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

Authors
  • Khandaker, Golam M.1
  • Dantzer, Robert2
  • 1 University of Cambridge, Department of Psychiatry, Cambridge Biomedical Campus, Cambridge, CB2 2QQ, UK , Cambridge (United Kingdom)
  • 2 MD Anderson Cancer Center, Department of Symptom Research, Division of Internal Medicine, Houston, TX, USA , Houston (United States)
Type
Published Article
Journal
Psychopharmacology
Publication Date
Jun 04, 2015
Volume
233
Issue
9
Pages
1559–1573
Identifiers
DOI: 10.1007/s00213-015-3975-1
Source
Springer Nature
Keywords
License
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Abstract

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.

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