Unit of Psychiatry, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy.
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
Int J Environ Res Public Health. 2022 May 5;19(9):5616. doi: 10.3390/ijerph19095616.
Evidence indicates shared physiopathological mechanisms between autism and psychosis. In this regard, the endocannabinoid system has been suggested to modulate neural circuits during the early stage of neurodevelopment, with implications for both autism and psychosis. Nevertheless, such potential common markers of disease have been investigated in both autism and psychosis spectrum disorders, without considering the conundrum of differentiating the two groups of conditions in terms of diagnosis and treatment. Here, we systematically review all human and animal studies examining the endocannabinoid system and its biobehavioral correlates in the association between autism and psychosis. Studies indicate overlapping biobehavioral aberrancies between autism and schizophrenia, subject to correction by modulation of the endocannabinoid system. In addition, common cannabinoid-based pharmacological strategies have been identified, exerting epigenetic effects across genes controlling neural mechanisms shared between autism and schizophrenia. Interestingly, a developmental and transgenerational trajectory between autism and schizophrenia is supported by evidence that exogenous alteration of the endocannabinoid system promotes progression to inheritable psychosis phenotypes in the context of biobehavioral autism vulnerability. However, evidence for a diametral association between autism and psychosis is scant. Several clinical implications follow from evidence of a developmental continuum between autism and psychosis as a function of the endocannabinoid system dysregulation.
证据表明自闭症和精神病之间存在共同的生理病理机制。在这方面，内源性大麻素系统被认为可以在神经发育的早期调节神经回路，这对自闭症和精神病都有影响。然而，在自闭症和精神病谱系障碍中都研究了这些潜在的疾病共同标志物，但没有考虑到在诊断和治疗方面区分这两组疾病的难题。在这里，我们系统地回顾了所有研究自闭症和精神病之间关联的人类和动物研究，这些研究检查了内源性大麻素系统及其生物行为相关性。研究表明，自闭症和精神分裂症之间存在重叠的生物行为异常，可以通过内源性大麻素系统的调节来纠正。此外，已经确定了常见的基于大麻素的药理学策略，这些策略对控制自闭症和精神分裂症之间共享神经机制的基因产生了表观遗传效应。有趣的是，有证据表明自闭症和精神分裂症之间存在发育和跨代轨迹，即外源性改变内源性大麻素系统会促进生物行为自闭症脆弱性背景下可遗传精神病表型的发展。然而，自闭症和精神病之间存在截然相反的关联的证据很少。自闭症和精神病之间存在发育连续性的证据表明，内源性大麻素系统失调是一个重要的因素。
