細胞激素與精神疾患

Cytokines and Major Psychiatric Disorders

目的：嚴重精神疾患病程常為慢性、反覆發作，且常出現於慢性身體疾病之個案，因而 有許多學著探討發炎反應與精神疾患之相關，目前研究發現促發炎介質 (pro-infl ammatory mediators) 及抗發炎介質 (anti-infl ammatory mediators) 兩者間的失調會出現精神疾患的症 狀，本綜說將回顧嚴重精神疾患與發炎反應之相關。方法：利用PubMed 及MEDLINE，找 出從1987 年1 月至2009 年8 月間以英文書寫的相關研究文獻，共篩選出60 篇文獻，進行 系統性的回顧。結果：細胞激素在大腦內扮演神經調節之功能，可影響大腦活動，如睡眠、 食慾神經內分泌的調控，並影響精神分裂病、重度憂鬱症、雙極性情感疾患的臨床表現。 結論：有越來越多證據顯示不同精神疾患與促發炎介質及抗發炎介質間有複雜之交互作用，但 對於其間之相關性仍在探討中，未來能若確定精神疾患與細胞激素之相關，將可應用於嚴重 精神疾患的臨床治療。

Background: Severe mental disorders are chronic, recurrent and usually combined chronic physical illness. The pathophysiology of mental disorder still remains a mystery. Convincing evidence supports that cytokines play an integral role in the pathophysiology of certain psychiatric disorders including schizophrenia, major depressive disorder, and bipolar disorder. Method: In this comprehensive overview, we reviewed all available published articles on the topic of cytokines and major psychiatric disorders. Results: Cytokine are generally known as chemical messengers between immune cells. As such, they play a crucial role in mediating infl ammatory and immune responses. Cytokines can signal the brain and serve as a mediators between immune and nerve cells.The brain is now seen as capable of infl uencing immune processes. Conversely, changes in brain activity can occur in association with an immunologic response. Cytokines can act as neuromodulators within the brain. Therefore, cytokines can affect important brain activities such as sleep, appetite, and neuroedocrine regulation. Conclusion: Discoveries about these processes have led to speculations about a possible link between cytokines and psychopathology. If we could identify the immunologic defects in psychiatric disorders, novel treatment strategies involving cytokines and/or cytokine inhibitors would be designed and tried clinically in the future.