Ermakov Evgeny A, Melamud Mark M, Buneva Valentina N, Ivanova Svetlana A
Laboratory of Repair Enzymes, Institute of Chemical Biology and Fundamental Medicine, Novosibirsk, Russia.
Department of Natural Sciences, Novosibirsk State University, Novosibirsk, Russia.
Front Psychiatry. 2022 Apr 25;13:880568. doi: 10.3389/fpsyt.2022.880568. eCollection 2022.
The immune system is generally known to be the primary defense mechanism against pathogens. Any pathological conditions are reflected in anomalies in the immune system parameters. Increasing evidence suggests the involvement of immune dysregulation and neuroinflammation in the pathogenesis of schizophrenia. In this systematic review, we summarized the available evidence of abnormalities in the immune system in schizophrenia. We analyzed impairments in all immune system components and assessed the level of bias in the available evidence. It has been shown that schizophrenia is associated with abnormalities in all immune system components: from innate to adaptive immunity and from humoral to cellular immunity. Abnormalities in the immune organs have also been observed in schizophrenia. Evidence of increased C-reactive protein, dysregulation of cytokines and chemokines, elevated levels of neutrophils and autoantibodies, and microbiota dysregulation in schizophrenia have the lowest risk of bias. Peripheral immune abnormalities contribute to neuroinflammation, which is associated with cognitive and neuroanatomical alterations and contributes to the pathogenesis of schizophrenia. However, signs of severe inflammation are observed in only about 1/3 of patients with schizophrenia. Immunological parameters may help identify subgroups of individuals with signs of inflammation who well respond to anti-inflammatory therapy. Our integrative approach also identified gaps in knowledge about immune abnormalities in schizophrenia, and new horizons for the research are proposed.
免疫系统通常被认为是抵御病原体的主要防御机制。任何病理状况都会反映在免疫系统参数的异常中。越来越多的证据表明免疫失调和神经炎症参与了精神分裂症的发病机制。在本系统综述中，我们总结了精神分裂症患者免疫系统异常的现有证据。我们分析了所有免疫系统组成部分的损伤情况，并评估了现有证据中的偏倚程度。研究表明，精神分裂症与所有免疫系统组成部分的异常有关：从先天免疫到适应性免疫，从体液免疫到细胞免疫。在精神分裂症患者中还观察到免疫器官的异常。精神分裂症患者中C反应蛋白升高、细胞因子和趋化因子失调、中性粒细胞和自身抗体水平升高以及微生物群失调的证据存在的偏倚风险最低。外周免疫异常会导致神经炎症，这与认知和神经解剖学改变有关，并促成了精神分裂症的发病机制。然而，只有约1/3的精神分裂症患者会出现严重炎症迹象。免疫参数可能有助于识别有炎症迹象且对抗炎治疗反应良好的个体亚组。我们的综合方法还发现了关于精神分裂症免疫异常的知识空白，并提出了新的研究方向。
