Serum and plasma glial fibrillary acidic protein in patients with schizophrenia: A systematic review and meta-analysis

BACKGROUND: Schizophrenia is a neurodevelopmental disorder with a progressive course that typically begins in late adolescence or early adulthood. Glial fibrillary acidic protein (GFAP), a key component of the astrocyte cytoskeleton, has been linked to schizophrenia, with abnormal GFAP levels observed in both brain tissue and peripheral blood samples. This study aims to systematically review and meta-analyze GFAP levels in schizophrenia patients to assess its potential as a biomarker of astrocytic damage. METHODS: statistic, and publication bias was evaluated through funnel plots and Egger's and Begg's tests. RESULTS: = 93.68%). Removing two specific studies one at a time rendered the results insignificant, while excluding other studies individually did not affect significance. Publication bias was suggested by Begg's test and Egger's test (p < 0.05). Quality assessment indicated low risk of bias in most domains, though most of the studies had high risk due to insufficient reporting on patient enrollment and blinding of laboratory technicians. DISCUSSION: Our findings suggest a significant difference in GFAP levels in patients with schizophrenia and indicate a potential role for GFAP in astrocytic pathology in these patients. Nonetheless, additional well-designed studies with larger sample sizes and rigorous methodologies are still needed to fully clarify its clinical relevance.