Converging lines of evidence suggest that activation of microglia (innate immune cells in the central nervous system [CNS]) is present in a subset of patients with schizophrenia. The extent to which antipsychotic drug treatment contributes to or combats this effect remains unclear. To address this question, we reviewed the literature for evidence that antipsychotic exposure influences brain microglia as indexed by in vivo neuroimaging and post-mortem studies in patients with schizophrenia and experimental animal models. We found no clear evidence from clinical studies for an effect of antipsychotics on either translocator protein (TSPO) radioligand binding (an in vivo neuroimaging measure of putative gliosis) or markers of brain microglia in post-mortem studies. In experimental animals, where drug and illness effects may be differentiated, we also found no clear evidence for consistent effects of antipsychotic drugs on TSPO radioligand binding. By contrast, we found evidence that chronic antipsychotic exposure may influence central microglia density and morphology. However, these effects were dependent on the dose and duration of drug exposure and whether an immune stimulus was present or not. In the latter case, antipsychotics were generally reported to suppress expression of inflammatory cytokines and inducible inflammatory enzymes such as cyclooxygenase and microglia activation. No clear conclusions could be drawn with regard to any effect of antipsychotics on brain microglia from current clinical data. There is evidence to suggest that antipsychotic drugs influence brain microglia in experimental animals, including possible anti-inflammatory actions. However, we lack detailed information on how these drugs influence brain microglia function at the molecular level. The clinical relevance of the animal data with regard to beneficial treatment effects and detrimental side effects of antipsychotic drugs also remains unknown, and further studies are warranted.

一系列证据表明，一部分精神分裂症患者存在小胶质细胞（中枢神经系统 [CNS] 中的先天免疫细胞）的激活。抗精神病药物治疗在多大程度上促进或对抗这种效应仍不清楚。为了解决这个问题，我们回顾了文献，寻找抗精神病药物暴露影响大脑小胶质细胞的证据，如精神分裂症患者和实验动物模型的体内神经影像学和尸检研究所表明的。我们从临床研究中没有发现明确的证据表明抗精神病药对易位蛋白（TSPO）放射性配体结合（假定神经胶质增生的体内神经影像测量）或死后研究中的脑小胶质细胞标记物有影响。在实验动物中，药物和疾病的影响可能有所不同，我们也没有发现明确的证据表明抗精神病药物对 TSPO 放射性配体结合的影响一致。相比之下，我们发现证据表明长期接触抗精神病药物可能会影响中央小胶质细胞的密度和形态。然而，这些作用取决于药物暴露的剂量和持续时间以及是否存在免疫刺激。在后一种情况下，抗精神病药通常被报道可抑制炎症细胞因子和诱导性炎症酶（例如环氧合酶和小胶质细胞活化）的表达。从目前的临床数据来看，尚无法得出关于抗精神病药物对大脑小胶质细胞的影响的明确结论。有证据表明抗精神病药物会影响实验动物的大脑小胶质细胞，包括可能的抗炎作用。然而，我们缺乏这些药物如何在分子水平上影响大脑小胶质细胞功能的详细信息。 动物数据关于抗精神病药物的有益治疗效果和有害副作用的临床相关性仍然未知，需要进一步研究。