Acute schizophrenia is accompanied by reduced T cell and increased B cell immunity.
Previous studies of lymphocyte distribution in schizophrenia have yielded inconsistent results, as summarized in the present study. Based on our own original data, potential confounds that might explain these variations are analyzed and discussed. Blood samples from 26 patients with acute paranoid schizophrenia were investigated in comparison with 32 matched healthy controls by flow cytometry (CD3, CD4, CD8, CD19, and CD56 phenotyping). A subgroup of drug-free patients was followed up after 6 weeks of treatment. Cotinine levels and the free cortisol index (FCI) were provided in order to control for medication, smoking, and stress. Cotinine levels correlated with natural killer (NK) cell counts (CD3⁻/CD56(+): r = -0.383, P = 0.003) while the FCI was related to B cell numbers (CD19(+): r = 0.390, P = 0.003). Considering these covariates, a lower level of T helper cells (P = 0.010), a reduced CD4/CD8 ratio (P = 0.029), and elevated B cells (P = 0.008) were found during acute psychosis. After 6 weeks of medication, an inverse pattern was observed in initially drug-free patients: total T cell (P = 0.005), T helper (P = 0.003), and T suppressor/cytotoxic cells (P = 0.005) increased, while B cell counts declined (P = 0.049). In conclusion, acute paranoid schizophrenia may be accompanied by a reduced T cell defense and a shift towards B cell immunity, which normalizes in response to treatment. In addition to disease stage or subtype and medication, cigarette smoking and stress are important co-factors.
Steiner
Johann
J
Department of Psychiatry, University of Magdeburg, Germany. johann.steiner@med.ovgu.de
Jacobs
Roland
R
Panteli
Benjamin
B
Brauner
Mareike
M
Schiltz
Kolja
K
Bahn
Sabine
S
Herberth
Marlis
M
Westphal
Sabine
S
Gos
Tomasz
T
Walter
Martin
M
Bernstein
Hans-Gert
HG
Myint
Aye Mu
AM
Bogerts
Bernhard
B
D000208:Acute Disease; D000328:Adult; D015703:Antigens, CD / Q000378:metabolism; D014150:Antipsychotic Agents / Q000494:pharmacology / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000145:classification / Q000187:drug effects / Q000276:immunology*; D016022:Case-Control Studies; D003367:Cotinine / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007694:Killer Cells, Natural / Q000187:drug effects / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012563:Schizophrenia, Paranoid / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology* / Q000503:physiopathology; D012907:Smoking / Q000503:physiopathology; D018709:Statistics, Nonparametric; D013315:Stress, Psychological / Q000503:physiopathology; D013601:T-Lymphocytes / Q000145:classification / Q000187:drug effects / Q000502:physiology*
D015703:Antigens, CD; D014150:Antipsychotic Agents; D003367:Cotinine; D006854:Hydrocortisone