Do biological alterations precede the onset of psychosis? A systematic review and meta-analysis of immune, cardiometabolic, prolactin and HPA axis alterations in clinical high-risk for psychosis

IF 8.8 2区医学 Q1 IMMUNOLOGY

Brain, Behavior, and Immunity Pub Date : 2025-04-07 DOI:10.1016/j.bbi.2025.04.009

Claudia Aymerich , Borja Pedruzo , Gonzalo Salazar de Pablo , Javier Labad , Robert McCutcheon , Toby Pillinger , Miguel Ángel González-Torres , Vanessa Sanchez-Gistau , Dominic Oliver , Daniel Alonso-Alconada , Pablo Navalón , Gisela Sugranyes , Eduard Vieta , Celso Arango , Philip McGuire , Paolo Fusar-Poli , Ana Catalan

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引用次数: 0

Abstract

First episode psychosis (FEP) individuals show biological abnormalities preceding antipsychotic treatment. However, it remains unclear whether such alterations are also present before the onset of psychosis. We aim to provide estimates of standardized mean differences for immune, cardiometabolic, prolactin, and HPA axis parameters in individuals at clinical high-risk for psychosis (CHR-P) compared to healthy controls (HC) and FEP individuals, and between CHR-P transitioning to psychosis (CHR-T) compared non-transitioning (CHR-NT). A multistep literature search was performed from database inception until September 25, 2023. PRISMA/MOOSE-compliant and pre-registered (PROSPERO: CRD42024507670) systematic review identified studies reporting on immune, cardiovascular or endocrine parameters in CHR-P samples compared with HC or FEP samples or comparing CHR-T vs CHR-NT. Inter-group differences in magnitude of effect were estimated using Hedges g and estimates were pooled using random-effects meta-analysis. Heterogeneity was high for most outcomes. 37 studies were included, total sample 2509 CHR-P, 710 FEP, and 1444 HC individuals. A statistically significant elevation of pro-inflammatory proteins was found among CHR-P compared with HC (k = 12; N = 1710; g = 0.16; p < 0.01) and FEP (k = 7; g = 0.15; p = 0.04) subjects. Interleukin-6 (IL-6) was increased in CHR-P compared to HC (k = 9; N = 1243; g = 0.54; p < 0.01), and interleukin-4 (IL-4) was increased in CHR-T compared with CHR-NT (k = 2; N = 318; g = 0.36; p < 0.01). CHR-P exhibited stronger cortisol awakening response than FEP subjects (k = 3; N = 173; g = 0.51; p = 0.01). CHR-P and FEP individuals did not show statistically significant differences in terms of prolactin levels. An inflammatory state (particularly marked by elevated IL-6 and IL-4 levels) and HPA axis alterations are present in CHR-P individuals.

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生物学上的改变先于精神病的发作吗？免疫、心脏代谢、催乳素和HPA轴改变在精神病临床高危人群中的系统回顾和荟萃分析

首发精神病（FEP）个体在抗精神病药物治疗前表现出生物学异常。然而，尚不清楚这种改变是否也存在于精神病发作之前。我们的目的是估计临床精神病高危人群（chrp）与健康对照（HC）和FEP个体之间的免疫、心脏代谢、催泌素和HPA轴参数的标准化平均差异，以及chrp向精神病过渡（chrt）与非过渡（chrt - nt）之间的标准化平均差异。从数据库建立到2023年9月25日进行多步文献检索。PRISMA/ moose合规和预注册（PROSPERO: CRD42024507670）系统评价确定了报告chrp样品与HC或FEP样品或chrt与chrt - nt比较的免疫、心血管或内分泌参数的研究。使用对冲系数g估计组间效应大小差异，并使用随机效应荟萃分析汇总估计值。大多数结果的异质性很高。纳入37项研究，总样本2509例chrp， 710例FEP， 1444例HC。与HC相比，CHR-P组促炎蛋白升高具有统计学意义(k = 12；n = 1710；g = 0.16；p & lt;0.01)和FEP (k = 7；g = 0.15；P = 0.04)。与HC相比，CHR-P组白细胞介素-6 （IL-6）升高(k = 9；n = 1243；g = 0.54；p & lt;0.01)，白细胞介素-4 （IL-4）在cr - t中较cr - nt升高(k = 2；n = 318；g = 0.36；p & lt;0.01)。chrp比FEP表现出更强的皮质醇觉醒反应(k = 3；n = 173；g = 0.51；p = 0.01)。CHR-P和FEP个体在催乳素水平方面无统计学差异。在chrp个体中存在炎症状态（特别是以IL-6和IL-4水平升高为标志）和HPA轴改变。

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来源期刊

Brain, Behavior, and Immunity 医学-免疫学

CiteScore

29.60

自引率

2.00%

发文量

290

审稿时长

28 days

期刊介绍： Established in 1987, Brain, Behavior, and Immunity proudly serves as the official journal of the Psychoneuroimmunology Research Society (PNIRS). This pioneering journal is dedicated to publishing peer-reviewed basic, experimental, and clinical studies that explore the intricate interactions among behavioral, neural, endocrine, and immune systems in both humans and animals. As an international and interdisciplinary platform, Brain, Behavior, and Immunity focuses on original research spanning neuroscience, immunology, integrative physiology, behavioral biology, psychiatry, psychology, and clinical medicine. The journal is inclusive of research conducted at various levels, including molecular, cellular, social, and whole organism perspectives. With a commitment to efficiency, the journal facilitates online submission and review, ensuring timely publication of experimental results. Manuscripts typically undergo peer review and are returned to authors within 30 days of submission. It's worth noting that Brain, Behavior, and Immunity, published eight times a year, does not impose submission fees or page charges, fostering an open and accessible platform for scientific discourse.