Miljevic Cedo, Munjiza-Jovanovic Ana, Jovanovic Teodora
Department of Psychiatry, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Clinical Trial Unit, Institute of Mental Health, Belgrade, Serbia.
Neuropsychiatr Dis Treat. 2023 Mar 11;19:579-586. doi: 10.2147/NDT.S396168. eCollection 2023.
Even though inflammation theory has been introduced in the pathophysiology of psychosis almost a century ago, many of its aspects have remained unelucidated. Numerous studies have shown cytokine dysregulation in schizophrenia and a predominance of pro-inflammatory cytokines, but on another side, various cytokines in a pro-inflammatory group have different trends in all subtypes of schizophrenia. Alterations are also present in anti-inflammatory and regulatory cytokines, but findings are still not consistent. On the other hand, it is well known that abuse and neglect in childhood may be predictors of psychotic disorders, and childhood adversity is also associated with alterations of the immune and inflammatory response (through various mechanisms including HPA dysregulation as well). This review aims to analyze conducted studies and elucidate the link between childhood abuse, schizophrenia, and cytokine alterations. Putting together this complex psycho-immunological puzzle for the subgroup of schizophrenia-diagnosed patients with distinct immunological abnormalities and a history of childhood abuse can help us to answer the question about the future treatment of these patients.
尽管炎症理论在近一个世纪前就已被引入精神病的病理生理学中,但其许多方面仍未阐明。大量研究表明,精神分裂症患者存在细胞因子失调,促炎细胞因子占主导,但另一方面,促炎细胞因子组中的各种细胞因子在精神分裂症的所有亚型中具有不同的趋势。抗炎和调节性细胞因子也存在改变,但研究结果仍不一致。另一方面,众所周知,童年期的虐待和忽视可能是精神障碍的预测因素,童年期逆境也与免疫和炎症反应的改变有关(通过包括下丘脑-垂体-肾上腺轴失调在内的各种机制)。本综述旨在分析已开展的研究,阐明童年期虐待、精神分裂症和细胞因子改变之间的联系。为患有明显免疫异常且有童年期虐待史的精神分裂症诊断患者拼凑这个复杂的心理免疫学谜题,有助于我们回答这些患者未来治疗的问题。