The Role of Inflammatory Markers in Schizophrenia: A Multicenter Cross-Sectional Study
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Background: Immune dysregulation and low-grade systemic inflammation may contribute to the clinical heterogeneity of schizophrenia, but evidence from Pakistan remains limited. Objective: To examine the associations between selected inflammatory markers, symptom severity, and illness duration among adults with schizophrenia. Methods: This multicentre cross-sectional study included 150 adults receiving psychiatric care in Lahore, Pakistan. Symptom severity was assessed using the Positive and Negative Syndrome Scale. Serum CRP, IL-6, TNF-α, IL-1β, and IL-10 concentrations were measured using enzyme-linked immunosorbent assays. Between-group differences, correlations, and adjusted associations were evaluated. Results: The moderate- and high-severity groups included 78 and 72 participants, respectively. Compared with moderate severity, high severity was associated with higher CRP by 3.40 mg/L (95% CI: 2.46–4.34), IL-6 by 4.90 pg/mL (95% CI: 3.80–6.00), TNF-α by 4.20 pg/mL (95% CI: 2.98–5.42), and IL-1β by 2.20 pg/mL (95% CI: 1.48–2.92), while IL-10 was lower by 1.70 pg/mL (95% CI: 0.87–2.53 lower); all p<0.001. IL-6 showed the largest observed correlation with PANSS total score (r=0.52), followed by TNF-α (r=0.46) and CRP (r=0.41); all p<0.001. Conclusion: Greater schizophrenia symptom severity was associated with a more pronounced pro-inflammatory profile and lower IL-10 concentration. Longitudinal controlled studies are required to establish temporal direction and clinical utility
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