Department of Psychiatry, University of Magdeburg, Germany.
Eur Arch Psychiatry Clin Neurosci. 2010 Oct;260(7):509-18. doi: 10.1007/s00406-010-0098-x. Epub 2010 Jan 27.
Previous studies of lymphocyte distribution in schizophrenia have yielded inconsistent results, as summarized in the present study. Based on our own original data, potential confounds that might explain these variations are analyzed and discussed. Blood samples from 26 patients with acute paranoid schizophrenia were investigated in comparison with 32 matched healthy controls by flow cytometry (CD3, CD4, CD8, CD19, and CD56 phenotyping). A subgroup of drug-free patients was followed up after 6 weeks of treatment. Cotinine levels and the free cortisol index (FCI) were provided in order to control for medication, smoking, and stress. Cotinine levels correlated with natural killer (NK) cell counts (CD3⁻/CD56(+): r = -0.383, P = 0.003) while the FCI was related to B cell numbers (CD19(+): r = 0.390, P = 0.003). Considering these covariates, a lower level of T helper cells (P = 0.010), a reduced CD4/CD8 ratio (P = 0.029), and elevated B cells (P = 0.008) were found during acute psychosis. After 6 weeks of medication, an inverse pattern was observed in initially drug-free patients: total T cell (P = 0.005), T helper (P = 0.003), and T suppressor/cytotoxic cells (P = 0.005) increased, while B cell counts declined (P = 0.049). In conclusion, acute paranoid schizophrenia may be accompanied by a reduced T cell defense and a shift towards B cell immunity, which normalizes in response to treatment. In addition to disease stage or subtype and medication, cigarette smoking and stress are important co-factors.
先前关于精神分裂症患者淋巴细胞分布的研究结果并不一致，本研究对此进行了总结。基于我们自己的原始数据，分析并讨论了可能解释这些差异的潜在混杂因素。通过流式细胞术（CD3、CD4、CD8、CD19 和 CD56 表型）比较 26 例急性偏执型精神分裂症患者和 32 名匹配的健康对照者的血液样本。对无药物治疗的患者亚组进行了 6 周治疗后的随访。提供了可铁宁水平和游离皮质醇指数（FCI），以控制药物、吸烟和压力的影响。可铁宁水平与自然杀伤（NK）细胞计数相关（CD3⁻/CD56(+): r = -0.383, P = 0.003），而 FCI 与 B 细胞数量相关（CD19(+): r = 0.390, P = 0.003）。考虑到这些混杂因素，在急性精神病期间发现 T 辅助细胞水平较低（P = 0.010），CD4/CD8 比值降低（P = 0.029），B 细胞升高（P = 0.008）。在最初无药物治疗的患者中，经过 6 周的药物治疗后，观察到相反的模式：总 T 细胞（P = 0.005）、T 辅助细胞（P = 0.003）和 T 抑制/细胞毒性细胞（P = 0.005）增加，而 B 细胞计数下降（P = 0.049）。总之，急性偏执型精神分裂症可能伴随着 T 细胞防御功能降低和 B 细胞免疫增强，而这种变化在治疗后会恢复正常。除了疾病阶段或亚型和药物外，吸烟和压力也是重要的混杂因素。
