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精神分裂症的药物治疗:免疫学方面及免疫治疗的潜在作用。

Pharmacotherapy of schizophrenia: immunological aspects and potential role of immunotherapy.

机构信息

Multidisciplinary Research Unit, Government Medical College & Hospital, Chandigarh, India.

Department of Physiology, Government Medical College & Hospital, Chandigarh, India.

出版信息

Expert Rev Neurother. 2021 Dec;21(12):1441-1453. doi: 10.1080/14737175.2021.1994857. Epub 2021 Oct 28.

Abstract

INTRODUCTION

Schizophrenia is a complex disorder owing to diversity in clinical phenotypes, overlapping symptoms, and heterogeneous clinical presentation. Even after decades of research, the exact causative mechanisms of schizophrenia are not completely known. Recent evidence indicates the role of immune dysfunction in schizophrenia pathogenesis as observed from alteration in immune cells, increased activity of complement cascade, and development of autoantibodies against neurotransmitter receptors. Immunotherapy involving immunosuppressants and cytokine-targeting drugs, have shown promising results in several clinical studies and it demands further research in this area.

AREAS COVERED

Here, the authors review the immunopathogenesis of schizophrenia, limitations of conventional, and atypical antipsychotic drugs and the potential role and limitations of immunotherapeutic drugs in schizophrenia management.

EXPERT OPINION

Schizophrenia is a complex disorder and poses a challenge to the currently available treatment approaches. Nearly 30% schizophrenia patients exhibit minimal response toward conventional and atypical antipsychotic drugs. Immune system dysfunction plays an important part of schizophrenia pathophysiology and existing monoclonal antibody (mAb) drugs targeting specific components of the immune system are being repositioned in schizophrenia. The authors call upon public and private funders to facilitate urgent and rigorous research efforts in exploring potential role of immunotherapy in schizophrenia.

摘要

简介

精神分裂症是一种复杂的疾病,其临床表型多样,症状重叠,临床表现异质性。即使经过几十年的研究,精神分裂症的确切病因机制仍不完全清楚。最近的证据表明,免疫功能障碍在精神分裂症发病机制中起作用,这可以从免疫细胞的改变、补体级联的活性增加以及神经递质受体自身抗体的发展中观察到。免疫疗法涉及免疫抑制剂和细胞因子靶向药物,在几项临床研究中显示出有前景的结果,这需要在该领域进行进一步的研究。

涵盖领域

作者在这里回顾了精神分裂症的免疫发病机制、传统和非典型抗精神病药物的局限性以及免疫治疗药物在精神分裂症管理中的潜在作用和局限性。

专家意见

精神分裂症是一种复杂的疾病,目前的治疗方法存在挑战。近 30%的精神分裂症患者对传统和非典型抗精神病药物的反应甚微。免疫系统功能障碍在精神分裂症的病理生理学中起着重要的作用,现有的针对免疫系统特定成分的单克隆抗体(mAb)药物正在被重新定位用于治疗精神分裂症。作者呼吁公共和私人资金支持,以促进在探索免疫疗法在精神分裂症中的潜在作用方面的紧急和严格的研究工作。

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