Schizophrenia, autoimmunity and immune system dysregulation: a comprehensive model updated and revisited. J Autoimmun

Beer Yaakov Mental Health Center, Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 1, Beer Yaakov 70350, Israel.
Journal of Autoimmunity (Impact Factor: 8.41). 10/2006; 27(2):71-80. DOI: 10.1016/j.jaut.2006.07.006
Source: PubMed


Recent investigation suggests a strong relationship between immunological effects and the pathophysiology of schizophrenia. Two prevalent approaches exist to this association. First, is more empirical a-priori research investigating immunological changes prevalent in schizophrenia and the second approach is more hypothesis-driven with analysis of immunological changes in schizophrenia based on known irregularities of the illness. The former approach is based upon three predominant lines of investigation including observations of a diffuse non-specific overactivation of the immunological response system, of a T-helper cell type 1 immune activation and of a T-helper cell type 2 immune activation in subgroups of schizophrenia patients. These last two theories suggest that a subgroup of patients with schizophrenia may demonstrate features of an autoimmune process, a theory supported by a growing database of investigation. The latter approach notes that many observations of immune dysregulation in schizophrenia overlap with central etiopathophysiological mechanisms as well as with clinical manifestations of the illness. Immunotherapy offers the opportunity to modify or re-balance the immune system and may become useful in management of the illness. Given that autoimmune mechanisms could interrupt neurotransmission, any process interfering with this disruption including therapeutic antibodies to involved cytokines, or with various other natural autoantibodies or immune system regulators, may become useful in the augmentative management of the illness.

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    • "Consistent with previous findings in literature (Gilvarry et al., 1996; Muller et al., 1999; Rothermundt et al., 2001; Strous and Shoenfeld, 2006), we found that there may be an immune/autoimmune component in schizophrenia. Some of the most significant genes associated with the disease are associated with this pathway. "
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    ABSTRACT: schizophrenia is a complex mental disorder marked by severely impaired thinking, delusional thoughts, hallucinations and poor emotional responsiveness. The biological mechanisms that lead to schizophrenia may be related to the genetic background of patients. Thus, a genetic perspective may help to unravel the molecular pathways disrupted in schizophrenia. In the present work, we used a molecular pathway analysis to identify the molecular pathways associated with schizophrenia. We collected data of genetic loci previously associated with schizophrenia, identified the genes located in those positions and created the metabolic pathways that are related to those genes' products. These pathways were tested for enrichment (a number of SNPs associated with the phenotype significantly higher than expected by chance) in a sample of schizophrenic patients and controls (4,486 and 4,477, respectively). The molecular pathway that resulted from the identification of all the genes located in loci previously found to be associated with schizophrenia was found to enriched, as expected (permutated p(10(6))=9.9999e-06).We found 60 SNPs amongst 30 different genes with a strong association with schizophrenia. The genes are related to the pathways related to neurodevelopment, apoptosis, vesicle traffic, immune response and MAPk cascade. The pathway related to the toll-like receptor family seemed to play a central role in the modulation/connection of various pathways whose disruption leads to schizophrenia. This pathway is related to the innate immune system, further stressing the role of immunological-related events in increasing the risk to schizophrenia. Copyright © 2014. Published by Elsevier Inc.
    Full-text · Article · Dec 2014 · Progress in Neuro-Psychopharmacology and Biological Psychiatry
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    • "We have further found that this variant is associated with immune dysregulation, indicated by increased levels of proinflammatory cytokines and autoantibodies in carriers of the variant (Marballi et al. 2010). This is of immense importance, given the large body of studies showing dysregulation of the immune system (Potvin et al. 2008; Strous and Shoenfeld 2006), including elevated levels of proinflammatory cytokines and autoantibodies in schizophrenia. "
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    ABSTRACT: Aberrant neuregulin 1-ErbB4 signaling has been implicated in schizophrenia. We previously identified a novel schizophrenia-associated missense mutation (valine to leucine) in the NRG1 transmembrane domain. This variant inhibits formation of the NRG1 intracellular domain (ICD) and causes decreases in dendrite formation. To assess the global effects of this mutation, we used lymphoblastoid cell lines from unaffected heterozygous carriers (Val/Leu) and non-carriers (Val/Val). Transcriptome data showed 367 genes differentially expressed between the two groups (Val/Val N = 6, Val/Leu N = 5, T test, FDR (1 %), α = 0.05, -log10 p value >1.5). Ingenuity pathway (IPA) analyses showed inflammation and NRG1 signaling as the top pathways altered. Within NRG1 signaling, protein kinase C (PKC)-eta (PRKCH) and non-receptor tyrosine kinase (SRC) were down-regulated in heterozygous carriers. Novel kinome profiling (serine/threonine) was performed after stimulating cells (V/V N = 6, V/L N = 6) with ErbB4, to induce release of the NRG1 ICD, and revealed significant effects of treatment on the phosphorylation of 35 peptides. IPA showed neurite outgrowth (six peptides) as the top annotated function. Phosphorylation of these peptides was significantly decreased in ErbB4-treated Val/Val but not in Val/Leu cells. These results show that perturbing NRG1 ICD formation has major effects on cell signaling, including inflammatory and neurite formation pathways, and may contribute significantly to schizophrenia pathophysiology.
    Full-text · Article · May 2014 · Journal of Neural Transmission
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    • "Several mechanisms may explain the epidemiologic data [Strous and Shoenfeld, 2006]. Individuals with auto-immune diseases have elevated prevalence of antibodies directed against brain proteins or may produce antibodies that cross-react with brain proteins [Irani and Lang, 2008]; individuals with SZ can also produce antibodies against proteins in the frontal cortex [Henneberg et al., 1994], cingulate gyrus [Ganguli et al., 1987; Kelly et al., 1987; Henneberg et al., 1994], hippocampus [Ganguli et al., 1987] and against glutamate receptors [Tsutsui et al., 2012]. "
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    ABSTRACT: Associations between human leukocyte antigen (HLA) polymorphisms on chromosome 6p and schizophrenia (SZ) risk have been evaluated for over five decades. Numerous case-control studies from the candidate gene era analyzed moderately sized samples and reported nominally significant associations with several loci in the HLA region (sample sizes, n = 100-400). The risk conferred by individual alleles was modest (odds ratios < 2.0). The basis for the associations could not be determined, though connections with known immune and auto-immune abnormalities in SZ were postulated. Interest in the HLA associations has re-emerged following several recent genome-wide association studies (GWAS); which utilized 10- to 100-fold larger samples and also identified associations on the short arm of chromosome 6. Unlike the earlier candidate gene studies, the associations are statistically significant following correction for multiple comparisons. Like the earlier studies; they have modest effect sizes, raising questions about their utility in risk prediction or pathogenesis research. In this review, we summarize the GWAS and reflect on possible bases for the associations. Suggestions for future research are discussed. We favor, in particular; efforts to evaluate local population sub-structure as well as further evaluation of immune-related variables in future studies. © 2013 Wiley Periodicals, Inc.
    Preview · Article · Jan 2014 · American Journal of Medical Genetics Part B Neuropsychiatric Genetics
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