Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Clinic of Neurology and Neurophysiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Fluids Barriers CNS. 2022 Jul 29;19(1):61. doi: 10.1186/s12987-022-00355-7.
Infectious and immunological theories of schizophrenia have been discussed for over a century. Contradictory results for infectious agents in association with schizophrenia spectrum disorders (SSDs) were reported. The rationale of this study was to investigate intrathecal antibody synthesis of the most frequently discussed neurotropic pathogens using a pathogen-specific antibody index (AI) in patients with SSD in comparison to controls.
In 100 patients with SSD and 39 mentally healthy controls with idiopathic intracranial hypertension (IIH), antibodies against the herpesviruses EBV, CMV, and HSV 1/2 as well as the protozoan Toxoplasma gondii, were measured in paired cerebrospinal fluid (CSF) and serum samples with ELISA-kits. From these antibody concentrations the pathogen-specific AIs were determined with the assumption of intrathecal antibody synthesis at values > 1.5.
No significant difference was detected in the number of SSD patients with elevated pathogen-specific AI compared to the control group. In a subgroup analysis, a significantly higher EBV AI was observed in the group of patients with chronic SSD compared to patients with first-time SSD diagnosis (p = 0.003). In addition, two identified outlier EBV patients showed evidence for polyspecific immune reactions (with more than one increased AI).
Evidence for the role of intrathecal EBV antibody synthesis was found in patients with chronic SSD compared to those first diagnosed. Apart from a possible infectious factor in SSD pathophysiology, the evidence for polyspecific immune response in outlier patients may also suggest the involvement of further immunological processes in a small subgroup of SSD patients.
精神分裂症的感染和免疫学理论已经讨论了一个多世纪。 与精神分裂症谱系障碍（SSDs）相关的感染因子的结果相互矛盾。 本研究的目的是使用最常讨论的神经亲和病原体的病原体特异性抗体指数（AI），在 SSD 患者中与对照组相比，研究鞘内抗体合成。
在 100 例 SSD 患者和 39 例特发性颅内高压（IIH）的心理健康对照者中，使用 ELISA 试剂盒测量针对疱疹病毒 EBV、CMV 和 HSV 1/2 以及原生动物弓形体的抗体，针对配对的脑脊液（CSF）和血清样本。 根据这些抗体浓度，假设在值 > 1.5 时存在鞘内抗体合成，确定病原体特异性 AIs。
与对照组相比，具有升高的病原体特异性 AI 的 SSD 患者数量没有显着差异。 在亚组分析中，与首次 SSD 诊断的患者相比，慢性 SSD 患者的 EBV AI 显着升高（p = 0.003）。 此外，两名确定的 EBV 患者异常值表现出多特异性免疫反应的证据（具有超过一种增加的 AI）。
与首次诊断的 SSD 患者相比，在慢性 SSD 患者中发现了鞘内 EBV 抗体合成的作用证据。 除了 SSD 病理生理学中可能存在感染因素外，异常值患者多特异性免疫反应的证据也可能表明在一小部分 SSD 患者中涉及进一步的免疫过程。
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