Consequently, the EGCG and placebo groups were combined to determine whether there was an association between changes in psychiatric symptoms and cytokine production from week 0 to week 10. Supplementary Table

3 shows nonsignificant reductions for TNF-α, IFN-γ, IL-10, and IL-9 (5.5%, 17.8%, 23.1%, and 22.3%, respectively). Discussion This 8-week, double-blind, prospective study of daily EGCG supplementation versus placebo in patients with schizophrenia, schizoaffective disorder, or bipolar disorder did not find significant differences in the efficacy or tolerability between the two treatments. Both EGCG and placebo groups showed significant decreases in psychiatric symptoms over time. Inhibitors,research,lifescience,medical The reduction in psychiatric symptomology was accompanied by nonsignificant

decreases in the production of Th1, Th2, and Th9 cytokines. It is well known that obesity is a significant contributor Inhibitors,research,lifescience,medical to inflammation [Stienstra et al. 2012]. According to the Centers for Disease Control and Prevention, an adult who has a BMI between 25 and 29.9 is considered overweight, and an adult who has a BMI of 30 or higher is considered obese (see http://www.cdc.gov/obesity/adult/defining.html). Inhibitors,research,lifescience,medical Based on these criteria, the mean BMIs for both the placebo and EGCG groups were greater than 32, placing them in the obese category. Consequently, the degree of inflammation in our sample may have contributed to the lack of statistically significant Inhibitors,research,lifescience,medical reductions in cytokine levels from Selleck Idarubicin baseline to week 10. Although we did not find significant treatment differences between EGCG and placebo groups, both groups showed significant reductions in psychotic, depressive, and anxiety symptoms, which were associated with reduced expression of cytokines. Pharmacokinetics play a critical role in the clinical outcomes Inhibitors,research,lifescience,medical of drug therapy. Studies designed to investigate drug interactions with EGCG and its absorption show significant variability between subjects [e.g. Chow et al. 2006; reviewed in Colalto, 2010]. This variability suggests that pharmacogenetic factors may influence the pharmacokinetic mechanisms as well as the potential therapeutic effects of EGCG. Recently, a common polymorphism

in the genetic code for catechol-O-methyltransferase (COMT) was investigated to assess the impact of COMT genotype on green tea catechin absorption and metabolism in humans. The authors of reported that the COMT polymorphism [i.e. Val(158/108)Met] does not appear to have a significant influence on EGCG absorption and elimination [Miller and Schwarz, 2012]. More research studies are needed to better understand the pharmacokinetic mechanisms of EGCG. Limitations of this study included a small sample size, broad diagnostic criteria, a single dose strength of EGCG, and no standardized use of antipsychotic medications. Standardizing the antipsychotic medications would have been optimal, but we proposed that EGCG would serve as an adjunct to schizophrenia pharmacotherapy.