A comprehensive meta-analysis on the composition of circulating immune cells from both the myeloid and the lymphoid lines including specialized subsets in blood and cerebrospinal fluid (CSF) of patients with psychotic disorders compared with healthy control participants has been lacking. Multiple databases (PubMed, EMBASE, Cochrane Library, Web of Science, ClinicalTrials.gov, and PsycINFO) were searched for eligible studies up until October 18, 2022. All studies investigating circulating immune cells in the blood and CSF from patients with psychotic disorders (ICD-10: F20 and F22-29) compared with healthy control participants were included. A total of 86 studies were included in the meta-analysis. In the blood, the following categories of immune cells were elevated: leukocyte count (31 studies, standardized mean difference [SMD] = 0.35; 95% CI, 0.24 to 0.46), granulocyte count (4 studies, SMD = 0.57; 95% CI, 0.12 to 1.01), neutrophil granulocyte count (21 studies, SMD = 0.32; 95% CI, 0.11 to 0.54), monocyte count (23 studies, SMD = 0.40; 95% CI, 0.23 to 0.56), and B lymphocyte count (10 studies, SMD = 0.26; 95% CI, 0.04 to 0.48). Additionally, the neutrophil/lymphocyte ratio (23 studies, SMD = 0.40; 95% CI, 0.19 to 0.60), the monocyte/lymphocyte ratio (9 studies, SMD = 0.31; 95% CI, 0.04 to 0.57), and the platelet/lymphocyte ratio (10 studies, SMD = 0.23; 95% CI, 0.03 to 0.43) were elevated. The CSF cell count showed a similar tendency but was not significantly elevated (3 studies, SMD = 0.14; 95% CI, −0.04 to 0.32). The results indicate a broad activation of the immune system in psychotic disorders, with cells from both the myeloid and the lymphoid line being elevated. However, CSF analyses were lacking in most of the studies, and many studies were hampered by insufficient adjustment for confounding factors such as body mass index and smoking.

中文翻译：

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精神疾病中的免疫细胞改变：全面的系统回顾和荟萃分析

目前还缺乏对精神障碍患者与健康对照参与者的骨髓和淋巴系循环免疫细胞组成（包括血液和脑脊液（CSF）中的特殊亚群）的全面荟萃分析。截至 2022 年 10 月 18 日，我们在多个数据库（PubMed、EMBASE、Cochrane Library、Web of Science、ClinicalTrials.gov 和 PsycINFO）中检索了符合条件的研究。所有研究均调查精神障碍患者血液和脑脊液中的循环免疫细胞（ ICD-10：F20 和 F22-29）与健康对照参与者进行比较。荟萃分析共纳入 86 项研究。血液中以下类别的免疫细胞升高：白细胞计数（31 项研究，标准化平均差 [S​​MD] = 0.35；95% CI，0.24 至 0.46）、粒细胞计数（4 项研究，SMD = 0.57；95% CI） ，0.12 至 1.01）、中性粒细胞计数（21 项研究，SMD = 0.32；95% CI，0.11 至 0.54）、单核细胞计数（23 项研究，SMD = 0.40；95% CI，0.23 至 0.56）和 B 淋巴细胞计数（ 10 项研究，SMD = 0.26；95% CI，0.04 至 0.48）。此外，中性粒细胞/淋巴细胞比率（23 项研究，SMD = 0.40；95% CI，0.19 至 0.60）、单核细胞/淋巴细胞比率（9 项研究，SMD = 0.31；95% CI，0.04 至 0.57）和血小板/淋巴细胞比率（10 项研究，SMD = 0.23；95% CI，0.03 至 0.43）升高。脑脊液细胞计数显示出类似的趋势，但并未显着升高（3 项研究，SMD = 0.14；95% CI，-0.04 至 0.32）。结果表明，精神疾病中免疫系统广泛激活，髓系和淋巴系细胞均升高。然而，大多数研究都缺乏脑脊液分析，并且许多研究因对体重指数和吸烟等混杂因素调整不足而受到阻碍。