University of Groningen, University Medical Center Groningen, Research School of Behavioral and Cognitive Neurosciences (BCN), Groningen, The Netherlands; University of Groningen, University Medical Centre Groningen, Department of Psychiatry, Groningen, The Netherlands; University of Groningen, University Medical Centre Groningen, Department of Biomedical Sciences, Cells and Systems, Groningen, The Netherlands.
Hôpitaux de Paris, Université Paris Est Créteil DMU Impact, Department of Addictology and Psychiatry, Mondor University Hospitals, Créteil, France; INSERM U955, IMRB, Team 15, "Translational NeuroPsychiatry", Créteil, France; Fondation FondaMental, Créteil, France.
Eur Neuropsychopharmacol. 2021 Apr;45:108-121. doi: 10.1016/j.euroneuro.2020.11.001. Epub 2020 Nov 12.
Diverse lines of research testify a link, presumably causal, between immune dysregulation and the development, course and clinical outcome of psychiatric disorders. However, there is a large heterogeneity among the patients' individual immune profile and this heterogeneity prevents the development of precise diagnostic tools and the identification of therapeutic targets. The aim of this review was to delineate possible subgroups of patients on the basis of clinical dimensions, investigating whether they could lead to particular immune signatures and tailored treatments. We discuss six clinical entry points; genetic liability to immune dysregulation, childhood maltreatment, metabolic syndrome, cognitive dysfunction, negative symptoms and treatment resistance. We describe the associated immune signature and outline the effects of anti-inflammatory drugs so far. Finally, we discuss advantages of this approach, challenges and future research directions.
多项研究表明，免疫失调与精神障碍的发生、病程和临床转归之间可能存在因果关系。然而，患者个体的免疫特征存在很大的异质性，这种异质性阻碍了精确诊断工具的开发和治疗靶点的确定。本综述旨在基于临床维度描绘可能的患者亚组，探讨它们是否能导致特定的免疫特征和针对性的治疗。我们讨论了六个临床切入点；免疫失调的遗传易感性、儿童期虐待、代谢综合征、认知功能障碍、阴性症状和治疗抵抗。我们描述了相关的免疫特征，并概述了迄今为止抗炎药物的作用。最后，我们讨论了这种方法的优点、挑战和未来的研究方向。
