Cytokine concentrations throughout pregnancy and risk for psychosis in adult offspring: a longitudinal case-control study.
Cytokine concentrations throughout pregnancy and risk for psychosis in adult offspring: a longitudinal case-control study.
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DOI：
10.1016/s2215-0366(20)30006-7
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发表时间：
2020-03
期刊：
影响因子：
--
通讯作者：
Cannon TD
中科院分区：
文献类型：
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作者：
Allswede DM;Yolken RH;Buka SL;Cannon TD
精神分裂症与妊娠和分娩并发症有关，胎儿暴露于炎症被认为是一种常见的潜在机制。然而，目前尚不清楚风险是否特定于怀孕的特定阶段，因为之前没有研究检查过从怀孕前三个月开始的评估中的孕妇血清样本。这项研究的目的是描述和比较妊娠期间母亲血清细胞因子水平的纵向模式，这些子女后来被证实患有精神病，这些病例的非精神病兄弟姐妹，以及作为对照的无关的非精神病个人。参与者包括90名病例、79名兄弟姐妹和273名匹配的对照，这些对照是从费城孕妇队列中确定的，随后是国家合作围产期项目[1959-1965]。成年期的精神障碍诊断通过回顾医疗记录进行评估，并通过验证性研究得到证实。细胞因子水平[肿瘤坏死因子α、白介素1β、白介素5、白介素6、白介素8、白介素10和白介素17a]采用多重微珠分析方法在产前检查和分娩期间收集的母体血清样本中进行评估。细胞因子模式用线性混合模型描述。与对照组相比，晚期精神病患者的母亲血清中促炎性肿瘤坏死因子α、IL-1β和IL-6水平显著升高。这些差异在妊娠前半期(7-20周)最大，在妊娠后半期逐渐减少到不显著。这些发现表明，在妊娠早期暴露于升高的母体促炎细胞因子水平可能在精神病的病因中发挥作用。
Schizophrenia has been associated with pregnancy and birth complications, and fetal exposure to inflammation is thought to be a common underlying mechanism. However, it is unclear whether risk is specific to particular phases of pregnancy, as no prior studies have examined maternal serum samples across assessments from the first trimester onward. The aim of this study was to characterize and compare longitudinal patterns of maternal serum levels of cytokines across pregnancy between offspring who were later ascertained as having a psychotic disorder diagnosis, non-psychotic siblings of these cases, and unrelated, non-psychotic individuals who served as controls. Participants included 90 cases, 79 siblings, and 273 matched controls identified from the Philadelphia cohort of pregnant women followed by the National Collaborative Perinatal Project [1959–1965]. Psychotic disorder diagnoses in adulthood were assessed with review of medical records and were confirmed with a validation study. Cytokine levels [TNFα, IL-1β, IL-5, IL-6, IL-8, IL-10, and IL-17a] were assessed using a multiplex bead assay in archived maternal serum samples collected across prenatal visits and birth. Cytokine patterns were characterized with linear mixed models. Levels of pro-inflammatory TNFα, IL-1β, and IL-6 were significantly higher in maternal serum of offspring who later developed psychosis relative to maternal serum of matched controls. These differences were maximal in first half of pregnancy (7–20 weeks), tapering to non-significant during the second half of pregnancy. These findings suggest that exposure to elevated maternal pro-inflammatory cytokine levels in early pregnancy may play a role in the etiology of psychosis.