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首发精神病和复发精神分裂症患者血清 2 型细胞因子水平升高和白细胞介素-17 降低。

Elevated serum level of type-2 cytokine and low IL-17 in first episode psychosis and schizophrenia in relapse.

机构信息

Department of Psychiatry, Faculty of Medicine, University of Kragujevac, Svetozara Markovica 69, 34 000 Kragujevac, Serbia.

出版信息

J Psychiatr Res. 2012 Nov;46(11):1421-6. doi: 10.1016/j.jpsychires.2012.08.016. Epub 2012 Sep 10.

Abstract

Schizophrenia is chronic and debilitating mental disorder. In broad spectrum of possible causes or contributing factors, immune system and cytokines were investigated in the onset and development of schizophrenia. The aim of our study was to analyze the serum concentrations of type-1 cytokines: TNF-α, IFN-γ, type-2 cytokines: IL-4, IL-10, type-17 cytokine: IL-17 and regulatory cytokines: TGF-β, IL-27, IL-6, in drug-naive patients with First Episode Psychosis - FEP (n = 88) and Schizophrenia in relapse - SC in relapse patients (n = 45), comparing to healthy controls (n = 36). Also, we attempted to determine potential correlation between cytokine levels and/or cytokine ratios with clinical parameters, such as severity of illness, positive, negative and general psychopathology. Our results showed decreased levels of IL-17 (p = 0.018), demonstrating that type-17 response is blunted in psychotic episode. Increased levels of IL-4 (p = 0.033) showed that type-2 response is overweight in psychotic episode. Also, levels of IL-4 in serum of SC in relapse patients were higher than controls (p < 0.0005) and patient with FEP (p = 0.003). This alteration was accompanied with increase in production of TGF-β in psychotic patients (p = 0.009) and also in FEP (p < 0.0005) and SC in relapse (p < 0.0005). Analysis showed that TGF-β can be a valuable marker for psychosis. The presence of enhanced anti-inflammatory/immunosuppressive activity in schizophrenia may be an attempt to counteract or limit ongoing pro-inflammatory processes and downregulating chronic inflammation. Finally we have documented decreased levels of IL-17 and IL-17/TGF-β ratio in these types of psychotic patients, suggesting the new aspects of schizophrenia pathophysiology.

摘要

精神分裂症是一种慢性且使人虚弱的精神障碍。在可能的病因或促成因素的广泛范围内,免疫系统和细胞因子已被研究用于精神分裂症的发病和发展。我们的研究目的是分析未经药物治疗的首发精神病(FEP)患者(n = 88)和精神病复发(SC in relapse)患者(n = 45)与健康对照组(n = 36)的血清中 1 型细胞因子(TNF-α、IFN-γ)、2 型细胞因子(IL-4、IL-10)、17 型细胞因子(IL-17)和调节性细胞因子(TGF-β、IL-27、IL-6)的浓度。我们还试图确定细胞因子水平和/或细胞因子比值与疾病严重程度、阳性、阴性和一般精神病学等临床参数之间的潜在相关性。我们的研究结果显示,IL-17 水平降低(p = 0.018),表明在精神病发作时 17 型反应受到抑制。IL-4 水平升高(p = 0.033)表明 2 型反应在精神病发作时过度活跃。此外,SC in relapse 患者血清中的 IL-4 水平高于对照组(p < 0.0005)和 FEP 患者(p = 0.003)。这种改变伴随着精神病患者 TGF-β产生增加(p = 0.009),也伴随着 FEP(p < 0.0005)和 SC in relapse(p < 0.0005)。分析表明,TGF-β 可能是精神病的一个有价值的标志物。在精神分裂症中存在增强的抗炎/免疫抑制活性可能是对抗或限制正在进行的促炎过程和下调慢性炎症的一种尝试。最后,我们在这些类型的精神病患者中记录到 IL-17 和 IL-17/TGF-β 比值降低,提示了精神分裂症病理生理学的新方面。

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