Background and Hypothesis Neuroinflammation and blood-brain barrier (BBB) dysfunction have been observed in patients with psychotic disorders. However, previous studies have mainly focused on selected patients and broad screenings of cerebrospinal fluid (CSF) of patients with recent onset psychosis compared to healthy controls are lacking. Study Design We included 104 patients with recent onset psychotic disorder and 104 individually matched healthy controls. CSF and blood were analyzed for readily available markers assessing neuroinflammation and BBB dysfunction. Primary outcomes were CSF white blood cell count (WBC), total protein, IgG Index, and CSF/serum albumin ratio. Secondary outcomes included additional markers of inflammation and BBB, and analyses of association with clinical variables. Study Results CSF/serum albumin ratio (Relative Mean Difference (MD): 1.11; 95%CI: 1.00–1.23; P = .044) and CSF/serum IgG ratio (MD: 1.17; 95%CI: 1.01–1.36; P = .036) was increased in patients compared to controls. A higher number of patients than controls had CSF WBC >3 cells/µl (seven vs. one, OR: 7.73, 95%CI: 1.33–146.49, P = .020), while WBC>5 cells/µl was found in two patients (1.9%) and no controls. Inpatients had higher serum WBC and neutrophil/lymphocyte ratio (all p-values for effect heterogeneity < .011). Mean CSF WBC (MD: 1.10; 95%CI: 0.97–1.26), protein (MD: 1.06; 95%CI: 0.98–1.15) and IgG index (MD: 1.05; 95%CI: 0.96–1.15) were not significantly elevated. Conclusions When comparing a broad group of patients with psychotic disorders with healthy controls, patients had increased BBB permeability, more patients had high CSF WBC levels, and inpatients had increased peripheral inflammation, consistent with the hypothesis of a subgroup of patients with increased activation of the immune system.

中文翻译：

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精神障碍中神经炎症和血脑屏障的脑脊液和血液生物标志物以及个体匹配的健康对照

背景和假设 在精神病患者中观察到神经炎症和血脑屏障（BBB）功能障碍。然而，之前的研究主要集中在选定的患者上，并且缺乏对最近发病的精神病患者与健康对照者的脑脊液（CSF）的广泛筛查。研究设计 我们纳入了 104 名近期发病的精神障碍患者和 104 名单独匹配的健康对照者。分析脑脊液和血液中评估神经炎症和血脑屏障功能障碍的现成标记物。主要结果是脑脊液白细胞计数 (WBC)、总蛋白、IgG 指数和脑脊液/血清白蛋白比率。次要结果包括炎症和 BBB 的其他标志物，以及与临床变量的关联分析。研究结果 CSF/血清白蛋白比率（相对平均差 (MD)：1.11；95%CI：1.00–1.23；P = 0.044）和 CSF/血清 IgG 比率（MD：1.17；95%CI：1.01–1.36；P = .036) 与对照组相比，患者增加。与对照组相比，脑脊液 WBC > 3 个细胞/μl 的患者数量较多（七对 1，OR：7.73，95% CI：1.33–146.49，P = 0.020），而 WBC > 5 个细胞/μl 的患者数量较多两名患者（1.9%），没有对照。住院患者的血清白细胞和中性粒细胞/淋巴细胞比率较高（效应异质性的所有 p 值均 < 0.011）。平均脑脊液白细胞 (MD: 1.10; 95%CI: 0.97–1.26)、蛋白质 (MD: 1.06; 95%CI: 0.98–1.15) 和 IgG 指数 (MD: 1.05; 95%CI: 0.96–1.15) 不显着升高。结论 当比较广泛的精神障碍患者与健康对照时，患者的血脑屏障通透性增加，更多的患者脑脊液白细胞水平较高，住院患者外周炎症增加，这与患者亚组激活增加的假设一致。免疫系统。