Review article

https://doi.org/10.24869/psyd.2021.3

AUTOIMMUNE CONCEPT OF SCHIZOPHRENIA: HISTORICAL ROOTS AND CURRENT FACETS

Margarita A. Mayorova ; Saint Petersburg State University, Saint-Petersburg, Russia
Boris G. Butoma ; Saint Petersburg State University, Saint-Petersburg, Russia; V. M. Bekhterev National Research Medical Center for Psychiatry and Neurology, Saint-Petersburg, Russia
Leonid P. Churilov ; Saint Petersburg State University, Saint-Petersburg, Russia; Saint-Petersburg Research Institute of Phthisiopulmonology, Saint-Petersburg, Russia
Boris Gilburd ; Saint Petersburg State University, Saint-Petersburg, Russia; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
Nataliya N. Petrova ; Saint Petersburg State University, Saint-Petersburg, Russia
Yehuda Shoenfeld ; Saint Petersburg State University, Saint-Petersburg, Russia; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel

Abstract

Background: The review analyzes the possible role of autoimmune processes in the pathogenesis of schizophrenia and the evolution of concepts on this issue from its origin to the present.
Results: Risks of autoimmune processes causing schizophrenia are associated with several factors: an impaired functioning of dopaminergic and glutamatergic systems in the brain, kynurenine pathway disorder with overproduction of quinolinic, anthranilic and kynurenic acids (possibly altering both neurons and T-regulators), increased intestinal permeability, as well as food antigens’ effects, stress and infections with various pathogens at different stages of ontogenesis. An increase in the levels of proinflammatory cytokines and chemokines as well as a decrease in the levels of anti-inflammatory ones also may contribute to schizophrenia risks. Schizophrenia often occurs in those patients having various autoimmune diseases and their first-degree relatives.
Conclusion: Cases of schizophrenia resulted from autoimmune pathogenesis (including autoimmune encephalitis caused by autoantibodies against various neuronal antigens) are characterized by quite severe cognitive and psychotic symptoms and a less favorable prognosis. This severe course may result from the chronic immune damage of the neuronal receptors such as NMDA, GABA, and others and depend on hyperprolactinemia, induced by antipsychotics, but aggravating autoimmune processes.

Keywords

risk of schizophrenia; autoimmune processes; proinflammatory cytokines and chemokines

Hrčak ID:

255887

URI

https://hrcak.srce.hr/255887

Publication date:

15.4.2021.

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