When we get sick, our immune system kicks in to fight the virus or bacteria. Our immune system represents the soldiers of our bodies that fight battles of foreign invasions and is composed of B cells which make antibodies, T cells which make killer cells and our lymph nodes where these soldiers live. Our nervous system also has its own immune system that fights foreign invaders, and the primary soldiers are known as microglia cells, which are responsible for fighting neuroinflammation. Studies have suggested that these “brain soldiers” may be increased in psychotic disorders such as schizophrenia.
Neuroinflammation may foretell psychotic episodes
Schizophrenia is characterized by psychotic episodes, which are marked by disorganized speech, hallucinations, neurocognitive deficits, depressed mood and loss of interest. This psychotic disorder has a huge genetic component and statistics show that a child is 40 percent more likely to be diagnosed with schizophrenia if both of his or her parents have the disease. Schizophrenia is usually diagnosed in patients who are in their mid-20s. Although this is not an inflammatory disorder such as multiple sclerosis, a recent study found that there is a higher density of microglia cells in the brain of those patients who have schizophrenia — opening the discussion that a neuroinflammation marker may foretell episodes of psychosis and may give clues to an early diagnosis of schizophrenia.
The onset of schizophrenia is often preceded by a brief psychotic episode and functional impairment, and 35 percent of high-risk people with these early symptoms will be diagnosed with a psychotic disorder, likely schizophrenia within 24 months. So can this marker of neuroinflammation be a prognostic indicator for the development of schizophrenia?
A marker associated with psychosis
A study in London compared patients diagnosed with schizophrenia with those who are at high risk and compared the density of the microglia cells in their central nervous systems (CNS) by using PET scans. Patients with schizophrenia and those who have been deemed high risk were found to have a large amount of microglia cells in their CNS. The specific marker for the microglia cells, known as [11C]PBR28, was increased in both patients who had been diagnosed with schizophrenia and those who were considered high risk for schizophrenia.
“The researchers concluded that [11C]PBR28, a marker of microglial activity, is elevated in subjects at ultra-high risk for psychosis and is independent of the effects of previous psychotic illness or its treatment,” wrote Brian Miller, M.D., Ph.D., for Psychiatric Times. “Furthermore, this marker was associated with subclinical psychotic symptoms, but not depression, which suggests an association that is specific to psychosis rather than to psychiatric symptoms in general.”
The next step in finding a cure
So what does this mean? Can a treatment be developed that targets these inflammatory cells to prevent or cure schizophrenia? No cure exists for schizophrenia and medicine treatments aim to prevent symptoms and periods of acute psychosis, but researchers are trying to change this and find a cure. Targeting these microglia cells and these inflammatory markers may be the next step in finding a cure for schizophrenia.
“This study suggests that persons at high risk for psychosis have evidence of neuroinflammation that may be involved in the development of psychotic disorders,” Miller wrote. “Replicated findings would indicate that anti-inflammatory treatment might be effective in preventing the transition to psychotic disorder in these persons.”
Sovereign Health of Rancho San Diego is a leading behavioral health treatment provider that treats adolescents with mental health disorders such as brief psychotic disorder and teen schizoaffective disorder, as well as substance use disorders and co-occurring disorders. For more information, please call our 24/7 helpline.
About the author
Kristen Fuller, M.D., is a senior staff writer at the Sovereign Health Group and enjoys writing about evidence-based topics in the cutting-edge world of medicine. She is a physician and author, who also teaches, practices medicine in the urgent care setting and contributes to medicine board education. She is also an outdoor and dog enthusiast. For more information and other inquiries about this article, contact the author at email@example.com.