The autoimmune model of schizophrenia.
The autoimmune model of schizophrenia.
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DOI：
10.5402/2012/758072
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发表时间：
2012-01-01
期刊：
影响因子：
--
通讯作者：
Ebringer, A
中科院分区：
文献类型：
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作者：
Adams, D D;Knight, J G;Ebringer, A
精神分裂症的起因很神秘。它不是传染性的，也不是先天性的，但显示出家族聚集性，孟德尔遗传学表明涉及多个共显性基因的不完全遗传。这是自身免疫性疾病的模式，例如甲状腺的格雷夫斯病，其中B淋巴细胞的被禁止克隆发展，并通过分泌与甲状腺的垂体促甲状腺激素受体反应的自身抗体引起甲状腺毒症。1982年，奈特假设影响大脑边缘区神经元功能的自身抗体可能是精神分裂症的原因。今天，这种可能性更大，因为已经发现易患精神分裂症的基因是免疫反应基因，一个在MHC中，两个是抗体轻链V基因。免疫反应基因控制免疫系统，决定自身免疫性疾病的遗传风险。对精神分裂症自身免疫基础的最简单的测试是在急性病例中使用强的松进行免疫抑制试验。迫切需要的研究是找到微生物的触发因素，就像Ebringer对类风湿性关节炎和强直性脊柱炎所做的那样。这可能导致通过接种疫苗来预防精神分裂症的触发微生物。
Schizophrenia is of mysterious causation. It is not infectious, not congenital, but shows familial aggregation, the Mendelian genetics indicating involvement of multiple codominant genes with incomplete penetrance. This is the pattern for autoimmune diseases, such as Graves' disease of the thyroid, where forbidden clones of B lymphocytes develop, and cause thyrotoxicosis by secreting autoantibodies that react with the thyroid gland's receptor for thyroid-stimulating hormone from the pituitary gland. In 1982, Knight postulated that autoantibodies affecting the function of neurons in the limbic region of the brain are a possible cause of schizophrenia. Today, this is even more probable, with genes predisposing to schizophrenia having being found to be immune response genes, one in the MHC and two for antibody light chain V genes. Immune response genes govern the immune repertoire, dictating the genetic risk of autoimmune diseases. The simplest test for an autoimmune basis of schizophrenia would be trial of immunosuppression with prednisone in acute cases. The urgent research need is to find the microbial trigger, as done by Ebringer for rheumatoid arthritis and for ankylosing spondylitis. This could lead to prophylaxis of schizophrenia by vaccination against the triggering microbe.