Study Of Peripheral Cd4~+T Cell Subsets And Inflammatory Factors In Schizophrenia Patients

BackgroundMental disorders are a large group of common diseases,including schizophrenia,depression,bipolar disorder,obsessive-compulsive disorder,and other substance dependence disorders,as well as organic mental disorders.These diseases account for about 13%of the total global disease burden,of which the lifetime prevalence of schizophrenia is about 1%worldwide.Schizophrenia(SZ)is generally characterized with complex disease course,high recurrence rate,heavy social and family burden,and high disability fatality rate.Although the disease places a huge economic burden on society and families and threatens the well-being of society,the etiology and pathogenesis of most cases of schizophrenia remain unknown.Inflammatory cytokine-mediated dysfunction was observed in peripheral immune system.Abnormal activation of cytokine network is one of the inducers that induce physiological and pathological symptoms of SZ.Few studies have been conducted on the functional activity status of various immune cells in peripheral blood of SZ patients,as well as the regulatory relationship between the activated immune cells and the corresponding immune effector molecules.Abnormal changes of CD4~+T cell subsets and corresponding cytokines in peripheral blood of SZ patients were observed.Meanwhile,functional changes of CD4~+T cell subsets and their relationship with corresponding cytokines and clinical manifestations were analyzed,so as to more accurately understand the mechanism of immune abnormalities in SZ patients and provide theoretical basis for clinical diagnosis and treatment.ObjectiveBy observing the expression of CD4~+T cell subsets and inflammatory cytokines in SZ patients,the correlation between corresponding immunological indicators and psychiatric symptoms was analyzed,as well as the possible influence on the curative effect,so as to provide theoretical basis for the treatment from the perspective of mental immunity.MethodFrom November 2017 to December 2018,100 schizophrenic patients and 100 healthy physical examinees were selected to be hospitalized in Henan Mental Health Center.There was no significant difference in age or gender between the two groups.Patients were treated with a single class of antipsychotic drugs(no more than two)with aripiprazole.Clinical efficacy and adverse reactions were assessed using standardized clinical scales and laboratory tests.Acute treatment lasted 4-6 weeks.Flow cytometry was used to detect the percentage of CD4~+T cell subsets in peripheral blood of healthy people and SZ patients before and after treatment,and the concentrations of IFN-γ,IL-6,IL-17 and TGF-βin serum were detected by ELISA.SPSS20.0 statistical software was used for analysis.Data were shown as mean±standard deviation(x±s),t-test was used for sample mean between groups,and chi-square test was used for counting data.Pearson linear correlation analysis is used for correlation analysis,and ROC curve analysis is used for each index to detect and diagnose efficacy separately.P<0.05 was considered statistically significant.Result1.Before treatment,the percentages of Th1,Th2,Th17 and Treg,the concentrations of IFN-γ,IL-6,IL-17 and TGF-βin SZ group were significantly higher than those in control group(P<0.05).2.Before treatment,there was a percentage imbalance between CD4~+T cell subsets and Th1/Th2 cells in SZ patients.The percentage imbalance of Th1/Th2 cells was significantly biased toward Th1 cells,while the percentage imbalance of Th17/Treg cells was significantly biased toward Th17 cells.3.The Pearson correlation analysis showed that Th1,Th17 and IL-17 were positively correlated with PANSS score reduction rate(P<0.05),TGF-βwas negatively correlated with PANSS score reduction rate(P<0.05),Th1 was positively correlated with Th2(P<0.01),TGF-β,IL-17 and IL-6 were negatively correlated(P<0.05).4.The Pearson correlation analysis can be seen,IFN-γ、IL-6、IL-17 and PANSS score points rate is significant positive correlation(P<0.01),Treg is negatively related to the rate of PANSS score points(P<0.05);Th1 was positively correlated with Th2 and TGF-β(P<0.01).ROC curve analysis found that IL-17 has certain reference and guiding significance for SZ diagnosis and treatment.5.The ROC curve analysis showed that when the cut-off value of Th1 was 13.17%,Th1 had relatively high efficiency in predicting the prognosis of SZ disease.ConclusionThe number of peripheral CD4~+T cell subsets and their corresponding inflammatory factors increased in patients with first episode of schizophrenia,and the ratio between subsets was unbalanced.Antipsychotics can reduce the number of CD4~+T cell subsets and the content of corresponding inflammatory factors,partially restore the ratio of CD4~+T cell subsets,and make the body incline to the state of immune balance.