Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain.
Biomedical Network Research Center on Mental Health (CIBERSAM), Institute of Salud Carlos III, Madrid, Spain.
Schizophr Bull. 2019 Jun 18;45(4):742-751. doi: 10.1093/schbul/sby125.
Despite mixed findings, increasing evidence suggests that people with first-episode psychosis (FEP) show increased pro-inflammatory and pro-oxidative status. We used the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to conduct a systematic literature search of cross-sectional studies comparing in vivo inflammatory and oxidative blood markers between FEP patients and healthy controls. We analyzed 61 independent samples from 59 publications, including 3002 patients with FEP (ie, patients with FEP, early psychosis, first-episode schizophrenia or early schizophrenia) and 2806 controls. After controlling for multiple comparisons, our meta-analysis showed that total antioxidant status and docosahexaenoic acid levels were significantly lower in FEP patients than in controls, whereas levels of homocysteine, interleukin-6 and tumor necrosis factor alpha were significantly higher in FEP patients than in controls. This suggests that FEP patients had reduced antioxidant status and a pro-inflammatory imbalance, and that these biological processes may be targets for managing FEP.
尽管研究结果存在差异，但越来越多的证据表明，首发精神病（FEP）患者表现出炎症和氧化应激状态增强。我们使用系统评价和荟萃分析的首选报告项目（PRISMA）指南，对比较 FEP 患者和健康对照者体内炎症和氧化血液标志物的横断面研究进行了系统文献检索。我们分析了 59 篇文献中的 61 个独立样本，包括 3002 例 FEP 患者（即 FEP、早期精神病、首发精神分裂症或早期精神分裂症患者）和 2806 例对照者。在控制了多次比较后，我们的荟萃分析表明，FEP 患者的总抗氧化状态和二十二碳六烯酸水平明显低于对照组，而同型半胱氨酸、白细胞介素-6 和肿瘤坏死因子-α水平明显高于对照组。这表明 FEP 患者的抗氧化状态降低，炎症失衡，这些生物学过程可能是治疗 FEP 的靶点。
