精神分裂症认知中免疫作用的证据：系统评价。
Evidence for an immune role on cognition in schizophrenia: a systematic review.
机构信息
Neurosciences Program, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil;
Neurosciences Program, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil; ; Interdisciplinary Laboratory of Medical Investigation, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil;
出版信息
Curr Neuropharmacol. 2014 May;12(3):273-80. doi: 10.2174/1570159X1203140511160832.
OBJECTIVE
Recent evidence has associated immune and inflammatory changes to cognitive performance in many diseases, including schizophrenia. Since this is a new research field where concepts are not yet solid and new questions and hypothesis are still arising, the present study aimed at summarizing the available clinical data associating schizophrenia, cognition and inflammation/immune function.
METHODS
A SYSTEMATIC REVIEW OF THE LITERATURE WAS MADE BY SEARCHING THE FOLLOWING TERMS IN MEDLINE: "schizophrenia or psychosis or psychotic" AND "inflamm* or immun* or cytokine or IL-* or TNF-* or kynureni* or KYNA", AND "cognit* or attention or memory or executive function".
RESULTS
Seventy five papers were identified using the selected terms, and seven papers were included in the review. Papers excluded focused mainly on basic research or other neuropsychiatric disorders.
CONCLUSIONS
Recent findings link inflammatory markers to cognition in schizophrenia, suggesting that inflammation is associated with worst cognitive performance. Microglial activation, monoaminergic imbalance, brain abnormalities and the kynurenine pathway are possible mechanisms underlying cognitive impairment in schizophrenia. Clinical trials with addition of immunomodulatory drugs have shown promising results, opening new windows to tackle cognition in schizophrenia.
目的
最近的证据表明，许多疾病（包括精神分裂症）的认知表现与免疫和炎症变化有关。由于这是一个新概念尚未成熟且仍在不断出现新问题和假设的新研究领域，本研究旨在总结现有文献中与精神分裂症、认知和炎症/免疫功能相关的临床数据。
方法
通过在 MEDLINE 中搜索以下术语进行文献系统回顾：“精神分裂症或精神病或精神错乱”和“炎症或免疫或细胞因子或 IL-* 或 TNF-* 或 kynureni* 或 KYNA”，以及“认知或注意力或记忆或执行功能”。
结果
使用选定的术语确定了 75 篇论文，其中 7 篇论文被纳入综述。被排除的论文主要集中在基础研究或其他神经精神障碍上。
结论
最近的研究结果表明，炎症标志物与精神分裂症患者的认知功能有关，提示炎症与认知功能最差有关。小胶质细胞激活、单胺能失衡、大脑异常和犬尿氨酸途径可能是精神分裂症认知障碍的潜在机制。免疫调节药物的临床试验取得了有希望的结果，为治疗精神分裂症的认知障碍开辟了新的途径。
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