Inflammation and the immune system

What is inflammation and the immune system?

Inflammation is caused by the immune system’s response to pathogens or tissue damage. Key cells in the innate (immediate) immune response are known as cytokines, including interleukins (IL). Cytokines are one of the most important immune defenders and are produced by many cells throughout the body but predominantly by T helper lymphocytes (Th cells, white blood cells). C-reactive protein is released by the body during inflammation. These processes may be disrupted in people with schizophrenia.

What is the evidence for inflammation and immunological changes?

Moderate to high quality evidence shows a medium-sized increase in cardiolipin IgM, and a small increase in cardiolipin IgG. Moderate quality evidence shows medium-sized increases in anti-gliadin IgG and anti-gliadin IgA, large increases in anti-TTG2 IgA and small increases in C-reactive protein and wheat protein antibodies. Antinuclear antibodies, DNA, dopamine receptor, gliadin IgA, heat shock protein 60, lupus anticoagulant, N-methyl-D-aspartate, rheumatoid factor, smith, thyroglobulin, thyroid microsomal, and tissue transglutaminase may also be increased. Moderate to low quality evidence finds increases in cold agglutinin, histone/anti-histone IgG, nucleoprotein, phospholipid, serotonin, and natural killer cells. Post-mortem studies have found medium-sized increases in cell microglia and pro-inflammatory molecular components (moderate to high quality evidence).

In people with an acute exacerbation of psychosis, moderate to hiqh quality evidence shows medium to large increases in IL-10, IL-IRA, IL-8, IFN-γ, TGF-β, TNF-α, IL-6, total white blood cell count, T-helper lymphocytes, natural killer cells, and small increases in the T-helper / suppressor lymphocyte ratio. In people with first-episode psychosis, there are medium to large increases in sIL-2R, IL-1β, IL-12, IFN-γ, TGF-β, TNF-α, IL-6, cardiolipin IgG (positive titers only) and N-methyl-D-aspartate. There is a medium-sized decrease in T-lymphocytes in first-episode patients who are antipsychotic naïve.

Following treatment with antipsychotics, moderate to high quality evidence suggests a medium-sized increase in T-suppressor/cytotoxic lymphocytes, natural killer cells, sIL-2R, IL-12 and T-lymphocytes, and a small to medium-sized increase in T-suppressor / cytotoxic lymphocytes. There is a medium-sized decrease in IL-1β, TGF-β, IL-6 and IFN-γ, and a small decrease in T-helper/suppressor lymphocyte ratio.

March 2019

Last updated at: 4:17 am, 26th March 2019
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