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严重精神障碍中 TNF 和 IL-1 标志物持续增加提示与特质相关的炎症:一项为期一年的随访研究。

Persistent increase in TNF and IL-1 markers in severe mental disorders suggests trait-related inflammation: a one year follow-up study.

机构信息

NORMENT - KG Jebsen Centre for Psychosis Research, University of Oslo and Oslo University Hospital, Oslo, Norway.

Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

出版信息

Acta Psychiatr Scand. 2017 Oct;136(4):400-408. doi: 10.1111/acps.12783. Epub 2017 Aug 16.

Abstract

OBJECTIVE

We evaluated if plasma levels of inflammatory markers are persistently altered in severe mental disorders with psychotic symptoms or associated with state characteristics in a longitudinal study.

METHODS

Soluble tumor necrosis factor receptor 1 (sTNF-R1), interleukin-1 receptor antagonist (IL-1Ra), von Willebrand factor (VWF), and osteoprotegerin (OPG) were measured in schizophrenia (n = 69) and affective (n = 55) spectrum patients at baseline and at one-year follow-up, and compared to healthy controls (HC) (n = 92) with analysis of covariance. Association between change in symptoms and inflammatory markers was analyzed with mixed-effects models.

RESULTS

sTNF-R1 was higher in the schizophrenia (P < 0.0001) and affective disorders (P = 0.02) compared to HC, while IL-1Ra was higher in schizophrenia (P = 0.01) compared to HC at one year follow-up. There were no significant differences between schizophrenia and affective groups; however, levels in the affective group were in between schizophrenia and HC for sTNF-R1 and IL-1Ra. There were no significant associations between change in symptoms and inflammatory markers.

CONCLUSION

Persistently increased sTNF-R1 and IL-1Ra after one year in patients with severe mental disorders primarily reflecting data from the schizophrenia group may suggest that inflammation is a trait phenomenon, and not only the result of stress-related mechanisms associated with acute episodes.

摘要

目的

我们通过纵向研究评估了严重精神障碍伴有精神病症状患者的炎症标志物血浆水平是否持续改变,以及是否与状态特征相关。

方法

在基线和一年随访时,我们测量了精神分裂症(n=69)和情感(n=55)谱系患者以及健康对照组(HC)(n=92)的可溶性肿瘤坏死因子受体 1(sTNF-R1)、白细胞介素-1 受体拮抗剂(IL-1Ra)、血管性血友病因子(VWF)和护骨素(OPG),并用协方差分析进行比较。采用混合效应模型分析症状变化与炎症标志物之间的关系。

结果

与 HC 相比,精神分裂症(P<0.0001)和情感障碍(P=0.02)患者的 sTNF-R1 水平更高,而 IL-1Ra 在一年随访时精神分裂症(P=0.01)患者的水平更高。精神分裂症和情感障碍组之间没有显著差异;然而,sTNF-R1 和 IL-1Ra 的水平在情感障碍组中处于精神分裂症和 HC 之间。症状变化与炎症标志物之间没有显著关联。

结论

在患有严重精神障碍的患者中,sTNF-R1 和 IL-1Ra 在一年后持续升高,主要反映了来自精神分裂症组的数据,这可能表明炎症是一种特质现象,而不仅仅是与急性发作相关的应激相关机制的结果。

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