Miyaoka Tsuyoshi
Department of Psychiatry, Shimane University School of Medicine.
Seishin Shinkeigaku Zasshi. 2011;113(4):361-7.
Idiopathic unconjugated hyperbilirubinemia (Gilbert's syndrome, or GS) is a relatively common congenital hyperbilirubinemia occurring in 3-7% of the world's population. It has been recognized as a benign familial condition in which hyperbilirubinemia occurs in the absence of structural liver disease or hemolysis, and the plasma concentration of conjugated bilirubin is normal. Recently, it has been reported that unconjugated bilirubin exhibited neurotoxicity in the developing nervous system. The 'neurodevelopmental hypothesis' of schizophrenia proposes that an as-yet-unidentified event occurs in utero or during early postnatal life. We have observed that patients suffering from schizophrenia frequently present with an increased unconjugated bilirubin plasma concentration when admitted to the hospital. As a result, we noticed a relationship between unconjugated bilirubin and the etiology of, and vulnerability to, schizophrenia. Our reported findings suggest that there are significant biological and clinical character differences between schizophrenic patients with and without GS. From the viewpoint of the heterogeneity of schizophrenia, there may be a poor outcome for the subtype of schizophrenia with GS.
特发性非结合胆红素血症（吉尔伯特综合征，简称GS）是一种相对常见的先天性高胆红素血症，全球3%至7%的人口受其影响。它被认为是一种良性家族性疾病，在无肝脏结构疾病或溶血的情况下出现高胆红素血症，且结合胆红素的血浆浓度正常。最近，有报道称非结合胆红素在发育中的神经系统中表现出神经毒性。精神分裂症的“神经发育假说”提出，在子宫内或出生后早期发生了一个尚未确定的事件。我们观察到，精神分裂症患者入院时经常出现非结合胆红素血浆浓度升高的情况。因此，我们注意到非结合胆红素与精神分裂症的病因及易感性之间存在关联。我们报告的研究结果表明，患有和未患有GS的精神分裂症患者在生物学和临床特征上存在显著差异。从精神分裂症的异质性角度来看，患有GS的精神分裂症亚型可能预后较差。
