The plasma-derived exosomal Gomafu levels are associated with psychopathological symptoms and symptomatic remission in drug-naïve patients with first-episode schizophrenia.

Long non-coding RNA (lncRNA) Gomafu has been implicated in the onset and progression of schizophrenia. In this study, we investigated the association between the plasma-derived exosomal Gomafu levels and psychopathological symptoms, as well as symptomatic remission following short-term treatment (4 weeks), in patients with drug-naïve patients with first-episode schizophrenia (DFSZ). We measured the plasma-derived exosomal Gomafu levels in 65 DFSZ schizophrenia patients and 65 healthy matched controls. All DFSZ patients received aripiprazole treatment. Positive and Negative Syndrome Scale (PANSS) assessment was performed to evaluate the psychotic symptoms. Cognitive function was assessed using the validated Chinese version of the MATRICS Consensus Cognitive Battery (MCCB). We found that the expression level of plasma-derived exosomal Gomafu in DFSZ patients was significantly higher than in the healthy control group. Receiver operating characteristic (ROC) curve analysis demonstrated a high diagnostic value for plasma-derived exosomal Gomafu in identifying DFSZ, with an area under the curve (AUC) of 0.921. Multiple linear regression analysis results showed that duration of untreated psychosis (DUP), PANSS negative score, PANSS total score, MCCB-attention and vigilance score, MCCB-social cognition score, and MCCB-total score were independent influencing factors of the expression level of plasma-derived exosomal Gomafu in patients with DFSZ. After 4 weeks of treatment with aripiprazole, the Gomafu levels significantly decreased in DFSZ patients. Moreover, the reduction in PANSS total score was positively correlated with the decrease in Gomafu levels. The Gomafu levels at baseline of remitters was lower than that of non-remitters. ROC curve analysis further suggested that baseline Gomafu levels could predict symptomatic remission, with an AUC of 0.695. The results of our study shows that plasma-derived exosomal Gomafu levels are ssociated with psychopathological symptoms (especially negative symptoms and cognitive impairment) and symptomatic remission with short-term aripiprazole treatment. Plasma-derived exosomal Gomafu may be a biological biomarker for DFSZ. Further studies are warranted to elucidate the mechanisms linking Gomafu to schizophrenia pathophysiology.