Abstract

Renewing interest in immune aspects of schizophrenia and new findings about the brain-fat axis encourage us to discuss the possible role of interleukin-6 (IL-6) in schizophrenia. Previously, it was suggested that a primary alteration of the innate immune system may be relevant in schizophrenia. Functional dichotomy of IL-6 suggests that this chemical messenger may be responsible for regulating the balance between pro- and anti-inflammatory responses, with tissue-specific properties at the periphery and in the central nervous system. Specific phase of this chronic and deteriorating disorder must be considered, which can involve IL-6 in acute or possible chronic inflammation and/or autoimmunity. We give an overview of IL-6 role in the onset and progression of this disorder, also considering cognitive impairment and metabolic changes in patients with schizophrenia. Data suggest that decreased serum level of IL-6 following antipsychotic therapy could be predisposing factor for the development of obesity and obesity-related metabolic disorders in schizophrenia. As we reviewed, the IL-6 plays significant role in disease genesis and progression, so the use of specific inhibitors may not only be beneficial for exacerbation and alleviation of positive symptoms, but may attenuate cognitive impairment in patients with schizophrenia.

Highlights

  • The immune system could be described as a sensory system whose primary purpose is identifying the foreign (“non-self ”) substances, referred to as antigens

  • Systemic level of IL-6 strongly correlates with obesity and insulin resistance and serum concentrations of IL-6, soluble IL-6R (sIL-6R), and gp130 are elevated in patients with metabolic syndrome (MetS) and related cardiovascular disorders [77]

  • Some researchers found an increase of anti-inflammatory cytokine IL-10 in sera of patients treated with antipsychotics [117] and we showed that increased levels of TGF-β stay elevated after antipsychotic therapy in first-episode psychosis and schizophrenia in relapse [62, 105]

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Summary

Introduction

The immune system could be described as a sensory system whose primary purpose is identifying the foreign (“non-self ”) substances, referred to as antigens. Besides its role in the innate immune response, IL-6 regulates acquired immunity by promoting specific differentiation of naive CD4+ T cells, but these effects are context dependent. Interleukin-6 has been widely studied in different aspects of schizophrenia: its onset and progression, association with different clusters of symptoms, response and resistance to the treatment, and metabolical and other comorbid states.

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