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弓形虫病与精神分裂症之间的关系:综述

Relationship between toxoplasmosis and schizophrenia: A review.

作者信息

Fuglewicz Aleksander J, Piotrowski Patryk, Stodolak Anna

机构信息

Department of Social Pediatrics, Faculty of Health Science, Wroclaw Medical University, Poland.

Department of Psychiatry, Faculty of Postgraduate Medical Training, Wroclaw Medical University, Poland.

出版信息

Adv Clin Exp Med. 2017 Sep;26(6):1031-1036. doi: 10.17219/acem/61435.

Abstract

A growing body of evidence suggests a correlation between schizophrenia and exposure to infectious agents. The majority of studied cases concerns the infection caused by T. gondii, an obligatory intracellular parasite that infects about 1/3 of the entire human population, according to the available data. The acute stage of the disease, predominantly short-lived and transient, transforms into the latent and chronic phase in which the parasite localizes within tissue cysts, mainly in the central nervous system. The chronic toxoplasmosis, primarily regarded as benign and asymptomatic, might be responsible, in light of current scientific evidence, for a vast array of neuropsychiatric symptoms. Numerous epidemiological case-control studies show a higher prevalence of T. gondii infestation in individuals with various psychiatric and behavior disorders, including schizophrenia. This paper tends to review the relevant studies that demonstrate links between schizophrenia and T. gondii infestation, of which the latter may be acquired in different developmental phases. Apart from epidemiological correlation studies, some papers on other associations were also presented, describing putative patophysiological mechanisms that might be at least partly responsible for chronic infection-induced neuromediator disturbances, together with morphological and functional alterations, e.g., low-grade neuroinflammation, which are likely to induce psychopathological symptoms. Toxoplasmosis is only one of the putative infectious agents that derange correct brain growth and differentiation, alongside genetic and environmental factors. All of them may lead eventually to schizophrenia. A better knowledge of infection mechanisms and its influence on neurobiochemical and neuropathological pathways may enable more efficient therapy and the prevention of this devastating disease.

摘要

越来越多的证据表明精神分裂症与接触传染原之间存在关联。根据现有数据,大多数研究病例涉及由弓形虫引起的感染,弓形虫是一种专性细胞内寄生虫,感染了约三分之一的全球人口。该疾病的急性期主要是短暂的,之后会转变为潜伏期和慢性期,在此期间寄生虫定位于组织囊肿内,主要是在中枢神经系统。慢性弓形虫病主要被认为是良性且无症状的,但根据目前的科学证据,它可能是造成大量神经精神症状的原因。众多流行病学病例对照研究表明,在患有各种精神和行为障碍(包括精神分裂症)的个体中,弓形虫感染的患病率更高。本文倾向于综述那些证明精神分裂症与弓形虫感染之间联系的相关研究,其中后者可能在不同发育阶段获得。除了流行病学相关性研究外,还介绍了一些关于其他关联的论文,描述了可能至少部分导致慢性感染引起的神经递质紊乱以及形态和功能改变(例如低度神经炎症)的假定病理生理机制,这些改变可能会诱发精神病理症状。弓形虫病只是与遗传和环境因素一起干扰大脑正常生长和分化的假定传染原之一。所有这些最终都可能导致精神分裂症。更好地了解感染机制及其对神经生化和神经病理途径的影响,可能会实现更有效的治疗并预防这种毁灭性疾病。

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