Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Department of Immunopathology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Early Interv Psychiatry. 2023 Feb;17(2):183-191. doi: 10.1111/eip.13319. Epub 2022 Jun 14.
Considering Acute and Transient psychotic disorders (ATPDs) to be a close entity to Schizophrenia (SZ) with a completely different course and outcome, studies evaluating the immunological abnormalities are scarce in ATPDs. We analysed immune-mediated inflammatory marker levels [Interleukin-2 (IL-2), Interleukin-4 (IL-4), Interleukin-6 (IL-6), Interleukin-8 (IL-8), Interleukin-17 (IL-17) and Tumour necrosis factor-alpha (TNF-α)] in patients with ATPDs (in the acute phase and after remission), and compared these with patients with SZ in remission and with healthy controls.
Ninteen subjects with ATPDs in acute phase of illness were age-/gender-matched with healthy controls and patients with schizophrenia in remission; recruited through purposive sampling. Clinical assessment and immune-marker levels were carried out in all the three groups. Follow -up repeat immune-marker levels assessment in the ATPD group was conducted after remission status was ensured. Immune-marker levels were compared across the three groups.
Patients with ATPDs had elevated levels of the pro-inflammatory cytokines IL-6 and IL-17 and low levels of IL-8 in the acute phase and low levels of IL-6 and elevated levels of IL-8 during the remission phase. Compared to patients with SZ in remission, patients with ATPD in remission had low levels of all the three pro-inflammatory cytokines (with significantly low IL-6 levels and non-significant, yet low levels of IL-8 and IL-17) and had significantly low and high levels of IL-6 and IL-8 respectively than healthy controls.
These findings suggest that there existed immunological abnormalities in the acute and remission phase of illness in patients with ATPDs compared to both patients with SZ in remission and healthy controls.
鉴于急性和短暂性精神病障碍（ATPDs）与精神分裂症（SZ）密切相关，具有完全不同的病程和结局，因此评估免疫异常的研究在 ATPDs 中很少见。我们分析了免疫介导的炎症标志物水平[白细胞介素 2（IL-2）、白细胞介素 4（IL-4）、白细胞介素 6（IL-6）、白细胞介素 8（IL-8）、白细胞介素 17（IL-17）和肿瘤坏死因子-α（TNF-α）]在 ATPDs 患者（急性发作期和缓解期）中的水平，并将这些水平与缓解期 SZ 患者和健康对照组进行了比较。
通过目的抽样，从急性发作期的 19 名 ATPDs 患者中招募年龄和性别匹配的健康对照者和缓解期的 SZ 患者。对所有三组患者进行临床评估和免疫标志物水平检测。在确保缓解状态后，对 ATPD 组进行重复的免疫标志物水平评估。比较三组之间的免疫标志物水平。
ATPDS 患者在急性发作期具有升高的促炎细胞因子 IL-6 和 IL-17 水平和降低的 IL-8 水平，在缓解期具有降低的 IL-6 和升高的 IL-8 水平。与缓解期的 SZ 患者相比，缓解期的 ATPD 患者的三种促炎细胞因子水平均较低（IL-6 水平显著降低，IL-8 和 IL-17 水平非显著降低），且与健康对照组相比，IL-6 和 IL-8 的水平分别显著降低和升高。
这些发现表明，与缓解期的 SZ 患者和健康对照组相比，ATPDS 患者在急性和缓解期都存在免疫异常。
