Is there a role for immune-to-brain communication in schizophrenia?

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• 作者：Golam M. Khandaker ; Robert Dantzer
• 关键词：Schizophrenia ; Psychotic disorder ; Inflammation ; Immunity ; Immune system ; Cytokine ; IL ; 6 ; CRP ; Blood–brain barrier ; Endothelial cell ; Treatment ; Common ; cause hypothesis
• 刊名：Psychopharmacology
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：233
• 期：9
• 页码：1559-1573
• 全文大小：693 KB
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• 作者单位：Golam M. Khandaker (1)
  Robert Dantzer (2)
  
  1. Department of Psychiatry, University of Cambridge, Box 189, Cambridge Biomedical Campus, Cambridge, CB2 2QQ, UK
  2. Department of Symptom Research, Division of Internal Medicine, MD Anderson Cancer Center, Houston, TX, USA
  
• 刊物类别：Biomedical and Life Sciences
• 刊物主题：Biomedicine
  Pharmacology and Toxicology
  Psychiatry
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-2072

文摘

Schizophrenia is characterised by hallucinations, delusions, depression-like so-called negative symptoms, cognitive dysfunction, impaired neurodevelopment and neurodegeneration. Epidemiological and genetic studies strongly indicate a role of inflammation and immunity in the pathogenesis of symptoms of schizophrenia. Evidence accrued over the last two decades has demonstrated that there are a number of pathways through which systemic inflammation can exert profound influence on the brain leading to changes in mood, cognition and behaviour. The peripheral immune system-to-brain communication pathways have been studied extensively in the context of depression where inflammatory cytokines are thought to play a key role. In this review, we highlight novel evidence suggesting an important role of peripheral immune-to-brain communication pathways in schizophrenia. We discuss recent population-based longitudinal studies that report an association between elevated levels of circulating inflammatory cytokines and subsequent risk of psychosis. We discuss emerging evidence indicating potentially important role of blood–brain barrier endothelial cells in peripheral immune-to-brain communication, which may be also relevant for schizophrenia. Drawing on clinical and preclinical studies, we discuss whether immune-mediated mechanisms could help to explain some of the clinical and pathophysiological features of schizophrenia. We discuss implication of these findings for approaches to diagnosis, treatment and research in future. Finally, pointing towards links with early-life adversity, we consider whether persistent low-grade activation of the innate immune response, as a result of impaired foetal or childhood development, could be a common mechanism underlying the high comorbidity between certain neuropsychiatric and physical illnesses, such as schizophrenia, depression, heart disease and type-two diabetes.