mesЭкстремальная биомедицинаExtreme Medicine3033-89643033-8972Centre for Strategic Planning of the Federal Medical and Biological Agency10.47183/mes.2025-27-1-56-63mes-273Research ArticleНЕВРОЛОГИЯ И ПСИХИАТРИЯNEUROLOGY & PSYCHIATRYШизофрения и нейровоспаление: патогенетические и терапевтические аспектыSchizophrenia and neuroinflammation: Pathogenetic and therapeutic aspectshttps://orcid.org/0000-0001-7173-3373ЧугуновД. А.ChugunovD. A.

Чугунов Дмитрий Александрович - канд. мед. наук

Москва

Dmitry A. Chugunov

Moscow

dr.dmitry.83@gmail.comhttps://orcid.org/0000-0002-1060-5076ШмиловичА. А.ShmilovichA. A.

Шмилович Андрей Аркадьевич - д-р мед. наук

Москва

Andrey A. Shmilovich

Moscow

shmilovich@bk.ruhttps://orcid.org/0009-0008-0113-6555НиколаеваД. В.NikolaevaD. V.

Николаева Дарья Валерьевна

Москва

Daria V. Nikolaeva

Moscow

daniva0103@gmail.comhttps://orcid.org/0009-0001-0438-4983ЯшинаТ. В.YashinaT. V.

Яшина Тамара Викторовна

Москва

Tamara V. Yashina

Moscow

toma.yaschina@yandex.ruhttps://orcid.org/0009-0007-6635-6914ЛаринаМ. Р.LarinaM. R.

Ларина Мария Руслановна

Москва

Mariya R. Larina

Moscow

mimityan11@gmail.comhttps://orcid.org/0000-0002-3682-6571РоговскийВ. С.RogovskyV. S.

Роговский Владимир Станиславович - канд. мед. наук

Москва

Vladimir S. Rogovsky

Moscow

qwer555@mail.ruhttps://orcid.org/0000-0003-1086-9052СвиридоваА. А.SviridovaA. A.

Свиридова Анастасия Алексеевна

Москва

Anastasia A. Sviridova

Moscow

anastasiya-ana@yandex.ruФедеральный центр мозга и нейротехнологий Федерального медико-биологического агентства; Российский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияFederal Center of Brain Research and Neurotechnologies of the Federal Medical and Biological Agency; Pirogov Russian National Research Medical UniversityRussian FederationРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian FederationФедеральный центр мозга и нейротехнологий Федерального медико-биологического агентстваРоссияFederal Center of Brain Research and Neurotechnologies of the Federal Medical and Biological AgencyRussian Federation2025230320252715663Copyright © Чугунов Д.А., Шмилович А.А., Николаева Д.В., Яшина Т.В., Ларина М.Р., Роговский В.С., Свиридова А.А., 20252025Чугунов Д.А., Шмилович А.А., Николаева Д.В., Яшина Т.В., Ларина М.Р., Роговский В.С., Свиридова А.А.Chugunov D.A., Shmilovich A.A., Nikolaeva D.V., Yashina T.V., Larina M.R., Rogovsky V.S., Sviridova A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.extrememedicine.ru/jour/article/view/273Введение

Введение. Шизофрения — это сложное психическое расстройство с гетерогенной симптоматикой, включающей в себя психотические, негативные, когнитивные, аффективные и психомоторные симптомы. Несмотря на то что патогенез шизофрении главным образом связывают с дисбалансом нейротрансмиттеров, исследования последних лет указывают на большое значение нейровоспаления в патогенезе этого заболевания.

Цель

Цель. Изучение роли нейровоспаления в патогенезе шизофрении с оценкой вовлечения клеток врожденного, адаптивного иммунного ответа и функционирования гематоэнцефалического барьера (ГЭБ) в возникновении заболевания, а также прогностическая оценка противовоспалительного эффекта антипсихотических средств при шизофрении.

Обсуждение

Обсуждение. Современные данные свидетельствуют о значительной роли нейровоспаления в развитии и течении шизофрении. На начальных этапах заболевания повышается количество лимфоцитов, а также уровень нескольких провоспалительных цитокинов (ИЛ-1, ИЛ-6, ФНО-α, ИЛ-1β), которые могут снижаться на фоне антипсихотической терапии. Исследования на экспериментальной модели материнской иммунной активации (МИА) и данные иммуногистохимических и ПЭТ-исследований подтверждают аномальную активацию микроглии, что указывает на вовлечение клеток врожденного иммунитета. Клетки адаптивного иммунного ответа также могут играть существенную роль в развитии нейровоспаления при шизофрении (выявлено повышенное содержание Th17-клеток и увеличение продукции провоспалительных цитокинов, коррелирующих с тяжестью заболевания). Обсуждается роль нейромедиаторов в модуляции иммуновоспалительного ответа. Существующие данные позволяют предположить, что участие дофамина в патогенезе шизофрении может быть опосредовано его иммуномодулирующим эффектом. На роль нейровоспаления при шизофрении также указывает клиническая эффективность применения противовоспалительного лечения при данном заболевании. С другой стороны, установлен иммуномодулирующий эффект антипсихотиков, который, по крайней мере частично, может опосредовать их клиническую эффективность при шизофрении.

Выводы

Выводы. Ввиду значимости нейровоспаления в патогенезе шизофрении перспективны дальнейшие исследования как противовоспалительных свойств антипсихотиков, так и клинической эффективности противовоспалительных препаратов при шизофрении с целью дальнейшей рационализации терапии данного заболевания.

Introduction

Introduction. Schizophrenia is a complex mental disorder with heterogeneous symptoms, including psychotic, negative, cognitive, affective, and psychomotor symptoms. Although the pathogenesis of schizophrenia is mainly associated with neurotransmitter imbalance, recent studies have suggested the importance of neuroinflammation in the pathogenesis of this disease.

Objective

Objective. To study the involvement of neuroinflammation in the pathogenesis of schizophrenia and a prognostic assessment of the potential anti-inflammatory effect of antipsychotic medications.

Discussion

Discussion. Current data indicate a significant role of neuroinflammation in the development and course of schizophrenia. At the initial stages of its development, the number of lymphocytes and the level of some proinflammatory cytokines (IL-1, IL-6, TNF-α, IL-1β) increase, which can be decreased by antipsychotic therapy. Studies involving experimental models of maternal immune activation (MIA) and data obtained by immunohistochemical and PET studies confirm an abnormal activation of microglia, indicating the involvement of innate immune cells. Adaptive immune response cells can also play a significant role in the development of neuroinflammation in schizophrenia. Thus, an increased level of Th17 cells and an increase in the production of proinflammatory cytokines, correlating with the disease severity, were revealed. The role of neurotransmitters in modulating the immune-inflammatory response is discussed. Available data suggest that the participation of dopamine in the schizophrenia pathogenesis can be mediated by its immunomodulatory effect. The role of neuroinflammation in schizophrenia is also indicated by the clinical effectiveness of anti-inflammatory treatment in this disease. On the other hand, the immunomodulatory effect of antipsychotics has been established, which, at least in part, may mediate their clinical effectiveness in schizophrenia.

Conclusions

Conclusions. Given the importance of neuroinflammation in the schizophrenia pathogenesis, further studies into both the anti-inflammatory properties of antipsychotics and the effects of anti-inflammatory drugs in schizophrenia are promising in order to further optimize the treatment of this disease.

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The authors declare that there are no conflicts of interest present.