Physical exercise is associated with a reduction in inflammatory biomarkers in first-episode psychosis: A pilot study of CRP, SAA, sICAM-1 and sVCAM-1

Abstract

Individualswith psychotic disorders are at greater risk for cardiovascular morbidity/mortality (Barcones et al., 2018; Laursen et al., 2012) andmetabolic syndrome components (Vancampfort et al., 2015). Physical exercise has favorable effects on cardiovascular and metabolic health, including anti-inflammatory properties (Lakka and Laaksonen, 2007; Teixeira-Lemos et al., 2011). Exercise has also been found to improve physical and mental health, including overall wellbeing, in psychotic patients (Firth et al., 2018; Firth et al., 2017; Gorczynski and Faulkner, 2010). To further examine the positive effects of exercise in individuals with psychosis, the FitForLife study was designed and carried out in Stockholm, Sweden (Forsell et al., 2015) following ethical approval by the Regional Ethics Review Board in Stockholm. The pilot phase of the study included young adults with first-episode psychosis (FEP), aged 18–35 years, who completed a 12-week structured physical exercise intervention program consisting of 60min sessions focusing on cardiovascular fitness and delivered by trained instructors. Following the intervention, FitForLife participants showed better cognitive functioning (Hallgren et al., 2019) and a trend for an improvement in measures of patient autonomy (Lambden et al., 2018). For the purpose of the present study, we collected blood samples from FitForLife participants based on the hypothesis that circulating levels of inflammatory analytes, such as C-reactive protein (CRP), serum amyloid-alpha (SAA), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1), may serve as biomarkers for monitoring cardiovascular health. Thus, our specific objectives were to (a) compare plasma levels of these four inflammatory analytes (CRP, SAA, sICAM-1 and sVCAM-1) in FEP subjects versus controls, and (b) examine whether these analytes are affected in FEP subjects by the FitForLife exercise intervention program (see also Sections 1–7 in Supplemental Materials).