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精神分裂症患者血清中血小板自身抗体升高的盲法验证——第二部分:成年受试者

Blind verification of elevated platelet autoantibodies in serum of schizophrenic patients--part II: adult subjects.

作者信息

Spivak Baruch, Schechtman Mila, Schonherz-Pine Yael, Blumensohn Rachel, Mostovoy Susanna, Amital Daniela, Deckmann Michael, Weizman Abraham, Shinitzky Meir

机构信息

Beer Yaakov-Ness Ziona Mental Health Center, Beer Yaakov, Israel.

出版信息

Neuropsychobiology. 2009;60(1):49-54. doi: 10.1159/000235802. Epub 2009 Sep 1.

Abstract

BACKGROUND

In our preceding study, we assayed in a blind fashion the blood sera of young normal subjects and schizophrenic patients for levels of platelet autoantibodies (PAA). The recorded PAA titers of the schizophrenic patients were significantly higher than those of the normal subjects. This observation has lent support to this test being used as an objective evaluation of schizophrenia in young subjects in the future. In addition, this finding strongly suggested that the etiology of a distinct group of sufferers of this disorder could have originated from an autoimmune reaction against platelets which can, under certain conditions, cross-react with brain tissue.

AIMS

In the present study, PAA titers in the sera of adult schizophrenic patients and matched normal subjects were determined analogously to the preceding study. The effect of hospitalization and drug treatments on the apparent blood test scoring in adult subjects could thus be evaluated.

METHODS

A total of 46 schizophrenia patients (30 men and 16 women) aged 19-45 years (mean +/- SD: 31.7 +/- 8.0 years) with a minimum score of 60 on the Positive and Negative Symptom Scale and 43 healthy control subjects (22 men and 21 women) aged 21-44 years (mean +/- SD: 31.9 +/- 6.9 years) participated in the study. The blood titers of PAA were evaluated in a single-blind fashion using an optimized ELISA test scored by optical density (OD) units. A positive test was defined as a value above 1.3 OD units.

RESULTS

The titers of PAA in the group of schizophrenic patients (1.1 +/- 0.55 OD units, range: 0.360-2.285 OD units) were significantly higher in comparison to those of the healthy control subjects (0.81 +/- 0.37 OD units, range: 0.360-1.704 OD units; p = 0.004, two-tailed unpaired t-test). Significantly more schizophrenic patients showed a positive test (15 patients out of 46) than the control subjects (5 out of 43). However, significantly higher OD values of 1.55 +/- 0.5 were recorded in the group of patients with less than 3 years of registered disease (n = 16, age 19-30 years), while in the group with 4-20 years of hospitalization (n = 30, age 24-45 years) the recorded OD values (0.85 +/- 0.4 OD units) were practically indistinguishable from those of the control group.

CONCLUSIONS

In the adult schizophrenic patients, the PAA blood test remains valid for patients who were hospitalized for less than 3 years. Drug treatment, length of disease and age can be assumed to reduce the PAA level considerably.

摘要

背景

在我们之前的研究中,我们以盲法检测了年轻正常受试者和精神分裂症患者血清中的血小板自身抗体(PAA)水平。记录的精神分裂症患者的PAA滴度显著高于正常受试者。这一观察结果支持了该检测在未来用于对年轻受试者的精神分裂症进行客观评估。此外,这一发现强烈表明,该疾病的一个特定患者群体的病因可能源于针对血小板的自身免疫反应,在某些情况下,这种反应可能与脑组织发生交叉反应。

目的

在本研究中,类似于之前的研究,测定了成年精神分裂症患者和匹配的正常受试者血清中的PAA滴度。从而可以评估住院治疗和药物治疗对成年受试者血液检测结果的影响。

方法

共有46例年龄在19 - 45岁(平均±标准差:31.7±8.0岁)、阳性和阴性症状量表得分至少为60分的精神分裂症患者(30名男性和16名女性)以及43名年龄在21 - 44岁(平均±标准差:31.9±6.9岁)的健康对照受试者(22名男性和21名女性)参与了该研究。使用通过光密度(OD)单位评分的优化ELISA检测以单盲方式评估PAA的血液滴度。阳性检测定义为值高于1.3 OD单位。

结果

与健康对照受试者(0.81±0.37 OD单位,范围:0.360 - 1.704 OD单位;p = 0.004,双侧不成对t检验)相比,精神分裂症患者组(1.1±0.55 OD单位,范围:0.360 - 2.28 OD单位)的PAA滴度显著更高。显示阳性检测的精神分裂症患者(46例中有15例)显著多于对照受试者(43例中有5例)。然而,在病程小于3年的患者组(n = 16,年龄19 - 30岁)中记录到显著更高的OD值1.55±0.5,而在住院4 - 20年的患者组(n = 30,年龄24 - 45岁)中记录的OD值(0.85±0.4 OD单位)与对照组几乎没有区别。

结论

在成年精神分裂症患者中,PAA血液检测对于住院时间少于3年的患者仍然有效。可以认为药物治疗、病程长短和年龄会使PAA水平大幅降低。

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