AUTOIMMUNE PHENOMENA & PSYCHOTIC RELAPSE--SCHIZOPHRENIA

这是一个正在进行的项目的竞争性续订申请，目标是 在检验一种假设时，一种自身免疫过程直接针对 脑抗原与精神病的病因或发病机制有关 精神分裂症患者亚组的症状。在这两年中 到目前为止，已经资助了118名精神分裂症患者和96名对照 进行了横断面研究。初步数据显示，31% 精神分裂症患者属于免疫异常亚群，可能是 免疫学区别于正常对照和免疫学 正常的精神分裂症患者。广泛的开发工作也已经完成 循环特异性抗脑抗体检测的研究进展 免疫球蛋白和抗脑细胞介导的免疫反应。 使用这些方法的初步结果表明，存在一个 脑内抗原和免疫球蛋白增强淋巴细胞有丝分裂刺激作用 与这些抗原结合的特异性免疫球蛋白在某些 精神分裂症患者。 在这次更新期间，招聘的跨部门人员 这项研究的一部分将包括180名精神分裂症患者 (包括60名从未服药的患者)和30名非精神病患者，脑部 受损的个体。40例免疫学纵向研究 异常和40名免疫正常的精神分裂症患者也将 开始吧。每名患者将接受为期一年的每周评估。 临床状态和每月免疫学评估。在.期间 精神病症状加重时，会做免疫学检查 每周一次。如果自身免疫机制在慢性粒细胞白血病的发病机制中起作用 免疫异常患者的精神症状，然后 临床和免疫状态指标将被预测为 时间仅限于该子组。此外，在免疫学上， 异常亚群，某些免疫指标的变化可能是暂时性的 先于精神病症状的恶化。 这是第一次对自身免疫进行多维研究。 精神分裂症的假说和免疫学研究的首次尝试 精神分裂症患者的纵向现象。

This is a competitive renewal application for an ongoing project aimed at testing the hypothesis that an autoimmune process directed against brain antigens is involved in the etiology or pathogenesis of psychotic symptoms in a subgroup of schizophrenics patients. During the 2 years so far funded, 118 schizophrenic patients and 96 controls have been studied cross-sectionally. Preliminary data show that 31% schizophrenics fall into an immunologically abnormal subgroup who can be immunologically distinguished from normal controls and immunologically normal schizophrenics. Extensive developmental work has also been carried out on the detection of circulating specific antibrain immunoglobulin and anti-brain cell-mediated immunologic responses. Preliminary results using these methods suggest that there is an increased mitotic stimulation of lymphocytes by brain antigens and specific immunoglobulins binding to these antigens in some schizophrenics. During the period of this renewal, recruitment of the cross-sectional portion of the study will be completed to include 180 schizophrenics (including 60 never-medicated patients) and 30 non-psychotic, brain damaged individuals. A longitudinal study of 40 immunologically abnormal and 40 immunologically normal schizophrenic patients will also begin. Each patient will be followed for one year with weekly ratings of clinical state and monthly immunologic assessments. During exacerbations of psychotic symptoms, immunologic tests will be done weekly. If autoimmune mechanisms play a role in the pathogenesis of psychotic symptoms in the immunologically abnormal patients, then clinical and immunologic state measures will be predicted to covary over time only in that subgroup. Furthermore, in the immunologically abnormal subgroup, changes in some immunologic measures may temporally precede the worsening of psychotic symptoms. This is the first multidimensional investigation of the autoimmune hypothesis in schizophrenia and the first attempt to study immunologic phenomena in schizophrenic patients longitudinally.