University of Toronto.
Sunnybrook Health Sciences Centre, University of Toronto.
J Am Acad Child Adolesc Psychiatry. 2014 Mar;53(3):274-96. doi: 10.1016/j.jaac.2013.11.013. Epub 2013 Dec 16.
There has been rapid growth in research regarding inflammation in neuropsychiatric disorders as it relates to youth. We therefore set out to systematically review the literature on inflammation and neuropsychiatric disorders in children and adolescents.
A systematic review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were included if proinflammatory markers (PIMs) in children and/or adolescents with neuropsychiatric disorders were measured.
Sixty-seven studies were included, involving 3,952 youth. Evidence for a proinflammatory state is strongest for autism spectrum disorders (ASD). PIMs are elevated in children and adolescents with major depressive disorder (MDD), bipolar disorder (BD), post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), Tourette's disorder (TD), attention-deficit/hyperactivity disorder (ADHD), and schizophrenia (SZ). However, the data are inconsistent. Evidence for specific PIMs is equivocal at this stage, although the findings in youth with MDD, BD, and PTSD converge with the extant adult literature in these areas. Definitive conclusions are limited by methodologic factors including cross-sectional and retrospective study design, between-study differences in specific markers and methods of analysis, small sample size, and other sources of heterogeneity.
The literature regarding inflammation among children and adolescents with neuropsychiatric disorders represents nearly 4,000 youth. There is preliminary evidence for elevated markers of inflammation in this population. Larger, prospective studies are needed to realize the goal of inflammatory markers informing clinical practice. In the interim, present findings suggest that further examination of this topic is warranted.
随着神经精神疾病炎症相关研究的快速发展，我们旨在对儿童和青少年神经精神疾病炎症的相关文献进行系统综述。
根据系统评价和荟萃分析的首选报告项目（PRISMA）声明，对文献进行系统综述。纳入的研究对象为儿童和/或青少年神经精神疾病患者的促炎标志物（PIMs）。
共纳入 67 项研究，涉及 3952 名青少年。自闭症谱系障碍（ASD）的促炎状态证据最强。患有重度抑郁症（MDD）、双相情感障碍（BD）、创伤后应激障碍（PTSD）、强迫症（OCD）、妥瑞氏症（TD）、注意缺陷多动障碍（ADHD）和精神分裂症（SZ）的儿童和青少年的 PIMs 升高。然而，数据不一致。目前，特定 PIMs 的证据尚不确定，尽管 MDD、BD 和 PTSD 青少年的研究结果与这些领域的现有成人文献一致。由于方法学因素的限制，包括横断面和回顾性研究设计、特定标志物和分析方法的研究间差异、样本量小以及其他来源的异质性，无法得出明确的结论。
针对儿童和青少年神经精神疾病炎症的文献涉及近 4000 名青少年。该人群中存在炎症标志物升高的初步证据。需要更大规模的前瞻性研究才能实现炎症标志物为临床实践提供信息的目标。在此期间，目前的研究结果表明，有必要进一步研究这一课题。
