Angiotensin-Converting Enzyme in Patients With Early-Stage Psychosis.

ACE protein levels are significantly lower in cerebrospinal fluid and serum of 122 early-stage psychosis patients versus 78 healthy controls, with Cohen d down to -1.16.

• Why it matters: Objective biomarkers are lacking for psychotic disorders, and it is unclear whether ACE genetic risk translates into measurable protein-level dysfunction in early illness.
• What they did: In a cross-sectional study at the Johns Hopkins Schizophrenia Center (ages 13–35; onset within 2 years), investigators measured ACE protein in cerebrospinal fluid and serum, ACE canonical enzymatic activity in serum, and ACE-related genetic burden.
• The result: Higher schizophrenia polygenic risk burden for ACE is linked to lower ACE protein levels (r = -0.35; P = .002) but not to ACE canonical enzymatic activity; treatment-resistant patients show lower serum ACE protein than non-treatment-resistant patients (Cohen d = -0.50; P = .03).

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