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强迫症:自身免疫与神经炎症。

Obsessive-Compulsive Disorder: Autoimmunity and Neuroinflammation.

机构信息

Inserm U955, Team 15, Genetic Psychiatry, 94000, Creteil, France.

AP-HP, DHU Pe-PSY, Henri Mondor - Albert Chenevier, group, Psychiatry, 94000, Creteil, France.

出版信息

Curr Psychiatry Rep. 2019 Aug 1;21(8):78. doi: 10.1007/s11920-019-1062-8.

Abstract

PURPOSE OF REVIEW

Here, we propose to review the immuno-inflammatory hypothesis in OCD given the concurrent incidence of autoimmune comorbidities, infectious stigma, and raised levels of inflammatory markers in a significant subset of patients. A better understanding of the immune dysfunction in OCD may allow stratifying the patients in order to design personalized pharmaco/psychotherapeutic strategies.

RECENT FINDINGS

A persistent low-grade inflammation involving both innate and adaptive immune system with coexisting autoimmune morbidities and stigma of infectious events has been prominently observed in OCD. Hence, specific treatments targeting inflammation/infection are a feasible alternative in OCD. This review highlights that OCD is associated with low-grade inflammation, neural antibodies, and neuro-inflammatory and auto-immune disorders. In some subset of OCD patients, autoimmunity is likely triggered by specific bacterial, viral, or parasitic agents with overlapping surface epitopes in CNS. Hence, subset-profiling in OCD is warranted to benefit from distinct immune-targeted treatment modalities.

摘要

目的综述

鉴于强迫症(OCD)并发自身免疫性合并症、传染性耻辱和相当一部分患者炎症标志物升高,我们提出在此重新审视 OCD 的免疫炎症假说。更好地了解 OCD 中的免疫功能障碍可能允许对患者进行分层,以便设计个性化的药物/心理治疗策略。

最近的发现

在 OCD 中,观察到涉及固有和适应性免疫系统的持续性低度炎症,同时存在自身免疫性疾病和传染性事件的耻辱感。因此,针对炎症/感染的特定治疗是 OCD 的一种可行选择。这篇综述强调 OCD 与低度炎症、神经抗体以及神经炎症和自身免疫性疾病有关。在 OCD 的某些患者亚群中,自身免疫可能是由中枢神经系统中具有重叠表面表位的特定细菌、病毒或寄生虫病原体触发的。因此,有必要对 OCD 进行亚组分析,以受益于独特的免疫靶向治疗方式。

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