Brown Alan S, Hooton Jonathan, Schaefer Catherine A, Zhang Haiying, Petkova Eva, Babulas Vicki, Perrin Megan, Gorman Jack M, Susser Ezra S
New York State Psychiatric Institute, 1051 Riverside Dr., Unit 2, New York, NY 10032, USA.
Am J Psychiatry. 2004 May;161(5):889-95. doi: 10.1176/appi.ajp.161.5.889.
Many studies have implicated prenatal infection in the etiology of schizophrenia. Cytokines, a family of soluble polypeptides, are critically important in the immune response to infection and in other inflammatory processes. The goal of this study was to determine whether second-trimester levels of four cytokines-interleukin-8 (IL-8), interleukin-1beta (IL-1beta), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha)-are higher in the mothers of offspring who later developed schizophrenia spectrum disorders than in matched comparison subjects.
The authors conducted a nested case-control study of maternal serum cytokine levels in a large birth cohort, born 1959-1967. Cases (N=59) were subjects diagnosed with schizophrenia spectrum disorders (mostly schizophrenia and schizoaffective disorder) who had available second-trimester maternal serum samples. Comparison subjects (N=105) were members of the birth cohort, had not been diagnosed with a schizophrenia spectrum disorder or major affective disorder, and were matched to subjects with schizophrenia for date of birth, gender, length of time in the cohort, and availability of maternal sera. Maternal second-trimester serum levels of IL-8, IL-1beta, IL-6, and TNF-alpha were determined by sandwich enzyme-linked immunosorbent assay.
The second-trimester IL-8 levels in mothers of offspring with schizophrenia spectrum disorders were significantly higher than those of the mothers of comparison subjects. There were no differences between subjects with schizophrenia and comparison subjects with respect to maternal levels of IL-1beta, IL-6, or TNF-alpha.
Using prospectively collected prenatal sera in a large and well-characterized birth cohort, the authors have documented a significant association between maternal IL-8 level during the second trimester and risk of schizophrenia spectrum disorders in the offspring. These findings provide further support for a substantive role of in utero infection or inflammation in the etiology of schizophrenia. Moreover, these results may have important implications for elucidating the mechanisms by which disrupted fetal development raises the risk of this disorder.
许多研究表明产前感染与精神分裂症的病因有关。细胞因子是一类可溶性多肽,在对感染的免疫反应及其他炎症过程中至关重要。本研究的目的是确定孕中期四种细胞因子——白细胞介素-8(IL-8)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)——的水平在后来患精神分裂症谱系障碍的后代母亲中是否高于匹配的对照对象。
作者对1959年至1967年出生的一个大型出生队列中的母亲血清细胞因子水平进行了巢式病例对照研究。病例组(N = 59)为被诊断患有精神分裂症谱系障碍(主要是精神分裂症和分裂情感性障碍)且有孕中期母亲血清样本的受试者。对照组(N = 105)是出生队列中的成员,未被诊断患有精神分裂症谱系障碍或重度情感障碍,并且在出生日期、性别、队列中的时间长度以及母亲血清的可获得性方面与精神分裂症患者相匹配。通过夹心酶联免疫吸附测定法测定母亲孕中期血清中IL-8、IL-1β、IL-6和TNF-α的水平。
患有精神分裂症谱系障碍的后代母亲孕中期的IL-8水平显著高于对照组母亲。精神分裂症患者与对照对象在母亲IL-1β、IL-6或TNF-α水平方面没有差异。
作者在一个大型且特征明确的出生队列中使用前瞻性收集的产前血清,记录了孕中期母亲IL-8水平与后代精神分裂症谱系障碍风险之间的显著关联。这些发现为子宫内感染或炎症在精神分裂症病因中的实质性作用提供了进一步支持。此外,这些结果可能对阐明胎儿发育中断增加该疾病风险的机制具有重要意义。