Ansari Zarrin, Pawar Sudhir, Seetharaman Rajmohan
Department of Pharmacology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India.
Postgrad Med. 2022 Mar;134(2):187-199. doi: 10.1080/00325481.2021.2006514. Epub 2021 Nov 26.
To summarize the main findings on the subject of neuroinflammation and oxidative stress in patients with Schizophrenia (SCZ).
A narrative review of all the relevant papers known to the authors was conducted.
SCZ is a chronic, debilitating, neuropsychiatric disorder associated with an immense and adverse impact on both the patient and the caregiver, and impairs the overall quality of life. The current modality of treatment involves the use of antipsychotics to balance the disturbances in the neurotransmitters in the dopaminergic and serotonin pathways in the brain, which have a role to play in SCZ. Contemporary management of SCZ focuses mainly on symptomatic control due to the lack of effective curative treatments.Despite the optimum use of antipsychotics, there is a considerable proportion of the patient population who are poor responders. This has necessitated the exploration of new etiopathologies in order to evolve new modalities of treatment. This narrative review, conducted over a period of 3 months, throws light on the large-scale evidence pointing toward neuroinflammation and oxidative stress as key etiopathological markers that merit further consideration in SCZ, and may even be the basis for devising novel pharmacotherapies for SCZ.
This review discusses the various plausible hypotheses, viz., cytokine hypothesis of peripheral inflammation, acute-phase reactants in SCZ, microglial hypothesis of central inflammation, neurogenesis in relation to neuroinflammation, and oxidative stress in SCZ. It also highlights the many opportunities available for repurposing already marketed drugs with anti-inflammatory and antioxidant properties with a view to devising more effective and comprehensive therapies to manage SCZ.
总结精神分裂症(SCZ)患者神经炎症和氧化应激主题的主要研究结果。
对作者所知的所有相关论文进行叙述性综述。
SCZ是一种慢性、使人衰弱的神经精神疾病,对患者和照顾者都有巨大的负面影响,并损害整体生活质量。目前的治疗方式包括使用抗精神病药物来平衡大脑中多巴胺能和血清素途径中神经递质的紊乱,这些途径在SCZ中起作用。由于缺乏有效的治愈性治疗方法,SCZ的当代管理主要集中在症状控制上。尽管抗精神病药物得到了最佳使用,但仍有相当一部分患者反应不佳。这就需要探索新的病因病理,以发展新的治疗方式。这项为期3个月的叙述性综述揭示了大量证据,表明神经炎症和氧化应激是SCZ中值得进一步考虑的关键病因病理标志物,甚至可能是为SCZ设计新型药物疗法的基础。
本综述讨论了各种合理的假设,即外周炎症的细胞因子假说、SCZ中的急性期反应物、中枢炎症的小胶质细胞假说、与神经炎症相关的神经发生以及SCZ中的氧化应激。它还强调了重新利用已上市的具有抗炎和抗氧化特性的药物的诸多机会,以期设计出更有效、更全面的疗法来治疗SCZ。