Th17 and Th2 Shift Immune Response in Patients with Chronic Schizophrenia

慢性思覺失調症病人的Th17及Th2免疫傾向

曾裕庭(Yu-Ting Tseng)；楊斯年(Szu-Nian Yang)；古世傑(Shih-Chieh Ku)；何佩駪(Pei-Shen Ho)；梁志頌(Chih-Sung Liang)

cytokines ； Th-17/Th2/Th1 ； inflammatory immunity ； chronic schizophrenia ； 輔助性T細胞 ； Th17/Th2/Th1 ； 免疫發炎 ； 慢性思覺失調症

台灣精神醫學

32卷3期（2018 / 09 / 01）

225 - 233+iv

英文

Objectives: In this study, we intended to study the interrelationship between T helper (Th) 1, Th2, and Th17 in patients with chronic schizophrenia. Methods: In this study, we recruited 20 individuals with chronic schizophrenia and 20 healthy controls. The blood levels of five cytokines (IFN-γ, TNF-α, IL-6, IL-10, and IL- 17) were analyzed using bead-based multiplex immunoassay technique. The Th17/ Th1 balance was indicated by IL-17/IFN-γ and IL-17/TNF-α, Th17/Th2 balance IL-17/IL-6 and IL-17/IL-10, and Th1/Th2 balance IFN-γ/IL-6, IFN-γ/IL-10, TNF-α/IL-6, and TNF-α/IL-10. Results: The patients with chronic schizophrenia showed significantly lower blood levels of IFN-γ (p ＜ 0.05) and significantly higher blood levels of IL-10 (p ＜ 0.01) and IL-17 (p ＜ 0.01). The group differences in ratios of Th17/Th1, Th17/Th2, and Th1/Th2 showed a significantly increased ratio of IL-17/IFN-γ (p ＜ 0.001) and decreased ratios of IFN-γ/IL-6 (p = 0.001) and IFN-γ/IL-10 (p ＜ 0.001) in patients with chronic schizophrenia. The other cytokine ratios did not show significant between-group differences. Conclusion: The patients with chronic schizophrenia had increased blood levels of Th2 cytokine (IL- 10) and Th17 cytokine (IL17), and decreased blood levels of Th1 cytokine (IFN-γ). The ratios of Th17/Th1, Th17/Th2, and Th1/Th2 showed dampened Th1 along with Th2- and Th17-slanted immune response. The complex immunological characteristics in chronic schizophrenia warrant further research.

目的：探討慢性思覺失調症病人第十七型輔助性T細胞(Th17)、第一型輔助性T細胞(Th1)及第二型輔助性T細胞(Th2)的相互關係。方法：我們招募了20位慢性思覺失調症患者及20位健康成人（對照組），抽血分析五種細胞激素，包括Th1相關的IFN-γ及TNF-α；Th2相關的IFN-γ及TNF-α；以及Th17相關的IL-17。除了此五種細胞激素的濃度外，也分析Th1/Th2、Th17/Th1以及Th17/Th2細胞激素比例在兩組的差異性。結果：相較於健康對照組，慢性思覺失調症患者有較低的IFN-γ (p ＜ 0.05)，較高的IL-10 (p ＜ 0.01), IL-17 (p ＜ 0.01)。在Th1/Th2、Th17/Th1以及Th17/Th2比例方面，慢性思覺失調症病人有較高的Th17/Th1比例(p ＜ 0.001)，較低的Th1/Th2比例(IFN-γ/IL-6, p = 0.001; IFN-γ/IL-10, p ＜ 0.001)；然而，其它細胞激素比例則未達到統計上的意義。結論：慢性思覺失調症患者相較於健康對照組有顯著的IFN-γ下降，以及IL-10, IL-17上升等情況，此外在Th1/Th2比例方面有明顯的Th2 shift情形，而在Th17/Th1有明顯的Th17 shift情況。這些結果暗示慢性思覺失調症病人有相對抑制的Th1及傾向Th2和Th17的免疫反應，關於思覺失調症的複雜免疫調節變化值得進一步的研究。

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