Chiaie Roberto Delle, Caronti Brunella, Macrì Francesco, Campi Sandra, Marino Marzia, Corrado Alessandra, Caredda Maria, Biondi Massimo
Departement of Neurology and Psichiatry, "Sapienza" University of Rome, Italy.
Clin Pract Epidemiol Ment Health. 2012;8:81-90. doi: 10.2174/1745017901208010081. Epub 2012 Aug 23.
Phenomena of autoimmunity are frequent among psychiatric patients, but we don't know yet if they should be considered primary and linked to the pathophisiology of the disorder, or aspecific and associated to a general immune system activation. Paraneoplastic Cerebellar Degeneration (PCD) represents a well known model of specific autoimmunity. In order to better understand the abovementioned issues, we used this condition to compare a set of immune dysfunctions found in a group of psychiatric patients. For this reason we tested sera from 48 psychiatric patients (24 schizophrenics, 17 bipolars and 7 obsessive-compulsive), 22 PCD patients and 52 healthy controls for the presence of anti-Purkinje autoantibodies and of some natural autoantibodies (ANAs, AMAs, APCAs, ASMAs). Psychopatological status of the psychiatric patients was assessed with BPRS, SANS, SAPS, HAM-D, CGI-S. In the psychiatric group anti-Purkinje autoantibodies were identified in 11/48 (22,9%) patients, while they were present in 22/22 (100%) PCD patients and in 0/52 (0%) healthy controls. Among all anti-Purkinje autoantibody positive patients (in the PCD and psychiatric samples), only those belonging to the psychiatric sample, but not those with PCD, were frequently found positive also for natural autoantibodies, that are considered good markers of aspecific immune activation. In these patients, both anti-Purkinje and natural autoantibodies were found associated with acute/positive psychopathological symptoms. These results seem to point out that some phenomena of auto-immunity described in psychiatric patients could be aspecific, unrelated to the pathophysiology of the concomitant mental disorders and could be more frequent during phases of acute/positive symptoms.
自身免疫现象在精神科患者中很常见，但我们尚不清楚它们是否应被视为原发性的并与该疾病的病理生理学相关，还是非特异性的且与一般免疫系统激活有关。副肿瘤性小脑变性（PCD）是一种众所周知的特异性自身免疫模型。为了更好地理解上述问题，我们利用这种情况来比较一组精神科患者中发现的一系列免疫功能障碍。因此，我们检测了48名精神科患者（24名精神分裂症患者、17名双相情感障碍患者和7名强迫症患者）、22名PCD患者和52名健康对照者的血清中是否存在抗浦肯野自身抗体和一些天然自身抗体（抗核抗体、抗线粒体抗体、抗胃壁细胞抗体、抗平滑肌抗体）。使用简明精神病评定量表（BPRS）、阴性症状评定量表（SANS）、阳性症状评定量表（SAPS）、汉密尔顿抑郁量表（HAM-D）、临床总体印象量表严重程度分量表（CGI-S）对精神科患者的精神病理状态进行评估。在精神科组中，11/48（22.9%）的患者检测出抗浦肯野自身抗体，而在22/22（100%）的PCD患者中检测出该抗体，在52名健康对照者中无一例（0%）检测出。在所有抗浦肯野自身抗体阳性的患者中（PCD患者和精神科样本中的患者），只有精神科样本中的患者，而非PCD患者，经常同时检测出天然自身抗体阳性，天然自身抗体被认为是非特异性免疫激活的良好标志物。在这些患者中，抗浦肯野自身抗体和天然自身抗体均与急性/阳性精神病理症状相关。这些结果似乎表明，精神科患者中描述的一些自身免疫现象可能是非特异性的，与并发精神障碍的病理生理学无关，且在急性/阳性症状阶段可能更常见。
