Cui Li-Jun, Cai Li-Li, Na Wan-Qiu, Jia Rui-Long, Zhu Jie-Lin, Pan Xin
Key Laboratory of Psychiatry, Huzhou Third Municipal Hospital, the Affiliated Hospital of Huzhou University, Huzhou 313000, Zhejiang Province, China.
Department of Psychiatry, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou 313000, Zhejiang Province, China.
World J Psychiatry. 2024 Dec 19;14(12):1804-1814. doi: 10.5498/wjp.v14.i12.1804.
The pathogenesis of cognitive impairment in schizophrenia (SCZ) remains unclear. Accumulating studies showed that inflammatory-immune dysregulation and altered brain derived neurotrophic factor (BDNF) levels play a crucial role in the psychopathology of SCZ. However, their association with cognitive dysfunction in first-episode SCZ patients has not been thoroughly investigated.
To explore the interaction effects between cognitive function and inflammatory cytokines and BDNF in first-episode SCZ.
The current study is a cross-sectional case-control investigation that recruited 84 patients with first-episode SCZ (SCZ group) and 80 healthy controls (HCs group) at the Huzhou Third Municipal Hospital between August 2021 and September 2023. ELISA was employed to measure the serum levels of interleukin (IL)-1β, IL-4, IL-6, IL-10, and BDNF. The Chinese brief cognitive test (C-BCT) and the positive and negative syndrome scales were measured the severity of cognitive impairment and psychiatric symptoms.
Compared to the HC group, the SCZ group exhibited elevated IL-1β and IL-6 levels, decreased BDNF levels, and reduced C-BCT scores (all < 0.001). In SCZ, BDNF was negatively correlated with IL-6 ( = -0.324, < 0.05). Information processing speed was negatively correlated with IL-6 ( = -0.315, < 0.05) and positively with BDNF ( = 0.290, < 0.05); attention, working memory, comprehensive ability, and executive function were negatively correlated with IL-1β and IL-6 (all < 0.05) and positively with BDNF (all < 0.05). Multiple regression analysis showed IL-6 influenced C-BCT dimensions ( = -0.218 to -0.327 all < 0.05); attention and executive ability were influenced by IL-1β ( = -0.199 to -0.261 all < 0.05; comprehensive executive ability was influenced by BDNF ( = 0.209, < 0.05.
Our findings suggested that interrelationships between immune dysfunction and neurotrophic deficiency might underlie the pathological mechanisms of cognitive impairments in first-episode SCZ patients.
精神分裂症（SCZ）认知障碍的发病机制仍不清楚。越来越多的研究表明，炎症免疫失调和脑源性神经营养因子（BDNF）水平改变在SCZ的精神病理学中起关键作用。然而，它们与首发SCZ患者认知功能障碍的关联尚未得到充分研究。
探讨首发SCZ患者认知功能与炎性细胞因子和BDNF之间的相互作用。
本研究为横断面病例对照研究，于2021年8月至2023年9月在湖州市第三人民医院招募了84例首发SCZ患者（SCZ组）和80例健康对照者（HCs组）。采用酶联免疫吸附测定法（ELISA）检测血清白细胞介素（IL）-1β、IL-4、IL-6、IL-10和BDNF水平。采用中文版简易认知测试（C-BCT）和阳性与阴性症状量表评估认知障碍和精神症状的严重程度。
与HC组相比，SCZ组IL-1β和IL-6水平升高，BDNF水平降低，C-BCT评分降低（均P<0.001）。在SCZ中，BDNF与IL-6呈负相关（r=-0.324，P<0.05）。信息处理速度与IL-6呈负相关（r=-0.315，P<0.05），与BDNF呈正相关（r=0.290，P<0.05）；注意力、工作记忆、综合能力和执行功能与IL-1β和IL-6呈负相关（均P<0.05），与BDNF呈正相关（均P<0.05）。多元回归分析显示，IL-6影响C-BCT维度（β=-0.218至-0.327，均P<0.05）；注意力和执行能力受IL-1β影响（β=-0.199至-0.261，均P<0.05）；综合执行能力受BDNF影响（β=0.209，P<0.05）。
我们的研究结果表明，免疫功能障碍与神经营养缺乏之间的相互关系可能是首发SCZ患者认知障碍病理机制的基础。
