Department of Psychiatry and Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZAmsterdam, the Netherlands.
Parnassia Academy, Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DHThe Hague, the Netherlands.
Psychol Med. 2021 Mar;51(4):538-549. doi: 10.1017/S0033291721000155. Epub 2021 Mar 3.
This meta-analysis on peripheral blood compounds in drug-naïve first-episode patients with either schizophrenia or major depressive disorder (MDD) examined which compounds change following psychopharmacological treatment.
The Embase, PubMed and PsycINFO databases were systematically searched for longitudinal studies reporting measurements of blood compounds in drug-naïve first-episode schizophrenia or MDD.
For this random-effects meta-analysis, we retrieved a total of 31 studies comprising 1818 schizophrenia patients, and 14 studies comprising 469 MDD patients. Brain-derived neurotrophic factor (BDNF) increased following treatment in schizophrenia (Hedges' g (g): 0.55; 95% confidence interval (CI) 0.39-0.70; p < 0.001) and MDD (g: 0.51; CI 0.06-0.96; p = 0.027). Interleukin (IL)-6 levels decreased in schizophrenia (g: -0.48; CI -0.85 to -0.11; p = 0.011), and for MDD a trend of decreased IL-6 levels was observed (g: -0.39; CI -0.87 to 0.09; p = 0.115). Tumor necrosis factor alpha (TNFα) also decreased in schizophrenia (g: -0.34; CI -0.68 to -0.01; p = 0.047) and in MDD (g: -1.02; CI -1.79 to -0.25; p = 0.009). Fasting glucose levels increased only in schizophrenia (g: 0.26; CI 0.07-0.44; p = 0.007), but not in MDD. No changes were found for C-reactive protein, IL-1β, IL-2 and IL-4.
Psychopharmacological treatment has modulating effects on BDNF and TNFα in drug-naïve first-episode patients with either schizophrenia or MDD. These findings support efforts for further research into transdiagnostic preventive strategies and augmentation therapy for those with immune dysfunctions.
本项针对未用药首发精神分裂症或重性抑郁障碍（MDD）患者外周血化合物的荟萃分析，旨在探讨精神药理学治疗后哪些化合物会发生变化。
系统检索了 Embase、PubMed 和 PsycINFO 数据库，以获取报告未用药首发精神分裂症或 MDD 患者血液化合物测量值的纵向研究。
本随机效应荟萃分析共纳入 31 项研究，包括 1818 例精神分裂症患者和 14 项研究，共纳入 469 例 MDD 患者。精神分裂症患者治疗后脑源性神经营养因子（BDNF）升高（Hedges' g：0.55；95%置信区间（CI）：0.39-0.70；p<0.001），MDD 患者也有升高趋势（g：0.51；CI：0.06-0.96；p=0.027）。精神分裂症患者白细胞介素（IL）-6 水平降低（g：-0.48；CI：-0.85 至-0.11；p=0.011），MDD 患者则观察到 IL-6 水平降低的趋势（g：-0.39；CI：-0.87 至 0.09；p=0.115）。肿瘤坏死因子-α（TNFα）在精神分裂症患者（g：-0.34；CI：-0.68 至-0.01；p=0.047）和 MDD 患者（g：-1.02；CI：-1.79 至-0.25；p=0.009）中也降低。仅在精神分裂症患者中发现空腹血糖水平升高（g：0.26；CI：0.07-0.44；p=0.007），而在 MDD 患者中未发现变化。C 反应蛋白、IL-1β、IL-2 和 IL-4 未发生变化。
精神药理学治疗对未用药首发精神分裂症或 MDD 患者的 BDNF 和 TNFα 具有调节作用。这些发现支持进一步研究免疫功能障碍患者的跨诊断预防策略和增效治疗。
