El Kissi Y, Hannachi N, Mtiraoui A, Samoud S, Bouhlel S, Gaabout S, Boukadida J, Ben Hadj Ali B
Service de psychiatrie, centre hospitalo-universitaire Farhat-Hached de Sousse, avenue Ibn-Jazzar, 4002 Sousse, Tunisie.
Département d'immunologie et de microbiologie, centre hospitalo-universitaire Farhat-Hached de Sousse, avenue Ibn-Jazzar, 4002 Sousse, Tunisie.
Encephale. 2015 Dec;41(6):470-6. doi: 10.1016/j.encep.2014.10.007. Epub 2014 Dec 18.
Schizophrenia is a highly disabling chronic mental illness. It is considerded as a neurodeveloppemental illness resulting from the interaction of genetic and environmental factors. Growing evidence supports the major role of prenatal infections and inflammation in the genesis of schizophrenia. The hypothesis including viral infections has been the subject of several studies and the role of parvovirus B19 (PB19) in the onset of the disease has been suggested. However, there is, up till now, no seroepidemiological evidence of his involvement.
To determine the prevalence of parvovirus B19 (PB19) in schizophrenic patients and in control subjects and to examine clinical associations between viral prevalence, risk factors of infectious disease and clinical features.
We carried out a case-control seroepidemiological study in the Psychiatry department of Farhat-Hached general hospital of Sousse (Tunisia). We recruited108 schizophrenic patients and 108 healthy controls free from any psychotic disorder and matched for age and sex. We collected sociodemographic data, medical history, axis I comorbid disorders and infectious risk factors. We assessed patients for psychopathology and severity of illness using respectively the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impressions (CGI). For each study participant, blood sample was collected and levels of IgG and IgM anti-PB19 were measured using the ELISA technique.
The prevalence of IgG antibodies to PB19 was significantly higher in schizophrenic patients than in controls (73.1% vs 60.2%; P=0.04). There were no statistical differences between the two groups regarding the prevalence of IgM antibodies to PB19. No association was found between viral prevalence and sociodemographic data, risk factors for infection or clinical characteristics. The presence of PB19 antibodies was associated with a lower score on the PANSS negative subscale (P=0.04). No other signficative association were found.
In our study, prevalence of IgG antibodies to PB19 was significantly higher in schizophrenic patients than in controls. This finding supports the hypothesis of the involvement of PB19 in schizophrenia. Further studies including both virological and immunological aspects are needed to better clarify the etiopathogenic mechanisms of schizophrenia which would challenge the management of this disease.
精神分裂症是一种极具致残性的慢性精神疾病。它被认为是一种由遗传和环境因素相互作用导致的神经发育性疾病。越来越多的证据支持产前感染和炎症在精神分裂症发病机制中起主要作用。包括病毒感染在内的这一假说已成为多项研究的主题，并且有人提出细小病毒B19（PB19）在该疾病发病中的作用。然而，迄今为止，尚无血清流行病学证据表明其参与其中。
确定精神分裂症患者和对照人群中细小病毒B19（PB19）的感染率，并研究病毒感染率、传染病危险因素与临床特征之间的临床关联。
我们在突尼斯苏塞法哈特 - 哈切德综合医院精神科进行了一项病例对照血清流行病学研究。我们招募了108名精神分裂症患者和108名无任何精神障碍且年龄和性别匹配的健康对照者。我们收集了社会人口学数据、病史、轴I共病障碍和感染危险因素。我们分别使用简明精神病评定量表（BPRS）、阳性症状评定量表（SAPS）、阴性症状评定量表（SANS）、阳性和阴性症状量表（PANSS）以及临床总体印象量表（CGI）评估患者的精神病理学和疾病严重程度。为每位研究参与者采集血样，并使用酶联免疫吸附测定（ELISA）技术测量抗PB19 IgG和IgM水平。
精神分裂症患者中抗PB19 IgG抗体的感染率显著高于对照组（73.1%对60.2%；P = 0.04）。两组之间抗PB19 IgM抗体的感染率无统计学差异。未发现病毒感染率与社会人口学数据、感染危险因素或临床特征之间存在关联。PB19抗体的存在与PANSS阴性分量表得分较低相关（P = 0.04）。未发现其他显著关联。
在我们的研究中，精神分裂症患者中抗PB19 IgG抗体的感染率显著高于对照组。这一发现支持了PB19参与精神分裂症发病的假说。需要进一步开展包括病毒学和免疫学方面的研究，以更好地阐明精神分裂症的病因发病机制，这将对该疾病的治疗产生挑战。
