In the field of psychiatry, biological markers are rarely, if ever, used in the diagnosis of mental health disorders. Clinicians rely primarily on patient histories and behavioral symptoms to identify specific psychopathologies, which makes diagnosis highly subjective. Moreover, therapies for mental health disorders are aimed specifically at attenuating behavioral manifestations, which overlooks the pathophysiological indices of the disease. This is highly evident in posttraumatic stress disorder (PTSD) where inflammation and immune system perturbations are becoming increasingly described. Further, patients with PTSD possess significantly elevated risks of developing comorbid inflammatory diseases such as autoimmune and cardiovascular diseases, which are likely linked (though not fully proven) to the apparent dysregulation of the immune system after psychological trauma. To date, there is little to no evidence that demonstrates current PTSD therapies are able to reverse the increased risk for psychological trauma-induced inflammatory diseases, which suggests the behavioral and somatic consequences of PTSD may not be tightly coupled. This observation provides an opportunity to explore unique mechanisms outside of the brain that contribute to the long-term pathology of PTSD. Herein, we provide an overview of neuroimmune mechanisms, describe what is known regarding innate and adaptive immunity in PTSD, and suggest new directions that are needed to advance the understanding, diagnosis, and treatment of PTSD moving forward.

中文翻译：

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创伤后应激障碍的先天性和适应性免疫系统后果


在精神病学领域，生物标志物很少（如果有的话）用于诊断心理健康障碍。临床医生主要依靠患者病史和行为症状来识别特定的精神病理学，这使得诊断非常主观。此外，心理健康障碍的治疗专门针对减轻行为表现，而行为表现忽视了疾病的病理生理指标。这在创伤后应激障碍 （PTSD） 中非常明显，其中炎症和免疫系统扰动越来越多地被描述。此外，PTSD 患者患自身免疫性疾病和心血管疾病等共病炎症性疾病的风险显着升高，这可能与心理创伤后免疫系统的明显失调有关（尽管尚未完全证实）。迄今为止，几乎没有证据表明目前的 PTSD 疗法能够逆转心理创伤诱发的炎症性疾病风险增加，这表明 PTSD 的行为和躯体后果可能并不紧密耦合。这一观察为探索大脑之外导致 PTSD 长期病理学的独特机制提供了机会。在本文中，我们概述了神经免疫机制，描述了有关 PTSD 先天免疫和适应性免疫的已知信息，并提出了推进 PTSD 理解、诊断和治疗所需的新方向。