Copenhagen Research Center for Biological and Precision Psychiatry, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Copenhagen Research Center for Biological and Precision Psychiatry, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.
Biol Psychiatry. 2024 Sep 1;96(5):331-341. doi: 10.1016/j.biopsych.2023.11.029. Epub 2024 Jan 6.
A comprehensive meta-analysis on the composition of circulating immune cells from both the myeloid and the lymphoid lines including specialized subsets in blood and cerebrospinal fluid (CSF) of patients with psychotic disorders compared with healthy control participants has been lacking.
Multiple databases (PubMed, EMBASE, Cochrane Library, Web of Science, ClinicalTrials.gov, and PsycINFO) were searched for eligible studies up until October 18, 2022. All studies investigating circulating immune cells in the blood and CSF from patients with psychotic disorders (ICD-10: F20 and F22-29) compared with healthy control participants were included.
A total of 86 studies were included in the meta-analysis. In the blood, the following categories of immune cells were elevated: leukocyte count (31 studies, standardized mean difference [SMD] = 0.35; 95% CI, 0.24 to 0.46), granulocyte count (4 studies, SMD = 0.57; 95% CI, 0.12 to 1.01), neutrophil granulocyte count (21 studies, SMD = 0.32; 95% CI, 0.11 to 0.54), monocyte count (23 studies, SMD = 0.40; 95% CI, 0.23 to 0.56), and B lymphocyte count (10 studies, SMD = 0.26; 95% CI, 0.04 to 0.48). Additionally, the neutrophil/lymphocyte ratio (23 studies, SMD = 0.40; 95% CI, 0.19 to 0.60), the monocyte/lymphocyte ratio (9 studies, SMD = 0.31; 95% CI, 0.04 to 0.57), and the platelet/lymphocyte ratio (10 studies, SMD = 0.23; 95% CI, 0.03 to 0.43) were elevated. The CSF cell count showed a similar tendency but was not significantly elevated (3 studies, SMD = 0.14; 95% CI, -0.04 to 0.32).
The results indicate a broad activation of the immune system in psychotic disorders, with cells from both the myeloid and the lymphoid line being elevated. However, CSF analyses were lacking in most of the studies, and many studies were hampered by insufficient adjustment for confounding factors such as body mass index and smoking.
目前缺乏对精神障碍患者血液和脑脊液中髓系和淋巴系循环免疫细胞组成的全面荟萃分析，包括专门的亚群。
截至 2022 年 10 月 18 日，我们在多个数据库（PubMed、EMBASE、Cochrane 图书馆、Web of Science、ClinicalTrials.gov 和 PsycINFO）中搜索了合格的研究。所有纳入的研究均调查了精神障碍患者（ICD-10：F20 和 F22-29）血液和脑脊液中循环免疫细胞，与健康对照参与者进行了比较。
共有 86 项研究纳入荟萃分析。在血液中，以下免疫细胞类别升高：白细胞计数（31 项研究，标准化均数差 [SMD] = 0.35；95%置信区间，0.24 至 0.46）、粒细胞计数（4 项研究，SMD = 0.57；95%置信区间，0.12 至 1.01）、中性粒细胞计数（21 项研究，SMD = 0.32；95%置信区间，0.11 至 0.54）、单核细胞计数（23 项研究，SMD = 0.40；95%置信区间，0.23 至 0.56）和 B 淋巴细胞计数（10 项研究，SMD = 0.26；95%置信区间，0.04 至 0.48）。此外，中性粒细胞/淋巴细胞比值（23 项研究，SMD = 0.40；95%置信区间，0.19 至 0.60）、单核细胞/淋巴细胞比值（9 项研究，SMD = 0.31；95%置信区间，0.04 至 0.57）和血小板/淋巴细胞比值（10 项研究，SMD = 0.23；95%置信区间，0.03 至 0.43）也升高。脑脊液细胞计数也呈现出类似的趋势，但没有显著升高（3 项研究，SMD = 0.14；95%置信区间，-0.04 至 0.32）。
结果表明，精神障碍患者的免疫系统广泛激活，髓系和淋巴系细胞均升高。然而，大多数研究中缺乏 CSF 分析，许多研究因体重指数和吸烟等混杂因素的调整不足而受到阻碍。
