This prospective observational cohort study investigated serum α-N-acetylgalactosaminidase levels in drug-naïve patients with Panic Disorder (PD) at baseline and after six weeks of follow-up and compared them with healthy controls (HC). Associations between enzyme levels, symptom severity, and inflammatory markers were examined. The study aimed to evaluate whether α-N-acetylgalactosaminidase levels are associated with PD symptom severity and inflammatory parameters.

Panic Disorder (PD) is associated with increased inflammatory markers. α-N-acetylgalactosaminidase mediates deglycosylation of vitamin D-binding protein (Gc protein), affecting macrophage activation and immune regulation. Its role in anxiety disorders has not been previously examined.

Thirty-three drug-naïve patients with PD and 33 healthy controls (HC) were enrolled. Patients with PD were evaluated at baseline and after six weeks of standard clinical treatment. Serum α-N-acetylgalactosaminidase levels were measured using ELISA. DSM-5 Panic Disorder Scale (PDS) scores and complete blood count inflammatory parameters were recorded.

No intervention was assigned as part of the research protocol. Participants received routine clinical care.

1. For Panic Disorder (PD) Group:

   • Inclusion Criteria:

     • Age ≥18 years and <65 years
     • Diagnosis of PD according to DSM-5-TR
     • Drug-naïve at baseline

   • Exclusion Criteria:

     • Age <18 years and >65 years
     • Any psychiatric diagnosis other than PD
     • Active alcohol or substance use disorder
     • Significant medical illness
     • Incomplete follow-up

2. For Healthy Control (HC) Group:

   • Inclusion Criteria:

     • Age ≥18 years and <65 years

   • Exclusion Criteria:

     • Age <18 years and >65 years
     • Any psychiatric diagnosis
     • Active alcohol or substance use disorder
     • Significant medical illness

The study population consisted of adult outpatients aged 18-65 years. The Panic Disorder (PD) group included consecutive, drug-naïve patients diagnosed with PD according to DSM-5-TR criteria who were admitted to the psychiatry outpatient clinic of Elazığ Mental Health and Diseases Hospital (Turkey). The healthy control (HC) group consisted of individuals from the general population who applied to the hospital medical board and had no current or past psychiatric or significant medical disorders. All participants provided informed consent prior to enrollment.

Deidentified individual participant data (IPD) underlying the results reported in this study (including demographic variables, serum α-N-acetylgalactosaminidase levels, complete blood count parameters, and DSM-5 Panic Disorder Scale scores at baseline and 6 weeks) will be made available to qualified researchers upon reasonable request for academic purposes.

Data will be shared after removal of all direct identifiers and in accordance with applicable ethical approvals and data protection regulations. Access to the data will require a methodologically sound research proposal and a data use agreement. Requests should be directed to the corresponding author.

Data will be available beginning 6 months after publication and will remain available for 5 years.

Access will be granted to researchers who provide a methodologically sound proposal. Requests must be approved by the principal investigator and may require a data use agreement in accordance with institutional and ethical regulations.