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Protease and Inhibitor Mechanisms · Journal article
Brain Behavior & Immunity - Health · August 1, 2026
Encouraging direction, but not yet definitive.
This systematic review identifies consistent elevation of soluble urokinase plasminogen activator receptor (suPAR) in patients with psychosis and major depression, with preliminary evidence suggesting association with antidepressant response and risk of hospital admission. However, the authors conclude that methodological heterogeneity, absence of longitudinal data, and inability to distinguish intrinsic immune pathology from confounding factors (lifestyle, medication, comorbidity) preclude routine clinical adoption at present.
Systematic review. Clinical and epidemiological studies of patients with mental disorders (primarily psychosis and major depression) in which plasma suPAR was quantitatively measured.. Intervention: Soluble urokinase plasminogen activator receptor (suPAR) measurement.
32 of 2,781 identified studies met inclusion criteria for quantitative suPAR measurement in psychiatric populations Elevated plasma suPAR levels were consistently observed in patients with psychosis and major depression Higher baseline suPAR levels were associated with greater likelihood of antidepressant response and faster treatment effects
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Clinicians should not adopt suPAR measurement in routine psychiatric practice at this time. While suPAR shows promise as a potential inflammation biomarker linked to depression and psychosis treatment response, methodological inconsistency across studies and unresolved questions about causality versus confounding limit current clinical applicability.
A systematic review of 32 studies showing consistent suPAR elevation in psychosis and depression with emerging prognostic signal (antidepressant response, hospital admission risk), but evidence remains sparse, methodologically inconsistent, and unsuitable for clinical routine use.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should not adopt suPAR measurement in routine psychiatric practice at this time. While suPAR shows promise as a potential inflammation biomarker linked to depression and psychosis treatment response, methodological inconsistency across studies and unresolved questions about causality versus confounding limit current clinical applicability.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background Mental disorders have been associated with systemic chronic inflammation, and conditions such as depression and schizophrenia are increasingly linked to inflammatory processes. Soluble urokinase plasminogen activator receptor (suPAR) is a biomarker of chronic inflammation and has proven useful as a prognostic marker in various somatic diseases. This review examines the evidence for suPAR use in psychiatric populations and evaluates its potential role in clinical psychiatry. Method A systematic search of Embase and PubMed was conducted using three concepts: biomarker, mental health–related terms, and psychotropics. Clinical and epidemiological studies investigating mental disorders with quantitatively measured suPAR were included. Screening was performed independently by two investigators. Results Of 2,781 identified studies, 32 met inclusion criteria. Elevated plasma suPAR levels were consistently observed in patients with psychosis and major depression, whereas findings for other psychiatric disorders were less conclusive. Evidence for predictive or prognostic applications remains sparse and inconclusive. Higher suPAR levels were associated with increased risk of subsequent antidepressant use and hospital admission for depression. Additionally, higher baseline suPAR levels were linked to a greater likelihood of antidepressant response and faster treatment effects. Discussion It remains unclear whether elevated suPAR reflects immune activation intrinsic to psychiatric disorders or confounding factors such as lifestyle or psychotropic medication. Longitudinal data on suPAR and symptom development are lacking. Although suPAR is a potential biomarker within psychiatry, methodological inconsistencies persist, and its routine clinical use in psychiatry is premature.
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