Objective

While genetic and cohort studies suggest immune and reduction/oxidation (redox) alterations occur in psychosis, less is known about potential alterations in children and adolescents.

Methods

We conducted a systematic review to identify immune and redox biomarker studies in children and adolescents (mean age ≤ 18 years old) across the psychosis spectrum: from psychotic like experiences, which are common in children, to threshold psychotic disorders like schizophrenia. We conducted meta-analyses when at least three studies measured the same biomarker.

Results

The systematic review includes 38 pediatric psychosis studies. The meta-analyses found that youth with threshold psychotic disorders had higher neutrophil/lymphocyte ratio (Hedge’s g = 0.40, 95 % CI 0.17 – 0.64), tumor necrosis factor (Hedge’s g = 0.38, 95 % CI 0.06 – 0.69), C-reactive protein (Hedge’s g = 0.38, 95 % CI 0.05 – 0.70), interleukin-6 (Hedge’s g = 0.35; 95 % CI 0.11 – 0.64), and total white blood cell count (Hedge’s g = 0.29, 95 % CI 0.12 – 0.46) compared to youth without psychosis. Other immune and oxidative stress meta-analytic findings were very heterogeneous.

Conclusion

Results from several studies are consistent with the hypothesis that signals often classified as “proinflammatory” are elevated in threshold pediatric psychotic disorders. Data are less clear for immune markers in subthreshold psychosis and redox markers across the subthreshold and threshold psychosis spectrum. Immune and redox biomarker intervention studies are lacking, and research investigating interventions targeting the immune system in threshold pediatric psychosis is especially warranted.

中文翻译：

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儿科精神病和精神病风险中的免疫和氧化应激生物标志物：荟萃分析和系统评价

客观的

虽然遗传和队列研究表明精神病中会发生免疫和还原/氧化（氧化还原）改变，但人们对儿童和青少年的潜在改变知之甚少。

方法

我们进行了一项系统回顾，以确定儿童和青少年（平均年龄≤18岁）整个精神病谱系的免疫和氧化还原生物标志物研究：从儿童常见的类似精神病的经历，到精神分裂症等阈值精神病。当至少三项研究测量相同的生物标志物时，我们进行了荟萃分析。

结果

系统评价包括 38 项儿科精神病研究。荟萃分析发现，患有阈值精神障碍的青少年具有较高的中性粒细胞/淋巴细胞比率（Hedge's g  = 0.40，95% CI 0.17 – 0.64）、肿瘤坏死因子（Hedge's g  = 0.38，95% CI 0.06 – 0.69）、C-反应蛋白（Hedge's g  = 0.38，95% CI 0.05 – 0.70）、白介素-6（Hedge's g  = 0.35；95% CI 0.11 – 0.64）和总白细胞计数（Hedge's g  = 0.29，95% CI 0.12 – 0.46）与没有精神病的年轻人相比。其他免疫和氧化应激荟萃分析结果非常异质。

结论

多项研究的结果与以下假设一致：通常被归类为“促炎症”的信号在儿科精神病阈值中升高。阈下精神病中的免疫标记物以及阈下和阈值精神病谱系中的氧化还原标记物的数据不太清楚。缺乏免疫和氧化还原生物标志物干预研究，特别有必要研究针对阈值儿科精神病的免疫系统的干预措施。