Cox David, Chan Man K, Bahn Sabine
Department of Chemical Engineering and Biotechnology, University of Cambridge, Cambridge, United Kingdom.
J Nerv Ment Dis. 2015 May;203(5):393-9. doi: 10.1097/NMD.0000000000000289.
Molecular profiling studies have helped increase the understanding of the immune processes thought to be involved in the etiology and pathophysiology of psychiatric disorders such as schizophrenia. Current therapeutic interventions with first- and second-generation antipsychotics are suboptimal. Poor response rates and debilitating side effects often lead to poor treatment compliance. This highlights the pressing need to identify more effective treatments as well as objective biomarker based tests, which can help predict treatment response and identify diagnostic subpopulations. Such tests could enable early detection of patients who will benefit from particular therapeutic interventions. In this review, we discuss studies relating to dysfunctions of the immune system in patients with schizophrenia and the effects of antipsychotic medication on the molecular components of these systems. Immune system dysfunction may in part be related to genetic risk factors for schizophrenia, but there is substantial evidence that a wide range of environmental factors ranging from exposure to infectious agents such as influenza and Toxoplasma gondii to HPA axis dysfunction play an important role in the etiopathogenesis of schizophrenia. Ongoing research efforts, testing therapeutic efficacy of anti-inflammatory agents used as add-on medications are also discussed. From a therapeutic perspective, these represent the initial steps toward novel treatment approaches and more effective patient care in the field of mental health.
分子谱分析研究有助于增进对免疫过程的理解，这些免疫过程被认为与精神分裂症等精神疾病的病因和病理生理学有关。目前使用第一代和第二代抗精神病药物的治疗干预效果并不理想。低反应率和使人衰弱的副作用常常导致治疗依从性差。这凸显了迫切需要确定更有效的治疗方法以及基于客观生物标志物的检测，这有助于预测治疗反应并识别诊断亚群。此类检测能够早期发现将从特定治疗干预中获益的患者。在本综述中，我们讨论了与精神分裂症患者免疫系统功能障碍以及抗精神病药物对这些系统分子成分的影响相关的研究。免疫系统功能障碍可能部分与精神分裂症的遗传风险因素有关，但有大量证据表明，从接触流感和弓形虫等传染源到下丘脑 - 垂体 - 肾上腺（HPA）轴功能障碍等广泛的环境因素在精神分裂症的病因发病机制中起重要作用。还讨论了正在进行的研究工作，即测试用作附加药物的抗炎药的治疗效果。从治疗角度来看，这些代表了心理健康领域朝着新型治疗方法和更有效患者护理迈出的初步步骤。
