Potential Benefits of Ketone Therapy as a Novel Immunometabolic Treatment for Schizophrenia

Rationale Current treatment options for patients with schizophrenia-spectrum disorders (SSD) remain unsatisfactory, leaving patients with persistent negative and cognitive symptoms and metabolic side effects. Therapeutic ketosis was recently hypothesized to target the bio-energetic pathophysiology of SSD. However, neuro-inflammation plays an important role in the pathobiology of SSD as well. Ideally, novel treatments would target both the bio-energetic, and the inflammatory aspects of SSD. In this study, we aimed to investigate the effects of ketone bodies on neuro-inflammation in an acute inflammation mouse model. Methods 8-week-old male C57BL/6 N mice (n=11) were treated with either ketone ester (KE) or vehicle for 3 days. On day 3, a single intraperitoneal injection of lipopolysaccharide (LPS) or phosphate buffered saline (PBS) was administered. Mice were euthanized 24 h after LPS/PBS injection. Whole brain gene expression analysis using RT-PCR was done for Tnf-a, Il-6 and Il-1b . Results LPS caused a potent transcriptional upregulation of Tnf-a, Il-6 and Il-1b in the vehicle-treated mouse brain compared to PBS-injected controls. KE strongly and significantly attenuated the increased transcription of pro-inflammatory cytokines ( Tnf-a, Il-6 and Il-1b ) in the brain upon LPS injection compared to vehicle. Conclusions KE potently dampened neuro-inflammation in this acute inflammation mouse model. Ketone therapy holds great promise as a treatment for SSD patients by simultaneously targeting two main pathophysiological disease pathways. We encourage more research into the immunometabolic potential of therapeutic ketosis in SSD. Highlights A brain bio-energetic deficit and neuro-inflammation are involved in schizophrenia Ketone therapy is being investigated as a bio-energetic treatment of schizophrenia Ketone ester inhibits neuro-inflammation in an acute inflammation mouse mode Therapeutic ketosis could target both pathophysiological pathways in SSD The Immunometabolic potential of ketone therapy for SSD warrants further attention