San Diego State University/University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States.
Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía (INNN), Mexico City, Mexico; Neuropsychiatry Department, INNN, Mexico City, Mexico.
Schizophr Res. 2020 Dec;226:13-23. doi: 10.1016/j.schres.2020.01.003. Epub 2020 Feb 20.
Research examining the role of inflammation in psychosis has produced inconsistent results. Variables that influence inflammation, including antipsychotic medication, are inconsistently controlled across studies and variation of inflammatory analytes across stages of psychosis may also influence findings. The purpose of this study was to assess for evidence of immuno-inflammatory dysregulation across the stages of early psychosis. We examined a immuno-inflammatory analytes in subjects at clinical high risk (CHR) for developing a psychotic disorder, antipsychotic-naïve (-n) and antipsychotic treated (-a) subjects in their first episode of psychosis (FEP), and healthy control (HC) subjects.
A total of 11 subjects at CHR, 50 subjects within their FEP (40 FEP-n, 10 FEP-a), and 10 HC subjects were recruited from early psychosis programs in San Diego and Mexico City. Plasma was collected for biomarker assay.
Immuno-inflammatory analytes significantly differed between groups: Interferon-gamma (IFN-γ), Interleukin-10 (IL-10), Eotaxin-1, Interferon Gamma-Induced Protein-10 (IP-10), Monocyte Chemotactic Protein-1 (MCP-1), Macrophage-Derived Chemokine (MDC), Macrophage Inflammatory Protein-1 beta (MIP-1β), Thymus and Activation Regulated Chemokine (TARC), and Brain Derived Neurotropic Factor (BDNF). Post-hoc analyses revealed an overall pattern of higher levels of IL-10, MCP-1, MIP-1β, TARC, and BDNF in CHR as compared to FEP-a, FEP-n, and HC subjects.
Results reveal a profile of immuno-inflammatory dysregulation in early stages of psychosis prior to psychotic conversion and treatment with antipsychotic medication. The CHR phase of early psychosis may represent a period of increased immuno-inflammatory activation, but due to limited sample size, these results deserve replication in a well characterized early psychosis population.
研究炎症在精神病中的作用产生了不一致的结果。影响炎症的变量，包括抗精神病药物，在研究中不一致地得到控制，炎症分析物在精神病各个阶段的变化也可能影响研究结果。本研究的目的是评估早期精神病各个阶段是否存在免疫炎症失调的证据。我们检查了处于精神病发展高危状态（CHR）的受试者、抗精神病药物初治（-n）和首次精神病发作（FEP）的抗精神病药物治疗（-a）受试者以及健康对照（HC）受试者的免疫炎症分析物。
从圣地亚哥和墨西哥城的早期精神病计划中招募了 11 名 CHR 受试者、50 名 FEP 受试者（40 名 FEP-n，10 名 FEP-a）和 10 名 HC 受试者。采集血浆进行生物标志物检测。
免疫炎症分析物在组间存在显著差异：干扰素-γ（IFN-γ）、白细胞介素-10（IL-10）、嗜酸性粒细胞趋化因子-1、干扰素γ诱导蛋白-10（IP-10）、单核细胞趋化蛋白-1（MCP-1）、巨噬细胞来源趋化因子（MDC）、巨噬细胞炎性蛋白-1β（MIP-1β）、胸腺激活调节趋化因子（TARC）和脑源性神经营养因子（BDNF）。事后分析显示，与 FEP-a、FEP-n 和 HC 受试者相比，CHR 受试者的 IL-10、MCP-1、MIP-1β、TARC 和 BDNF 总体水平较高。
结果显示，在精神病转化和抗精神病药物治疗之前的精神病早期阶段存在免疫炎症失调的特征。早期精神病的 CHR 阶段可能代表一个免疫炎症激活增加的时期，但由于样本量有限，这些结果需要在特征明确的早期精神病人群中得到复制。
