IL: Interleukin-8; TNF-α: Tumor necrosis factor-alpha.

Figure 4 Correlation of the serum interleukin-8 concentration, Positive and Negative Syndrome Scale general psychopathology subscale score and reduction in the Positive and Negative Syndrome Scale positive symptom subscale score. A: Correlation between the serum interleukin-8 concentration and Positive and Negative Syndrome Scale general psychopathology subscale score after electroconvulsive therapy treatment; B: Correlation between the serum interleukin-8 concentration and reduction in the Positive and Negative Syndrome Scale positive symptom subscale score after electroconvulsive therapy in the responder group. ECT: Electroconvulsive therapy; IL: Interleukin-8; PANSS: Positive and Negative Syndrome Scale.