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一项假设生成性病例对照研究的结果:军事人员中的疱疹家族病毒与精神分裂症

Results from a hypothesis generating case-control study: herpes family viruses and schizophrenia among military personnel.

作者信息

Niebuhr David W, Millikan Amy M, Yolken Robert, Li Yuanzhang, Weber Natalya S

机构信息

Division of Preventive Medicine, Department of Epidemiology, Walter Reed Army Institute of Research, Silver Spring, MD 20901, USA.

出版信息

Schizophr Bull. 2008 Nov;34(6):1182-8. doi: 10.1093/schbul/sbm139. Epub 2007 Dec 21.

Abstract

BACKGROUND

Herpes family viruses can cause central nervous system inflammatory changes that can present with symptoms indistinguishable from schizophrenia and therefore are of interest in schizophrenia research. Most existing studies of herpes viruses have used small populations and postdiagnosis specimens. As part of a larger research program, we conducted a hypothesis-generating case-control study of selected herpes virus antibodies among individuals discharged from the US military with schizophrenia and pre- and postdiagnosis sera.

METHODS

Cases (n = 180) were servicemembers hospitalized and discharged from military service with schizophrenia. Controls, 3:1 matched on several factors, were members not discharged. The military routinely collects and stores members' serum specimens. We used microplate enzyme immunoassay to measure immunoglobulin G (IgG) antibody levels to 6 herpes viruses in pre- and postdiagnosis specimens. Conditional logistic regression was used, and the measure of association was the hazard ratio (HR).

RESULTS

Overall, we found a significant association between human herpes virus type 6 and schizophrenia, with an HR of 1.17 (95% confidence interval [CI] = 1.04, 1.32). Women and blacks had significant negative associations with herpes simplex virus type 2 and cytomegalovirus; among blacks, there was a significant positive association with herpes simplex virus type 1. Among men, there was a HHV-6 temporal effect with an HR of 1.41 (95% CI = 1.02, 1.96) for sera drawn 6-12 months before diagnosis.

DISCUSSION

Findings from previous studies of herpes family viruses and schizophrenia have been inconsistent. Our study is based on a larger population than most previous studies and used serum specimens collected before onset of illness. This study adds to the body of knowledge and provides testable hypotheses for follow-on studies.

摘要

背景

疱疹病毒家族可引起中枢神经系统炎症性改变,其症状可能与精神分裂症难以区分,因此在精神分裂症研究中备受关注。大多数现有的疱疹病毒研究使用的样本量较小且为确诊后的标本。作为一个更大研究项目的一部分,我们对从美国军队退伍的精神分裂症患者以及诊断前后的血清进行了一项探索性病例对照研究,检测特定疱疹病毒抗体。

方法

病例组(n = 180)为因精神分裂症住院并退伍的军人。对照组按几个因素1:3匹配,为未退伍的军人。军队常规收集并储存军人的血清标本。我们使用微孔板酶免疫测定法检测诊断前后标本中针对6种疱疹病毒的免疫球蛋白G(IgG)抗体水平。采用条件逻辑回归分析,关联度衡量指标为风险比(HR)。

结果

总体而言,我们发现6型人类疱疹病毒与精神分裂症之间存在显著关联,HR为1.17(95%置信区间[CI] = 1.04, 1.32)。女性和黑人与2型单纯疱疹病毒和巨细胞病毒存在显著负相关;在黑人中,与1型单纯疱疹病毒存在显著正相关。在男性中,诊断前6 - 12个月采集的血清存在HHV - 6时间效应,HR为1.41(95% CI = 1.02, 1.96)。

讨论

先前关于疱疹病毒家族与精神分裂症的研究结果并不一致。我们的研究基于比大多数先前研究更大的样本量,并使用了疾病发作前采集的血清标本。本研究丰富了知识体系,并为后续研究提供了可检验的假设。

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