Niacin Skin Flush Backs—From the Roots of the Test to Nowadays Hope

Journal of Clinical Medicine · 9 authors, 6 centres

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TL;DR

This narrative review examines the history, methodology, and potential clinical applications of the niacin skin flush test (NSFT), a simple test proposed as a biomarker for fatty acid metabolism abnormalities in psychosis spectrum disorders. The review suggests NSFT could aid in early intervention, staging, and personalized dietary recommendations in psychiatry, but notes the critical need for a standardized, validated assessment method.

Full summary

1,554 CHARS

This narrative review synthesizes literature from 1977 to 2022 on the niacin skin flush test (NSFT), a non-invasive test assessing skin vasodilation response to methyl nicotinate application, proposed as a marker for membrane fatty acid metabolism. The background links historical theories of prostaglandin deficiency in schizophrenia (SCH) to the test's pathophysiology involving the phospholipase A2/COX cascade and arachidonic acid release. Methods involved a literature search of human studies in PubMed, Google Scholar, and Web of Science. Key results describe NSFT's association with psychosis spectrum disorders (SCH, bipolar disorder, schizoaffective disorder) and ultra-high risk (UHR) states, though responses are heterogeneous, with some UHR patients showing increased sensitivity. The review details varied methodologies (thermal, optical, Doppler) and factors influencing results, including age, gender, and genetic polymorphisms in PLA2/COX genes. It discusses the potential for NSFT in clinical staging and the promise of polyunsaturated fatty acid (PUFA) supplementation, particularly omega-3s, in subclinical or prodromal phases. Limitations highlighted include methodological inconsistency, the influence of confounding factors (e.g., age, gender, substance use), and the absence of a standardized scoring system. Implications suggest NSFT could contribute to personalized medicine in psychiatry through early risk identification and dietary intervention, but its clinical utility is contingent on future validation and standardization.

STUDY TYPE

narrative_review

SPECIALTY

psychiatry

SUMMARISED BY

AI pipeline

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100% · A

ORIGINAL PAPER

PMC10003235

Niacin Skin Flush Backs—From the Roots of the Test to Nowadays Hope

Journal of Clinical Medicine

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ABSTRACT

The niacin skin flush test (NSFT) is a simple method used to assess the content of fatty acids in cell membranes and is a possible indicator of factors hidden behind various outcomes in patients. The purpose of this paper is to determine the potential usefulness of NSFT in mental disorder diagnostics along with the determination of factors that may affect its results. The authors reviewed articles from 1977 onwards, focusing on the history, variety of methodologies, influencing factors, and proposed mechanisms underlying its performance. Research indicated that NSFT could be applicable in early intervention, staging in psychiatry, and the search for new therapeutic methods and drugs based on the mechanisms of NSFT action. The NSFT can contribute to defining an individualized diet for patients and prevent the development of damaging disease effects at an early stage. There is promising evidence for supplementation with polyunsaturated fatty acids, which have a beneficial influence on the metabolic profile and are effective even in the subclinical phase of the disease. NSFT can contribute to the new classification of diseases and a better understanding of certain mental disorders’ pathophysiology. However, there is a need to establish a validated method for assessing the NSFT results.

CITATION EXPORT

Ryszard Sitarz, Dariusz Juchnowicz, Kaja Karakuła et al.. Niacin Skin Flush Backs—From the Roots of the Test to Nowadays Hope. Journal of Clinical Medicine. (2023). https://doi.org/10.3390/jcm12051879

AUTHORS

9 · 6 CENTRES

Ryszard Sitarz, Dariusz Juchnowicz, Kaja Karakuła, Alicja Forma, Jacek Baj, Joanna Rog, Robert Karpiński, Anna Machrowska, Hanna Karakuła-Juchnowicz

11st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Gluska Street 1, 20-439 Lublin, Poland
2Department of Psychiatry and Psychiatric Nursing, Medical University of Lublin, 20-059 Lublin, Poland
3Department of Forensic Medicine, Medical University of Lublin, 20-059 Lublin, Poland
4Department of Anatomy, Medical University of Lublin, 20-059 Lublin, Poland
5Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 02-776 Warsaw, Poland
6Department of Machine Design and Mechatronics, Faculty of Mechanical Engineering, Lublin University of Technology, 20-618 Lublin, Poland

EDITOR / REVIEWER

Domenico De Berardis