Université Paris-Est Créteil (UPEC), INSERM, IMRB, Translational Neuropsychiatry, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Fondation FondaMental, F-94010 Créteil, France.
Inserm, Centre d'Investigation Clinique 1430 et AP-HP, Hôpitaux Universitaires Henri Mondor, Univ Paris Est Creteil, F-94010 Créteil, France.
Brain Behav Immun. 2023 Aug;112:42-50. doi: 10.1016/j.bbi.2023.05.015. Epub 2023 May 30.
A history of Childhood Maltreatment (CM) has been repeatedly associated with an increased risk of developing bipolar disorders (BD) or schizophrenia (SZ). The impact of severe stress induced by CM has been proposed to be mediated by elevated inflammation reflected by dysregulated inflammatory processes. Little is known about the potential impact of CM on lymphocyte subpopulations or the role of pre-existing infections on CM physiological consequences. This study therefore explored the role of CM and past infection exposure impact on lymphocyte subpopulations to give an indication of their relevance as stressors in the pathoetiology of major mood and psychotic disorders. 118 adult patients with SZ, and 152 with BD were included in the analysis. CM history was assessed by the Childhood Trauma Questionnaire (CTQ), with current and past psychiatric symptomatology also evaluated. Circulating immune cell subsets were analyzed using flow cytometry-based analysis. Past exposure to common infectious stigma including toxoplasma, cytomegalovirus (CMV) and Epstein-Barr virus (EBV) were measured by solid phase-enzyme microplate and ELISA immunoassays. The relationship between CM, biological phenotypes (including immune cell subsets distribution and past infectious status) and clinical phenotypes were analyzed using univariate and multivariate analyses. BD patients with, versus without, CM had higher levels of CD3CD8 cytotoxic T cells and CMV antibodies along with decreased levels of CD45RACCR7CD8 naïve CD8 T cells, and a more severe clinical profile. CMV antibody levels were inversely associated with the CD3 + CD8 + lymphocyte subset level. SZ patients with, versus without, CM, showed lower levels of CD14 + monocytes and no specific clinical characteristics. The accumulation of different types of maltreatment associated with increased body mass index and CMV autoantibodies as well as decreased levels of CD14 + monocytes. In both BD and SZ, further analysis according to the type and the number of CM subtypes showed association with specific changes in lymphocyte cell subsets, clinical profile, and infectious stigma. Adults with BD or SZ exposed to CM exhibit specific immune cell subset profiles, clinical features, and stigma of past infections. In BD, our data indicate an interplay between CM and CMV infections, which may possibly contribute to premature aging and cellular senescence, both of which have previously been shown to associate with mood disorders. Longitudinal studies of CM-exposed patients are required to clarify the interactions of CM and viral infections, including as to the pathophysiological processes driving patient symptomatology.
童年期虐待(CM)史与双相障碍(BD)或精神分裂症(SZ)的发病风险增加有关。CM 引起的严重应激的影响被认为是通过失调的炎症过程反映的炎症升高来介导的。关于 CM 对淋巴细胞亚群的潜在影响,或既往感染对 CM 生理后果的作用,知之甚少。因此,这项研究探讨了 CM 和既往感染暴露对淋巴细胞亚群的影响,以了解它们作为主要情绪和精神病性障碍发病机制中的应激源的相关性。纳入了 118 名 SZ 成年患者和 152 名 BD 患者进行分析。通过童年创伤问卷(CTQ)评估 CM 史,同时评估当前和既往的精神症状。使用流式细胞术分析循环免疫细胞亚群。通过固相酶微板和 ELISA 免疫测定法测量常见感染标志物,包括弓形体、巨细胞病毒(CMV)和 EB 病毒(EBV)的既往暴露情况。使用单变量和多变量分析分析 CM、生物学表型(包括免疫细胞亚群分布和既往感染状态)和临床表型之间的关系。与无 CM 的 BD 患者相比,有 CM 的 BD 患者具有更高水平的 CD3+CD8+细胞毒性 T 细胞和 CMV 抗体,同时具有更低水平的 CD45RA+CCR7+CD8+幼稚 CD8+T 细胞和更严重的临床特征。CMV 抗体水平与 CD3+CD8+淋巴细胞亚群水平呈负相关。与无 CM 的 SZ 患者相比,有 CM 的 SZ 患者具有更低水平的 CD14+单核细胞,且无特定的临床特征。不同类型的虐待累积与体重指数增加和 CMV 自身抗体增加以及 CD14+单核细胞水平降低有关。在 BD 和 SZ 中,根据 CM 亚型的类型和数量进一步分析显示,与淋巴细胞细胞亚群、临床特征和既往感染标志物的特定变化有关。暴露于 CM 的 BD 或 SZ 成年患者表现出特定的免疫细胞亚群特征、临床特征和既往感染标志物。在 BD 中,我们的数据表明 CM 和 CMV 感染之间存在相互作用,这可能导致过早衰老和细胞衰老,这两者先前都与情绪障碍有关。需要对暴露于 CM 的患者进行纵向研究,以阐明 CM 和病毒感染之间的相互作用,包括驱动患者症状的病理生理过程。