Garcia-Rizo Clemente, Casanovas Marta, Fernandez-Egea Emilio, Oliveira Cristina, Meseguer Ana, Cabrera Bibiana, Mezquida Gisela, Bioque Miquel, Kirkpatrick Brian, Bernardo Miquel
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic, Barcelona, Spain.
August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
Early Interv Psychiatry. 2019 Feb;13(1):95-100. doi: 10.1111/eip.12456. Epub 2017 Aug 8.
Schizophrenia is a complex medical entity with a reduced life expectancy, mostly due to an increased prevalence of cardiovascular diseases compared to the general population. An unbalanced immune response and a pro-inflammatory state might underlie this process. In treated patients, abnormal white blood cell (WBC), lymphocyte and neutrophil count suggests atypical immune response related to clinical variables. We aimed to test the hypothesis that newly diagnosed naïve patients with non-affective psychosis would show abnormal blood cell count values after controlling for potential confounding factors compared to matched controls.
Seventy-five patients were compared with 80 controls matched for age, gender, body mass index and smoking. Analyses were conducted before and after controlling for smoking.
Patients and controls displayed similar mean values (×10 /μL [SD]) for WBC count 7.02 [2.2] vs 6.50 [1.7] (P = .159), neutrophil count 4.25 [1.8] vs 3.84 [1.3] (P = .110) and monocyte count 0.43 [0.2] vs 0.40 [0.1] (P = .326). After controlling for smoking, 38 non-smoking patients showed a higher WBC and neutrophil count compared with 49 matched controls. Respective means of 7.01 [2.2] vs 5.97 [1.4] (P = .011) for WBC and 4.24 [1.9] vs 3.51 [1.2] (P = .028) for neutrophil count. Monocyte count showed an increased mean value 0.43 [0.2] vs 0.36 [0.1] with a trend towards signification (P = .063).
These results suggest that abnormal immune response is present before the effects of medication and other confounders had taken place. Increased immune parameters might underlie the high ratio of medical co-morbidities described in schizophrenia.
精神分裂症是一种复杂的医学病症，预期寿命缩短，主要原因是与普通人群相比，心血管疾病的患病率增加。免疫反应失衡和促炎状态可能是这一过程的基础。在接受治疗的患者中，白细胞（WBC）、淋巴细胞和中性粒细胞计数异常表明与临床变量相关的非典型免疫反应。我们旨在检验这一假设：与匹配的对照组相比，新诊断的未接受过治疗的非情感性精神病患者在控制潜在混杂因素后，血细胞计数会出现异常。
将75名患者与80名年龄、性别、体重指数和吸烟情况相匹配的对照组进行比较。在控制吸烟因素前后分别进行分析。
患者和对照组的白细胞计数平均值（×10⁹/μL[标准差]）相似，分别为7.02[2.2]和6.50[1.7]（P = 0.159）；中性粒细胞计数分别为4.25[1.8]和3.84[1.3]（P = 0.110）；单核细胞计数分别为0.43[0.2]和0.40[0.1]（P = 0.326）。在控制吸烟因素后，38名不吸烟患者的白细胞和中性粒细胞计数高于49名匹配的对照组。白细胞计数的各自平均值分别为7.01[2.2]和5.97[1.4]（P = 0.011），中性粒细胞计数分别为4.24[1.9]和3.51[1.2]（P = 0.028）。单核细胞计数平均值有所增加，分别为0.43[0.2]和0.36[0.1]，有显著趋势（P = 0.063）。
这些结果表明，异常免疫反应在药物和其他混杂因素产生影响之前就已存在。免疫参数升高可能是精神分裂症中所述高比例合并症的基础。
