title: Acute schizophrenia is accompanied by reduced T cell and increased B cell immunity.
abstract: 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.
authors.affiliation: Department of Psychiatry, University of Magdeburg, Germany. johann.steiner@med.ovgu.de
authors.forename: Johann
authors.initials: J
authors.lastname: Steiner
authors.forename: Roland
authors.initials: R
authors.lastname: Jacobs
authors.forename: Benjamin
authors.initials: B
authors.lastname: Panteli
authors.forename: Mareike
authors.initials: M
authors.lastname: Brauner
authors.forename: Kolja
authors.initials: K
authors.lastname: Schiltz
authors.forename: Sabine
authors.initials: S
authors.lastname: Bahn
authors.forename: Marlis
authors.initials: M
authors.lastname: Herberth
authors.forename: Sabine
authors.initials: S
authors.lastname: Westphal
authors.forename: Tomasz
authors.initials: T
authors.lastname: Gos
authors.forename: Martin
authors.initials: M
authors.lastname: Walter
authors.forename: Hans-Gert
authors.initials: HG
authors.lastname: Bernstein
authors.forename: Aye Mu
authors.initials: AM
authors.lastname: Myint
authors.forename: Bernhard
authors.initials: B
authors.lastname: Bogerts
mesh_terms: 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*
chemical_list: D015703:Antigens, CD; D014150:Antipsychotic Agents; D003367:Cotinine; D006854:Hydrocortisone