Recent advances in psychoneuroimmunology relevant to schizophrenia therapeutics

Immunological understanding of neurological and cognitive alterations of schizophrenia has made a significant breakthrough in unfolding the pathophysiological mechanisms of schizophrenia, at least in a group of patients. Such psychoneuroimmunological aberrations essentially argue for an alternative treatment approach based on immunomodulation in schizophrenia.

Recent findings in schizophrenia have shown exaggerated immuno-inflammatory responses due to persistent systemic inflammation and neuroinflammation involving microglia activation. The existing antipsychotic drugs have shown substantial benefits in the control of positive symptoms, but they have not demonstrated adequate immuno-dampening effects specifically and effectively. However, a group of emerging nonsteroidal as well as other anti-inflammatory drugs currently being used as an adjunct therapy seem to exhibit increased target specificity and effectiveness in reducing symptom severity to some extent.

The anti-inflammatory drugs that have been shown to reduce the levels of pro-inflammatory mediators and inhibit microglia activation have paved the way for better outcomes of schizophrenia treatment. However, many of the currently tested anti-inflammatory drugs often lack methodological robustness. The identification of novel target(s) that will integrate the processes evoked by various risk determinants into a common signalling pathway is urgently required, and this may take immunomodulation into a new therapeutic domain in schizophrenia.