Psychotic disorders are very common and serious diseases, characterized by an altered perception of reality, the main symptoms of which are hallucinations, delusions and distortions of thought. It is a disabling disorder that involves both the emotional and cognitive sphere of the person, causing an important alteration in work and social skills. It generally occurs during adolescence, although, recent data have also shown an increase in childhood. Even if this disease has been described since Greek times, there are no programs in Italy dedicated to the identification of pre-psychotic conditions. Various risk factors have been identified including biological, genetic, psychological and environmental factors (such as childhood adverse events, prenatal infections, substance abuse, etc.) but the underlying pathophysiological mechanisms are not fully understood. Emerging evidence highlights the immune system, underestimated until now, as a possible underlying mechanism for the development of these disorders. Social and relational stress, adverse psycho-social experiences, unfavorable climates during childhood seem to have an effect on the immune system, tending to increase pro-inflammatory signaling in adulthood and the onset of psychosis, especially in subjects carrying functional polymorphisms in specific genes (eg COMT, BDNF, etc.). Hence, the hypothesis on which this work is based is that early psychosocial and prenatal adverse events can trigger an abnormal immune response by altering neuronal connectivity during development which could increase the risk of psychosis. The identification of predictive immune markers for the risk of developing psychosis, would provide an important mean for public health to identify children and adolescents at risk of major psychosis, guarantee an early diagnosis and treatment, and consequently reduce the percentage of subjects with psychosis, the severity of the disability and the associated costs to the community.
I disturbi psicotici sono malattie molto comuni e gravi, caratterizzati da un’alterata percezione della realtà, i cui principali sintomi sono allucinazioni, delusioni e distorsioni del pensiero. È un disturbo invalidante che coinvolge sia la sfera affettiva che cognitiva della persona, alterando le sue capacità lavorative e sociali. Generalmente insorge durante l’adolescenza, anche se dati recenti, ne hanno mostrato un incremento anche durante l’infanzia. Pur essendo patologie conosciute e descritte già dai tempi dei greci, non vi sono in Italia programmi dedicati all’identificazione di condizioni pre-psicotiche. Sono stati indicati vari fattori di rischio tra cui fattori biologici, genetici, psicologici e ambientali (come eventi avversi infantili, infezioni prenatale, abuso di sostanze, etc.) ma i meccanismi fisiopatologici alla base non sono del tutto compresi. Prove emergenti vedono come possibile meccanismo sottostante lo sviluppo di questi disturbi il sistema immunitario, fino ad ora sottostimato. Stress sociale e relazionale, esperienze psico-sociali avverse, climi familiari poco favorevoli durante l’infanzia sembrano avere un effetto sul sistema immunitario, tendendo ad aumentare la segnalazione pro-infiammatoria in età adulta e l’insorgenza di psicosi, soprattutto in soggetti portatori di polimorfismi funzionali di geni specifici (es. COMT, BDNF, etc.). Pertanto, l’ipotesi su cui si basa questo studio è che i primi eventi avversi psicosociali e prenatali possano innescare una risposta immunitaria anormale alterando la connettività neuronale durante lo sviluppo che può, a sua volta, aumentare il rischio di psicosi. L’identificazione di eventuali marcatori immunitari predittivi del rischio di sviluppare psicosi fornirebbe un importante mezzo per la sanità pubblica per identificare bambini e adolescenti a maggior rischio di psicosi, garantendo una diagnosi e un trattamento precoce e di conseguenza riducendo la percentuale di soggetti con psicosi conclamata, la gravità della disabilità e i relativi costi per la comunità.
Studio del profilo di espressione genica del sistema immunitario come marcatore predittivo dello sviluppo di psicosi
PRATESI, MARIA LUISA
2019/2020
Abstract
Psychotic disorders are very common and serious diseases, characterized by an altered perception of reality, the main symptoms of which are hallucinations, delusions and distortions of thought. It is a disabling disorder that involves both the emotional and cognitive sphere of the person, causing an important alteration in work and social skills. It generally occurs during adolescence, although, recent data have also shown an increase in childhood. Even if this disease has been described since Greek times, there are no programs in Italy dedicated to the identification of pre-psychotic conditions. Various risk factors have been identified including biological, genetic, psychological and environmental factors (such as childhood adverse events, prenatal infections, substance abuse, etc.) but the underlying pathophysiological mechanisms are not fully understood. Emerging evidence highlights the immune system, underestimated until now, as a possible underlying mechanism for the development of these disorders. Social and relational stress, adverse psycho-social experiences, unfavorable climates during childhood seem to have an effect on the immune system, tending to increase pro-inflammatory signaling in adulthood and the onset of psychosis, especially in subjects carrying functional polymorphisms in specific genes (eg COMT, BDNF, etc.). Hence, the hypothesis on which this work is based is that early psychosocial and prenatal adverse events can trigger an abnormal immune response by altering neuronal connectivity during development which could increase the risk of psychosis. The identification of predictive immune markers for the risk of developing psychosis, would provide an important mean for public health to identify children and adolescents at risk of major psychosis, guarantee an early diagnosis and treatment, and consequently reduce the percentage of subjects with psychosis, the severity of the disability and the associated costs to the community.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/12459