Identification and predictive analysis for participants at ultra-high risk of psychosis:A comparison of three psychometric diagnostic interviews

BACKGROUND An accurate identification of individuals at ultra-high risk(UHR)based on psychometric tools to prospectively identify psychosis as early as possible is required for indicated preventive intervention.The diagnostic comparability of several psychometric tools,including the comprehensive assessment of at risk mental state(CAARMS),the structured interview for psychosis-risk syndrome(SIPS)and the bonn scale for the assessment of basic symptoms(BSABS),is unknown.AIM To address the psychometric comparability of CAARMS,SIPS and BSABS for subjects who are close relatives of patients with schizophrenia.METHODS In total,189 participants aged 18-58 years who were lineal relative by blood and collateral relatives by blood up to the third degree of kinship of patients with schizophrenia were interviewed in the period of May 2017 to January 2019.Relatives of the participants diagnosed schizophrenia were excluded.All the participants were assessed for a UHR state by three psychometric tools(CAARMS,SIPS and BSABS).The psychometric diagnosis results included at risk of psychosis(UHR+),not at risk of psychosis(UHR-)and psychosis.Demographic and clinical characteristics were also measured.The inter-rater agreement was assessed for evaluation of the coherence of the three scales.Transition rates for UHR+subjects to psychosis within 2 years were also recorded.RESULTS The overall agreement percentages were 93.12%,92.06%and 93.65%of CAARMS and SIPS,SIPS and BSABS and CAARMS and BSABS,respectively.The overall agreement percentage of the relative functional impairment of the three groups(UHR+,not at risk of psychosis and psychosis)were 89.24%,86.36%and 88.12%,respectively.The inter-rater reliability of the CAARMS,SIPS and BSABS total score was 0.90,0.89 and 0.85.The inter-rater reliability was very good to excellent for all the subscales of these three instruments.For CAARMS,SIPS and BSABS,the kappa coefficient about UHR criteria agreement was 0.87,0.84 and 0.82,respectively(P<0.001).The transition rates of UHR+to psychosis within 2 years were 16.7%(CAARMS),10.0%(SIPS)and 17.7%(BSABS).CONCLUSION There is good diagnostic agreement between the CAARMS,SIPS and BSABS towards identification of UHR participants who are close relatives of patients with schizophrenia.

Effects of immunoglobulin D on expression of IgD receptor and protein tyrosine kinase signaling in human CD4^+ T cells

OBJECTIVE To observe whether human CD4^+T cells could be activated by immuno-globulin D(IgD) via IgD receptor(IgDR)-Lck.METHODS Human CD4^+T cells were purified from peripheral blood mononuclear cells(PBMCs) with microbeads.The viability of T cells were detected by CCK-8.The binding affinity and expression of IgDR on T cells were detected by flow cytometry.The protein expression of IgDR,Lck and P-Lck were analyzed by western blot.RESULTS IgD could concentration-dependent bind to IgDR on CD4^+T cells.The expression of IgDR was increased in response to treatment with IgD in a time-dependent and concentration-dependent manner.Stimulating by IgD resulted in enhanced phosphorylation of Lck compared with that in the medium control sample.The expression of Lck was not changed.As inhibitor of PTK,Herbimycin A or A770041,which combined with IgD could significantly inhibit phosphorylation of Lck(Tyr^(394)).The proliferation promoting effect of IgD was blocked by Herbimycin A or A770041.IgD could stimulate CD4^+T cell activation and proliferation through upregulating activating tyrosine residue of Lck(Tyr^(394)) phosphorylation.CONCLUSION These results demonstrate that IgD exaggerates CD4^+T cell activities,which may be through promoting Lck phosphorylation.