The authors have declared that there are no conflicts of interest in relation to the subject of this study.
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Volume Article Contents Abstract. Material and Methods. Nielsen , Philip R. Oxford Academic. Preben B. Cite Cite Philip R. Select Format Select format. Permissions Icon Permissions. Abstract Infections and immune responses have been suggested to play an important role in the etiology of schizophrenia. Table 1. Hospital Infection. In contrast to older studies, recent studies report significantly more CMV antibodies in persons with schizophrenia than in controls.
In a study by Leweke and colleagues, 19 for example, 36 treatment-naive schizophrenic patients had significantly more antibodies in their sera P P 20 Another recent study reports that serum antibodies to CMV are particularly high in schizophrenic persons who have predominantly negative symptoms the so-called deficit syndrome.
Finally, a recent treatment trial showed significant symptomatic improvement in schizophrenic patients who were treated with valacyclovir, an antiviral agent effective against herpes viruses. Endogenous retroviruses are DNA elements that have become part of the human genome through infection and integration into germ line cells of humans and nonhuman primate progenitors. Retroviruses lie dormant most of the time. When activated, however, they can influence the transcription of genes above or below the site of their chromosomal integration.
Genetic polymorphisms of endogenous retroviruses have been linked with an alteration in immune response and increased susceptibility to autoimmune disorders. Endogenous retroviruses share properties of both genes and infectious agents, and are thus potential links between the two. Increased retroviral transcription in the CSF and blood of persons with recentonset psychosis supports a possible role for human endogenous retrovirus in the development of schizophrenia.
Proving a causative role for infectious agents in schizophrenia and bipolar disorder would open the door to new treatments and disease prevention strategies. With the support of The Stanley Medical Research Institute, we are conducting several double-blind treatment trials that involve the use of adjunctive antibiotics and antiviral medications in persons with schizophrenia and bipolar illness. To date, these medications show some promise in patients with recent-onset disease.
The results are less remarkable in persons with long-standing illness. In the future, it might even be possible to develop a vaccine to protect children against possible infections that contribute to these 2 mental illnesses. Even with what is known today, in clinical settings, some patients who present initially with symptoms suggestive of schizophrenia or bipolar disorder could instead be in the initial stages of viral encephalitis.
Some physicians would argue that patients with first-admission psychosis should have a lumbar puncture and CSF analysis, adding other studies as appropriate if indicated by an increase in CSF protein or lymphocytes. A small sample of the CSF could be frozen and stored for future analysis. With further advances in research at the interface between psychiatry and infectious disease, these samples may eventually provide the key to proving the connection between infection and mental disturbance, and pave the way for pharmacologic treatment specifically targeted to that causative infectious organism.
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Schizophr Res. Drugs used in the treatment of schizophrenia and bipolar disorder inhibit the replication of Toxoplasma gondii. Webster JP. Rats, cats, people and parasites: the impact of latent toxoplasmosis on behaviour. By Joe Gramigna, MA. Read next. February 14, Receive an email when new articles are posted on. Please provide your email address to receive an email when new articles are posted on.
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