TY - JOUR

T1 - Autoimmune Concept of Schizophrenia

T2 - Historical Roots and Current Facets

AU - Mayorova, Margarita A.

AU - Butoma, Boris G.

AU - Churilov, Leonid P.

AU - Gilburd, Boris

AU - Petrova, Nataliya N.

AU - Shoenfeld, Yehuda

N1 - Publisher Copyright: © Medicinska naklada - Zagreb, Croatia

PY - 2021/4/14

Y1 - 2021/4/14

N2 - BACKGROUND: The review analyzes the possible role of autoimmune processes in the pathogenesis of schizophrenia and the evolution of concepts on this issue from its origin to the present. RESULTS: Risks of autoimmune processes causing schizophrenia are associated with several factors: an impaired functioning of dopaminergic and glutamatergic systems in the brain, kynurenine pathway disorder with overproduction of quinolinic, anthranilic, and kynurenic acids (possibly altering both neurons and T-regulators), increased intestinal permeability, as well as food antigens' effects, stress and infections with various pathogens at different stages of ontogenesis. An increase in the levels of proinflammatory cytokines and chemokines as well as a decrease in the levels of anti-inflammatory ones also may contribute to schizophrenia risks. Schizophrenia often occurs in those patients having various autoimmune diseases and their first-degree relatives. CONCLUSION: Cases of schizophrenia resulted from autoimmune pathogenesis (including autoimmune encephalitis caused by autoantibodies against various neuronal antigens) are characterized by quite severe cognitive and psychotic symptoms and a less favorable prognosis. This severe course may result from the chronic immune damage of the neuronal receptors such as NMDA, GABA, and others and depend on hyperprolactinemia, induced by antipsychotics, but aggravating autoimmune processes.

AB - BACKGROUND: The review analyzes the possible role of autoimmune processes in the pathogenesis of schizophrenia and the evolution of concepts on this issue from its origin to the present. RESULTS: Risks of autoimmune processes causing schizophrenia are associated with several factors: an impaired functioning of dopaminergic and glutamatergic systems in the brain, kynurenine pathway disorder with overproduction of quinolinic, anthranilic, and kynurenic acids (possibly altering both neurons and T-regulators), increased intestinal permeability, as well as food antigens' effects, stress and infections with various pathogens at different stages of ontogenesis. An increase in the levels of proinflammatory cytokines and chemokines as well as a decrease in the levels of anti-inflammatory ones also may contribute to schizophrenia risks. Schizophrenia often occurs in those patients having various autoimmune diseases and their first-degree relatives. CONCLUSION: Cases of schizophrenia resulted from autoimmune pathogenesis (including autoimmune encephalitis caused by autoantibodies against various neuronal antigens) are characterized by quite severe cognitive and psychotic symptoms and a less favorable prognosis. This severe course may result from the chronic immune damage of the neuronal receptors such as NMDA, GABA, and others and depend on hyperprolactinemia, induced by antipsychotics, but aggravating autoimmune processes.

KW - risk of schizophrenia

KW - autoimmune processes

KW - proinflammatory cytokines and chemokines

KW - Autoimmune processes

KW - Proinflammatory cytokines

KW - Risk of schizophrenia

KW - Chemokines

UR - http://www.scopus.com/inward/record.url?scp=85104434180&partnerID=8YFLogxK

U2 - 10.24869/psyd.2021.3

DO - 10.24869/psyd.2021.3

M3 - Review article

C2 - 33857035

VL - 33

SP - 3

EP - 17

JO - Psychiatria Danubina

JF - Psychiatria Danubina

SN - 0353-5053

IS - 1

ER -