Orbe Elif Bayram, Benros Michael Eriksen
Copenhagen Research Centre for Biological and Precision Psychiatry, Mental Health Centre Copenhagen, Copenhagen University Hospital, 2900 Hellerup, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 1172 Copenhagen, Denmark.
J Pers Med. 2023 Sep 15;13(9):1382. doi: 10.3390/jpm13091382.
Psychotic disorders, notably schizophrenia, impose a detrimental burden on both an individual and a societal level. The mechanisms leading to psychotic disorders are multifaceted, with genetics and environmental factors playing major roles. Increasing evidence additionally implicates neuro-inflammatory processes within at least a subgroup of patients with psychosis. While numerous studies have investigated anti-inflammatory add-on treatments to current antipsychotics, the exploration of immunological biomarkers as a predictor of treatment response remains limited. This review outlines the current evidence from trials exploring the potential of baseline inflammatory biomarkers as predictors of the treatment effect of anti-inflammatory drugs as add-ons to antipsychotics and of antipsychotics alone. Several of the studies have found correlations between baseline immunological biomarkers and treatment response; however, only a few studies incorporated baseline biomarkers as a primary endpoint, and the findings thus need to be interpreted with caution. Our review emphasizes the need for additional research on the potential of repurposing anti-inflammatory drugs while utilizing baseline inflammatory biomarkers as a predictor of treatment response and to identify subgroups of individuals with psychotic disorders where add-on treatment with immunomodulating agents would be warranted. Future studies investigating the correlation between baseline inflammatory markers and treatment responses can pave the way for personalized medicine approaches in psychiatry centred around biomarkers such as specific baseline inflammatory biomarkers in psychotic disorders.
精神障碍，尤其是精神分裂症，在个人和社会层面都造成了有害负担。导致精神障碍的机制是多方面的，遗传和环境因素起着主要作用。越来越多的证据还表明，至少在一部分精神病患者中存在神经炎症过程。虽然众多研究调查了在当前抗精神病药物基础上加用抗炎治疗，但将免疫生物标志物作为治疗反应预测指标的探索仍然有限。本综述概述了目前来自试验的证据，这些试验探讨了基线炎症生物标志物作为抗炎药物作为抗精神病药物附加治疗以及单独使用抗精神病药物治疗效果预测指标的潜力。一些研究发现基线免疫生物标志物与治疗反应之间存在相关性；然而，只有少数研究将基线生物标志物纳入主要终点，因此对这些发现需要谨慎解读。我们的综述强调，需要进一步研究重新利用抗炎药物的潜力，同时利用基线炎症生物标志物作为治疗反应的预测指标，并确定精神障碍患者中哪些亚组有必要接受免疫调节剂附加治疗。未来研究基线炎症标志物与治疗反应之间的相关性，可以为以生物标志物为中心的精神病学个性化医疗方法铺平道路，例如精神障碍中的特定基线炎症生物标志物。
