A Meta-analysis of Immune Parameters, Variability, and Assessment of Modal Distribution in Psychosis and Test of the Immune Subgroup Hypothesis.
C-Reactive Protein
/ immunology
Case-Control Studies
Cytokines
/ immunology
Humans
Interferon-gamma
/ immunology
Interleukin-17
/ immunology
Interleukin-1beta
/ immunology
Interleukin-4
/ immunology
Interleukin-6
/ immunology
Interleukin-8
/ immunology
Leukocyte Count
Lymphocyte Count
Models, Statistical
Prodromal Symptoms
Psychotic Disorders
/ immunology
Schizophrenia
/ immunology
Transforming Growth Factor beta
/ immunology
Tumor Necrosis Factor-alpha
/ immunology
immune
inflammation
psychosis
variability
Journal
Schizophrenia bulletin
ISSN: 1745-1701
Titre abrégé: Schizophr Bull
Pays: United States
ID NLM: 0236760
Informations de publication
Date de publication:
11 09 2019
11 09 2019
Historique:
pubmed:
9
11
2018
medline:
11
7
2020
entrez:
9
11
2018
Statut:
ppublish
Résumé
Immune parameters are elevated in psychosis, but it is unclear whether alterations are homogenous across patients or heterogeneity exists, consistent with the hypothesis that immune alterations are specific to a subgroup of patients. To address this, we examine whether antipsychotic-naïve first-episode psychosis patients exhibit greater variability in blood cytokines, C-reactive protein, and white cell counts compared with controls, and if group mean differences persist after adjusting for skewed data and potential confounds. Databases were searched for studies reporting levels of peripheral immune parameters. Means and variances were extracted and analyzed using multivariate meta-analysis of mean and variability of differences. Outcomes were (1) variability in patients relative to controls, indexed by variability ratio (VR) and coefficient of variation ratio (CVR); (2) mean differences indexed by Hedges g; (3) Modal distribution of raw immune parameter data using Hartigan's unimodality dip test. Thirty-five studies reporting on 1263 patients and 1470 controls were included. Variability of interleukin-6 (IL6) (VR = 0.19), tumor necrosis factor-α (TNFα) (VR = 0.36), interleukin-1β (VR = 0.35), interleukin-4 (VR = 0.55), and interleukin-8 (VR = 0.28) was reduced in patients. Results persisted for IL6 and IL8 after mean-scaling. Ninety-four percent and one hundred percent of raw data were unimodally distributed in psychosis and controls, respectively. Mean levels of IL6 (g = 0.62), TNFα (g = 0.56), interferon-γ (IFNγ) (g = 0.32), transforming growth factor-β (g = 0.53), and interleukin-17 (IL17) (g = 0.48) were elevated in psychosis. Sensitivity analyses indicated this is unlikely explained by confounders for IL6, IFNγ, and IL17. These findings show elevated cytokines in psychosis after accounting for confounds, and that the hypothesis of an immune subgroup is not supported by the variability or modal distribution.
Identifiants
pubmed: 30407606
pii: 5164363
doi: 10.1093/schbul/sby160
pmc: PMC6737479
mid: EMS82490
doi:
Substances chimiques
CXCL8 protein, human
0
Cytokines
0
IFNG protein, human
0
IL1B protein, human
0
IL4 protein, human
0
IL6 protein, human
0
Interleukin-17
0
Interleukin-1beta
0
Interleukin-6
0
Interleukin-8
0
TNF protein, human
0
Transforming Growth Factor beta
0
Tumor Necrosis Factor-alpha
0
Interleukin-4
207137-56-2
Interferon-gamma
82115-62-6
C-Reactive Protein
9007-41-4
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1120-1133Subventions
Organisme : Medical Research Council
ID : MC_U120097115
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 200102/Z/15/Z
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC-A656-5QD30
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 094849/Z/10/Z
Pays : United Kingdom
Informations de copyright
© The Author(s) 2018. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.
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