Maes M, Bocchio Chiavetto L, Bignotti S, Battisa Tura G, Pioli R, Boin F, Kenis G, Bosmans E, de Jongh R, Lin A, Racagni G, Altamura C A
IRCCS, Istituto, Fatebenefratelli, Brescia, Italy.
Eur Neuropsychopharmacol. 2000 Mar;10(2):119-24. doi: 10.1016/s0924-977x(99)00062-0.
There is now some evidence that schizophrenia may be accompanied by an activation of the inflammatory response system (IRS) and that typical antipsychotics may suppress some signs of IRS activation in that illness. This study was carried out to examine (i) the serum concentrations of interleukin-6 (IL-6), IL-6 receptor (IL-6R), IL-1R antagonist (IL-1RA) and Clara Cell protein (CC16), an endogenous anticytokine, in nonresponders to treatment with typical neuroleptics and (ii) the effects of atypical antipsychotics on the above IRS variables. The above parameters were determined in 17 patients with treatment-resistant schizophrenia (TRS) to treatment with neuroleptics and in seven normal volunteers and 14 schizophrenic patients who had a good response to treatment with antipsychotic agents. Patients with TRS had repeated measurements of the IRS variables before and 2 and 4 months after treatment with atypical antipsychotics. Serum IL-6 was significantly higher in schizophrenic patients, irrespective of their response to typical antipsychotics, than in normal controls. Serum IL-1RA was significantly higher in the TRS patients than in controls, whereas responders took up an intermediate position. The serum concentrations of CC16 were significantly lower after treatment with atypical antipsychotics during 4 months than before treatment. It is concluded that (i) schizophrenia and, in particular, TRS is characterized by an activation of the monocytic arm of cell-mediated immunity and (ii) atypical antipsychotics may decrease the anti-inflammatory capacity of the serum in TRS patients.
目前有一些证据表明，精神分裂症可能伴有炎症反应系统（IRS）的激活，并且典型抗精神病药物可能会抑制该疾病中IRS激活的一些迹象。本研究旨在检查：（i）典型抗精神病药物治疗无效者血清中白细胞介素-6（IL-6）、IL-6受体（IL-6R）、IL-1受体拮抗剂（IL-1RA）和内源性抗细胞因子克拉拉细胞蛋白（CC16）的浓度；（ii）非典型抗精神病药物对上述IRS变量的影响。对17例难治性精神分裂症（TRS）患者、7名正常志愿者以及14例对抗精神病药物治疗反应良好的精神分裂症患者进行了上述参数的测定。TRS患者在接受非典型抗精神病药物治疗前、治疗后2个月和4个月重复测量IRS变量。无论对典型抗精神病药物的反应如何，精神分裂症患者血清IL-6均显著高于正常对照组。TRS患者血清IL-1RA显著高于对照组，而反应良好者处于中间水平。接受非典型抗精神病药物治疗4个月后血清CC16浓度显著低于治疗前。得出以下结论：（i）精神分裂症，尤其是TRS，其特征是细胞介导免疫的单核细胞分支激活；（ii）非典型抗精神病药物可能会降低TRS患者血清的抗炎能力。
