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Serum selenium, iron and rubidium are altered in treatment-resistant schizophrenia

We propose that the changes in selenium and cytokines might drive the expression of hepcidin, resulting in reduced serum iron levels.

Published in Molecular PsychiatryObservational cohort study
3/5 Observational
Evidence Meter · 3/5

Real-World Observation

Finds meaningful patterns in human health records or cohorts, though observational data cannot prove direct cause.

Source

Real-World Observation

3/5

Further research should investigate the relationship between peripheral and central measures of these elements and their metabolism, and further explore the relevance of pro-oxidant stress to the neuropathology of schizophrenia.

What Changes?

Psychiatry · Real-World Cohort

Current Standard

Conventional psychiatry practice relies on standard-of-care monitoring and existing regimens prior to this observational cohort study.

New Finding

The changes in serum iron, rubidium and selenium discriminate between control individuals and TRS cases, and they were not affected by age or clozapine serum levels.

3 Key Takeaways

Plain English Summary
  1. 01Core Finding

    In recent postmortem and imaging studies, we identified disturbances in iron homeostasis in cortical and subcortical regions of individuals with schizophrenia.

  2. 02Study Evidence

    Tested in a observational cohort study at the real-world cohort stage.

  3. 03Practical Meaning

    Observational cohort findings reveal real-world links, though lifestyle or unmeasured factors cannot be fully ruled out without an RCT.

What This Means for You

The changes in serum iron, rubidium and selenium discriminate between control individuals and TRS cases, and they were not affected by age or clozapine serum levels. We propose that the changes in selenium and cytokines might drive the expression of hepcidin, resulting in reduced serum iron levels. Further research should investigate the relationship between peripheral and central measures of these elements and their metabolism, and further explore the relevance of pro-oxidant stress to the neuropathology of schizophrenia.

The Discovery

The molecular basis of schizophrenia is complex, involving an interplay of genetic and environmental factors. In recent postmortem and imaging studies, we identified disturbances in iron homeostasis in cortical and subcortical regions of individuals with schizophrenia. These may be relevant to neuropathology identified in the disorder and could relate to mechanisms of oxidative stress and inflammation. Recent work has proposed that there is a dysregulation of brain metals and other elements in schizophrenia that might impact on oxidative stress. Using a metallomics approach, we report robust changes in serum levels of pro-oxidant iron, anti-oxidant selenium, and the potassium-marker, rubidium, in a cohort of people with treatment-resistant schizophrenia (TRS). The cohort also expressed elevated levels of serum pro-inflammatory cytokines and hepcidin, and lower levels of anti-oxidant selenoproteins, selenoprotein-P1 (SEPP1) and glutathione peroxidase 3 (GPX3).

How It Works, Simply

This psychiatry research focuses on inflammation · Genetics. Researchers evaluated it using an observational cohort study at the real-world cohort stage of medical research.

3 Key Takeaways

Clinical Takeaways
  1. 01Core Finding

    In recent postmortem and imaging studies, we identified disturbances in iron homeostasis in cortical and subcortical regions of individuals with schizophrenia.

  2. 02Study Evidence

    Tested in a observational cohort study at the real-world cohort stage.

  3. 03Practical Meaning

    Observational cohort findings reveal real-world links, though lifestyle or unmeasured factors cannot be fully ruled out without an RCT.

01

Biological Mechanism & Study Design

Study Design & Cohort

Observational cohort study

Observational cohort study · Real-World Cohort

Biological Pathway & Modality

Inflammation · Genetics

Intervention: Serum selenium, iron and rubidium are altered in treatment-resistant schizophrenia

02

Experimental Findings & Endpoints

The molecular basis of schizophrenia is complex, involving an interplay of genetic and environmental factors.

In recent postmortem and imaging studies, we identified disturbances in iron homeostasis in cortical and subcortical regions of individuals with schizophrenia. These may be relevant to neuropathology identified in the disorder and could relate to mechanisms of oxidative stress and inflammation.

Recent work has proposed that there is a dysregulation of brain metals and other elements in schizophrenia that might impact on oxidative stress. Using a metallomics approach, we report robust changes in serum levels of pro-oxidant iron, anti-oxidant selenium, and the potassium-marker, rubidium, in a cohort of people with treatment-resistant schizophrenia (TRS).

The cohort also expressed elevated levels of serum pro-inflammatory cytokines and hepcidin, and lower levels of anti-oxidant selenoproteins, selenoprotein-P1 (SEPP1) and glutathione peroxidase 3 (GPX3).

03

Clinical Translation & Practice Context

The changes in serum iron, rubidium and selenium discriminate between control individuals and TRS cases, and they were not affected by age or clozapine serum levels.

We propose that the changes in selenium and cytokines might drive the expression of hepcidin, resulting in reduced serum iron levels. Further research should investigate the relationship between peripheral and central measures of these elements and their metabolism, and further explore the relevance of pro-oxidant stress to the neuropathology of schizophrenia.

03

The Bottom Line · Clinical Pearl

“Further research should investigate the relationship between peripheral and central measures of these elements and their metabolism, and further explore the relevance of pro-oxidant stress to the neuropathology of schizophrenia.”

Published in Molecular Psychiatry · Current Stage: Real-World Cohort

Psychiatry · Real-World Cohort
Study Type
Observational cohort study

Observational cohort study

Evidence Score
3/5 · Real-World Observation
Evidence Meter · 3/5

Real-World Observation

Finds meaningful patterns in human health records or cohorts, though observational data cannot prove direct cause.

Finds meaningful patterns in human health records or cohorts, though observational data cannot prove direct cause.

Who It Applies To
Individuals with schizophrenia
Intervention & Mechanism
Serum selenium, iron and rubidium are altered in treatment-resistant schizophrenia

Inflammation · Genetics

Key Limitation
Observational cohort findings reveal real-world links, though lifestyle or unmeasured factors cannot be fully ruled out without an RCT.

Translational Stage

LEVEL 2 · Real-World Cohort

Classified as Observational cohort study along the clinical evidence continuum

  1. Lab & Discovery
  2. Early Trials
  3. Human Evidence
  4. 4Real-World CohortActive

Indexed Clinical Entities

Original Publication & AMA Citation

Serum selenium, iron and rubidium are altered in treatment-resistant schizophrenia. Molecular Psychiatry. Published 2026;Nov 2. Accessed November 15, 2026. https://pubmed.ncbi.nlm.nih.gov/42972008/

Molecular Psychiatry

https://pubmed.ncbi.nlm.nih.gov/42972008/

Read Original Paper

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