Social Aetiology of Mental Illness Training Program, Centre for Addiction and Mental Health, 455 Spadina Avenue, Suite 300, Toronto, Ontario M5S 2G8, Canada; University of Toronto, 455 Spadina Avenue, Suite 300, Toronto, Ontario M5S 2G8, Canada.
Social Aetiology of Mental Illness Training Program, Centre for Addiction and Mental Health, 455 Spadina Avenue, Suite 300, Toronto, Ontario M5S 2G8, Canada.
Schizophr Res. 2014 Feb;152(2-3):521-7. doi: 10.1016/j.schres.2013.12.001. Epub 2013 Dec 22.
BACKGROUND: Dohan first proposed that there may be an association between gluten sensitivity and schizophrenia in the 1950s. Since then, this association has been measured using several different serum biomarkers of gluten sensitivity. At this point, it is unclear which serum biomarkers of gluten sensitivity are elevated in patients with schizophrenia. However, evidence suggests that the immune response in this group is different from the immune response to gluten found in patients with Celiac disease. METHODS: A systematic literature review was performed to identify all original articles that measured biomarkers of gluten sensitivity in patients with schizophrenia and non-affective psychoses compared to a control group. Three databases were used: Ovid MEDLINE, Psych INFO, and Embase, dating back to 1946. Forward tracking and backward tracking were undertaken on retrieved papers. A meta-analysis was performed of specific biomarkers and reported according to MOOSE guidelines. RESULTS: 17 relevant original articles were identified, and 12 met criteria for the meta-analysis. Five biomarkers of gluten sensitivity were found to be significantly elevated in patients with non-affective psychoses compared to controls. The pooled odds ratio and 95% confidence intervals were Anti-Gliadin IgG OR=2.31 [1.16, 4.58], Anti-Gliadin IgA OR=2.57 [1.13, 5.82], Anti-TTG2 IgA OR=5.86 [2.88, 11.95], Anti-Gliadin (unspecified isotype) OR=7.68 [2.07, 28.42], and Anti-Wheat OR=2.74 [1.06, 7.08]. Four biomarkers for gluten sensitivity, Anti-EMA IgA, Anti-TTG2 IgG, Anti-DGP IgG, and Anti-Gluten were not found to be associated with schizophrenia. CONCLUSIONS: Not all serum biomarkers of gluten sensitivity are elevated in patients with schizophrenia. However, the specific immune response to gluten in this population differs from that found in patients with Celiac disease.
背景：多翰（Dohan）在 20 世纪 50 年代首次提出麸质敏感性与精神分裂症之间可能存在关联。从那时起，人们使用几种不同的麸质敏感性血清生物标志物来测量这种关联。目前尚不清楚精神分裂症患者的哪些麸质敏感性血清生物标志物升高。然而，有证据表明，该人群的免疫反应与乳糜泻患者的免疫反应不同。
方法：进行了系统的文献综述，以确定所有在精神分裂症和非情感性精神病患者中测量麸质敏感性生物标志物的原始文章，并与对照组进行比较。使用了三个数据库：Ovid MEDLINE、Psych INFO 和 Embase，回溯到 1946 年。对检索到的论文进行了前向跟踪和后向跟踪。对特定的生物标志物进行了荟萃分析，并按照 MOOSE 指南进行了报告。
结果：确定了 17 篇相关的原始文章，其中 12 篇符合荟萃分析的标准。与对照组相比，非情感性精神病患者的 5 种麸质敏感性生物标志物明显升高。合并的优势比和 95%置信区间为抗麦胶蛋白 IgG 的比值比=2.31[1.16, 4.58]，抗麦胶蛋白 IgA 的比值比=2.57[1.13, 5.82]，抗组织转谷氨酰胺酶 2 IgA 的比值比=5.86[2.88, 11.95]，抗麦胶蛋白（未特指同型）的比值比=7.68[2.07, 28.42]，和抗小麦的比值比=2.74[1.06, 7.08]。未发现抗肠膜抗体 IgA、抗组织转谷氨酰胺酶 2 IgG、抗脱酰胺麦谷蛋白 IgG 和抗谷蛋白等 4 种麸质敏感性生物标志物与精神分裂症相关。
结论：并非所有的麸质敏感性血清生物标志物在精神分裂症患者中均升高。然而，该人群对麸质的特定免疫反应与乳糜泻患者不同。
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