Inflammation and immunity in schizophrenia: implications for pathophysiology and treatment
Open accessAbstract
Complex interactions between the immune system and the brain might have important aetiological and therapeutic implications for neuropsychiatric brain disorders. A possible association between schizophrenia and the immune system was postulated over a century ago, and is supported by epidemiological and genetic studies pointing to links with infection and inflammation. Contrary to the traditional view that the brain is an immunologically privileged site shielded behind the blood-brain barrier, studies in the past 20 years have noted complex interactions between the immune system, systemic inflammation, and the brain, which can lead to changes in mood, cognition, and behaviour. In this Review, we describe some of the important areas of research regarding innate and adaptive immune response in schizophrenia and related psychotic disorders that, we think, will be of interest to psychiatric clinicians and researchers. We discuss potential mechanisms and therapeutic implications of these findings, including studies of anti-inflammatory drugs in schizophrenia, describe areas for development, and offer testable hypotheses for future investigations.
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According to the immune hypothesis of psychiatric diseases, therapeutic control of peripheral and brain inflammation could offer novel tools in the treatment of severe mental and mood disorders, such as major depression.
“according to the immune hypothesis of psychiatric diseases, therapeutic control of peripheral and brain inflammation could offer novel, important tools in the treatment of severe mental and mood disorders, such as major depression (Khandaker et al. 2015; Miller and Raison 2016).”
From Prospective examination of synthetic 5-methoxy-N,N-dimethyltryptamine inhalation: effects on salivary IL-6, cortisol levels, affect, and non-judgment (2020) · cites this paper as Khandaker et al. 2015
These triggers can induce inflammatory changes that are associated with reduced neurotransmitter signaling, increased oxidative stress, and reduced synaptic branching.
“These triggers can induce inflammatory changes that are associated with reduced neurotransmitter signaling, increased oxidative stress, and reduced synaptic branching [118].”
From Brain-Derived Neurotrophic Factor in Brain Disorders: Focus on Neuroinflammation (2019) · cites this paper as [118]
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- Authors
- Khandaker, G. M., Cousins, L., Deakin, J., Lennox, B. R., Yolken, R., & Jones, P. B.
- Affiliations
- University of Cambridge (GB)
- University of Oxford (GB)
- Johns Hopkins University (US)
- Venue
- The Lancet Psychiatry
- Publisher
- Elsevier BV
- Published
- 2015-03
- Volume
- 2
- Issue
- 3
- Pages
- 258-270
- ISSN
- 2215-0366 (ISSN-L)
- PMC
- PMC4595998
- OpenAlex
- W2121637331
- Cited by
- 926
- References
- 135
- Citations by year
- 2026: 82 · 2025: 81 · 2024: 111 · 2023: 104 · 2022: 94 · 2021: 105 · 2020: 78 · 2019: 86 · 2018: 62 · 2017: 63 · 2016: 54 · 2015: 5
- FWCI
- 3.45
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Lancet Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Apollo (University of Cambridge) (acceptedVersion)
- Explore Bristol Research (submittedVersion)
- Funders
- Wellcome Trust to GMK ((094790/Z/10/Z; 2010-'13))
- National Institute of Mental Health ((MH-94268))
- Wellcome Trust ((095844/Z/11/Z and 088869/Z/09/Z))
- National Institute for Health Research ((RP-PG-0606–1335))
- Topics
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Keywords
- schizophrenia, inflammation, immunity, innate immune response, adaptive immune response, infection, blood-brain barrier, anti-inflammatory agents, psychosis, pathophysiology, treatment
- MeSH terms
- Humans, Immune System, Inflammation, Schizophrenia, Randomized Controlled Trials as Topic
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