Suvisaari Jaana, Mantere Outi
Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, P.O. Box 30, FIN-00271 Helsinki, Finland.
Infect Disord Drug Targets. 2013 Feb;13(1):59-70. doi: 10.2174/18715265112129990032.
Recent research suggests that inflammation and immunity may have a role in the etiology of psychotic disorders. There is evidence of proinflammatory activation of the innate immune system and an activation of the T-cells of the adaptive immune system in both schizophrenia and bipolar disorder. Studies of antipsychotic-naïve patients with first-episode psychosis have found that inflammation is present already at this stage. Some of these abnormalities resolve after the initiation of treatment, suggesting that they are state markers of acute psychosis, but other abnormalities persist. There is also evidence for prenatal infections being involved in the etiology of schizophrenia. Several hypotheses link inflammation and immunity with psychotic disorders. In this review, we focus on hypotheses related to prenatal development, disturbed regulation of neurogenesis, microglial activation, autoimmunity and microbial environment, and consider the potential confounding effects related to stress, childhood adversities, lifestyle and medical comorbidity as well as some methodological limitations. We also review the current evidence for the effectiveness of anti-inflammatory medication in the treatment of psychotic disorders.
近期研究表明，炎症和免疫可能在精神障碍的病因学中发挥作用。有证据显示，在精神分裂症和双相情感障碍中，先天性免疫系统存在促炎激活，适应性免疫系统的T细胞也被激活。对首发精神病且未服用过抗精神病药物的患者研究发现，炎症在这一阶段就已存在。其中一些异常在治疗开始后会消失，这表明它们是急性精神病的状态标志物，但其他异常依然存在。也有证据表明产前感染与精神分裂症的病因有关。有几种假说将炎症和免疫与精神障碍联系起来。在本综述中，我们重点关注与产前发育、神经发生调节紊乱、小胶质细胞激活、自身免疫和微生物环境相关的假说，并考虑与压力、童年逆境、生活方式和合并症相关的潜在混杂效应以及一些方法学上的局限性。我们还综述了目前关于抗炎药物治疗精神障碍有效性的证据。
