Alterações inflamatórias nos estados de ultra-alto risco para psicose
Arquivos
Data
2017-03-10
Autores
Gama, Maiara Zeni Graiff 
Orientadores
Brietzke, Elisa Macedo
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: Existem evidências de que indivíduos em alto risco de desenvolver esquizofrenia possam ter alterações no sistema imunológico, evidenciadas por aumentos de marcadores pró-inflamatórios observáveis tanto no cérebro quanto na periferia. No entanto, pouco se sabe sobre as alterações imunológicas em indivíduos em estados mentais de risco (EMR) para esquizofrenia. Objetivo: O objetivo do presente estudo foi avaliar os níveis séricos de citocinas pró e anti-inflamatórias em indivíduos em EMR, comparando-os com os de controles saudáveis. Método: Para isso, foi realizado um estudo transversal comparando-se dois grupos: 12 pacientes em EMR e 16 voluntários saudáveis. Todos os sujeitos foram submetidos à entrevista psiquiátrica padronizada. A avaliação diagnóstica foi realizada através da aplicação da SCID-I (Structured Clinical Interview for DSM-IV, Axis I), Global Assessment of Functioning (GAF), Montgomery-Åsberg Depression Rating Scale (MADRS), e Childhood Trauma Questionnaire. Foi realizada uma coleta de sangue para análise de citocinas (Interleucina (IL)-2, IL-4, IL-6, IL-10, Fator de Necrose Tumoral (TNF), (Interferon)-IFN-γ e IL-17) presentes no soro dos pacientes. Os níveis desses biomarcadores foram determinados pela técnica de citometria de fluxo. Resultado: Comparado com o grupo controle saudável, os pacientes em EMR apresentaram níveis aumentados de IL-6 (Z = -2.370, p = 0.018) e níveis diminuídos de IL-17 no soro (Z = -1.959, p = 0.050). Os níveis de IL-17 foram positivamente correlacionados com os valores da GAF Sintomas (rho = 0,632, p = 0,028). Conclusão: Os resultados desse estudo sugerem que os desequilíbrios imunológicos podem estar presentes nas fases iniciais da psicose, incluindo em estágios em risco. As diferenças observadas entre os grupos nesse estudo abrem caminho para novas pesquisas sobre a patofisiologia da esquizofrenia, desenvolvendo novas e mais eficazes estratégias terapêuticas.
Introduction: There is evidence that individuals at high risk of developing schizophrenia may have changes in the immune system, as evidenced by the brain and blood increase of pro-inflammatory markers However, little is known about the immunological changes in individuals at mental state of risk (ARMS) for schizophrenia. Objective: The objective of the present study was to evaluate the serum levels of cytokines in individuals in ARMS, comparing them with those of healthy controls. Method: For this, a cross-sectional study was carried out comparing 2 groups: 12 patients in ARMS and 16 healthy volunteers. All subjects were submitted to a standardized psychiatric interview. The diagnostic evaluation was performed through the application of SCID-I (Structured Clinical Interview for DSM-IV, Axis I), Global Assessment of Functioning (GAF), Montgomery-Åsberg Depression Rating Scale (MADRS), and Childhood Trauma Questionnaire. A blood sample was collected for the analysis of cytokines (IL-2, IL-4, IL-6, IL-10, TNF, IFN-γ and IL-17) present in the patients' serum. The levels of these biomarkers were determined by the flow cytometry technique. Results: Compared with the healthy control group, patients on RRM showed increased levels of IL-6 (Z = -2,370, p = 0.018) and decreased levels of IL-17 in serum (Z = -1.959, p = 0.050). IL-17 levels were positively correlated with values in GAF symptoms (rho = 0.632, p = 0.028). Conclusion: The results of this study suggest that immunological imbalances may be present in the early stages of psychosis, including in stages at risk. The differences observed between the groups in this study open the way to new research on the pathophysiology of schizophrenia, developing new and more effective therapeutic strategies.
Introduction: There is evidence that individuals at high risk of developing schizophrenia may have changes in the immune system, as evidenced by the brain and blood increase of pro-inflammatory markers However, little is known about the immunological changes in individuals at mental state of risk (ARMS) for schizophrenia. Objective: The objective of the present study was to evaluate the serum levels of cytokines in individuals in ARMS, comparing them with those of healthy controls. Method: For this, a cross-sectional study was carried out comparing 2 groups: 12 patients in ARMS and 16 healthy volunteers. All subjects were submitted to a standardized psychiatric interview. The diagnostic evaluation was performed through the application of SCID-I (Structured Clinical Interview for DSM-IV, Axis I), Global Assessment of Functioning (GAF), Montgomery-Åsberg Depression Rating Scale (MADRS), and Childhood Trauma Questionnaire. A blood sample was collected for the analysis of cytokines (IL-2, IL-4, IL-6, IL-10, TNF, IFN-γ and IL-17) present in the patients' serum. The levels of these biomarkers were determined by the flow cytometry technique. Results: Compared with the healthy control group, patients on RRM showed increased levels of IL-6 (Z = -2,370, p = 0.018) and decreased levels of IL-17 in serum (Z = -1.959, p = 0.050). IL-17 levels were positively correlated with values in GAF symptoms (rho = 0.632, p = 0.028). Conclusion: The results of this study suggest that immunological imbalances may be present in the early stages of psychosis, including in stages at risk. The differences observed between the groups in this study open the way to new research on the pathophysiology of schizophrenia, developing new and more effective therapeutic strategies.
Descrição
Citação
GAMA, Maiara Zeni Graiff. Alterações inflamatórias nos estados de ultra-alto risco para psicose. São Paulo, 2017. [80] p. Dissertação (Mestrado em Psiquiatria e psicologia médica) - Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, 2017.