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发布者:鑫达医学翻译公司 发布时间:2011-08-15 8:50:52 阅读:

原文:
Recent advances in immunological research regarding the differentiation between the type-1 and type-2 immune response are discussed. Increased levels of Interleukin-6 (IL-6) and the activation of the IL-6 system in schizophrenia might be the result of the activation of type-2 monocytes/macrophages, too. On
the contrary, several parameters of the specific cellular immune system are blunted, e. g. the decreased type-1 related immune parameters in schizophrenic patients. This study was performed as a double-blind, placebocontrolled, randomized evaluation of risperidone and celecoxib versus risperidone and placebo. Fifty schizophrenic patients were included in the study: 25 patients received risperidone and placebo, and 25 patients received risperidone and celecoxib for 5 weeks after the wash-out period.The treatment effect was calculated by ANCOVA. In parallel, serum levels of sTNF-R1 and sIL-2R, and the percentages of CD3+-, CD4+-, and CD19+ lymphocytes were estimated. As expected, both groups of schizophrenic patients showed significant improvement. However, the celecoxib add-on therapy group showed a significant group effect in the PANSS total score. The cytokines and lymphocytes reflected the type-1/type-2 balancing effects of COX-2 inhibitors.Additional treatment with celecoxib has significant positive effects on the therapeutic action of risperidone with regard to the total schizophrenia psychopathology. Moreover, the fact that treatment with an immunomodulatory drug shows beneficial effects on the symptomatology of schizophrenia indicates that immune dysfunction in schizophrenia is not just an epiphenomenon, but related to the pathomechanism of the disorder.

译文:
本文对区分1、2型免疫学应答的近期相关研究展开讨论。精神分裂患者体内白介素-6(IL-6)水平增加及IL-6系统活化可能源于2型单核-巨噬细胞活化。而特定细胞免疫系统的相关参数则发生钝化,如患者1型免疫应答相关参数出现降低等。本研究为一项随机双盲安慰剂对照研究,患者随机接受利培酮联合塞来考昔或利培酮联合安慰剂治疗。研究纳入50名精神分裂症患者:25名患者接受利培酮联合安慰剂治疗,其余25人接受利培酮联合塞来考昔治疗,治疗周期为间歇期后5周。采用协方差分析(ANCOVA)评价治疗效果。同时,检测血清内可溶性肿瘤坏死因子(sTNF-R1)和可溶性IL-2受体水平,以及CD3+、CD4+与CD19+淋巴细胞含量。两组精神分裂症患者症状发生明显改善,与预期相符。塞来考昔辅助治疗组PANSS总评分改善显著。细胞因子与淋巴细胞变化反应出COX-2抑制剂对1、2型免疫应答的平衡效应。针对精神分裂病理学方面,塞来考昔辅助治疗可增强利培酮疗效。此外,患者服用免疫调节药物对其症状产生获益,表明免疫异常并非仅为精神分裂症患者的一种附带现象,而与其病理机制相关。


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