Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.
Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.
Psychoneuroendocrinology. 2021 May;127:105200. doi: 10.1016/j.psyneuen.2021.105200. Epub 2021 Mar 13.
Subclinical inflammation has been associated with psychosis; however, it remains unknown whether this phenomenon appears also in the premorbid phase. Therefore, we performed a systematic review and meta-analysis of studies comparing peripheral blood levels of C-reactive protein (CRP) and cytokines between individuals at risk of psychosis and controls. Moreover, we tested the hypothesis that the levels of these markers may be different in high-risk converters versus non-converters. Two independent reviewers searched electronic databases until Dec 16th, 2020. After reviewing publication records, 16 studies (548 high-risk individuals and 559 controls) were included. Random-effects meta-analyses with Hedges' g as the effect size estimate were performed. Individuals at clinical risk of psychosis had significantly higher levels of interleukin-6 (IL-6) compared to controls (g = 0.33, 95%CI: 0.06-0.60, p = 0.018). Heterogeneity was not significant in this subgroup analysis. Changes in the levels of IL-6 in subjects at familial risk of psychosis were not significant (g = 0.04, 95%CI: -0.24 to 0.31, p = 0.798). The use of antidepressants was associated with significantly higher levels of IL-6 in high-risk individuals (Beta = 1.56, 95%CI: 0.60-2.53, p = 0.001). No significant differences in the levels of immune-inflammatory markers were found between high-risk converters and non-converters. Our findings suggest that individuals at clinical risk of psychosis show subclinical inflammation in terms of elevated IL-6 levels. This phenomenon might be related to the use of antidepressants. The present meta-analysis does not support the usefulness of single immune-inflammatory markers in predicting transition to psychosis.
亚临床炎症与精神病有关；然而，这种现象是否也出现在发病前阶段尚不清楚。因此，我们对比较精神病高危人群和对照组外周血 C 反应蛋白 (CRP) 和细胞因子水平的研究进行了系统评价和荟萃分析。此外，我们还检验了这样一种假设，即这些标志物的水平在高风险转化者和非转化者之间可能不同。两位独立的审查员搜索了电子数据库，直到 2020 年 12 月 16 日。在审查出版记录后，纳入了 16 项研究（548 名高危个体和 559 名对照）。使用 Hedge's g 作为效应量估计值进行随机效应荟萃分析。有精神病临床风险的个体的白细胞介素-6 (IL-6) 水平明显高于对照组（g = 0.33，95%CI：0.06-0.60，p = 0.018）。在这个亚组分析中，异质性不显著。精神病家族风险个体的 IL-6 水平变化不显著（g = 0.04，95%CI：-0.24 至 0.31，p = 0.798）。抗抑郁药的使用与高危个体中 IL-6 水平显著升高有关（Beta = 1.56，95%CI：0.60-2.53，p = 0.001）。高危转化者和非转化者之间的免疫炎症标志物水平没有显著差异。我们的研究结果表明，有精神病临床风险的个体表现出亚临床炎症，表现为升高的 IL-6 水平。这种现象可能与抗抑郁药的使用有关。本荟萃分析不支持单一免疫炎症标志物在预测精神病转化中的有用性。
