Anti-inflammatory signaling in schizophrenia

A great deal of interest has been centered upon activated inflammatory processes in schizophrenia and their contribution to disease-relevant brain and behavioral impairment. In contrast, the role of anti-inflammatory signaling has attracted somewhat less attention in this context. The present article focuses on the emerging role of anti-inflammatory signaling in schizophrenia and discusses the potential influence of altered anti-inflammatory activity on progressive inflammatory processes, physical and metabolic functions, and treatment effects related to the use of conventional antipsychotic drugs and immunomodulatory agents in the pharmacotherapy of schizophrenia. By reviewing existing evidence, it appears that enhanced anti-inflammatory activity has many faces in schizophrenia: On the one hand, it may effectively limit potentially harmful inflammatory processes and may contribute to the improvement of psychopathological symptoms, especially when the anti-inflammatory system is boosted at early stages of the disease. On the other hand, enhanced anti-inflammatory activity may render affected individuals more susceptible to distinct physiological abnormalities such as cardiovascular disease, and may further impede the resistance to specific infectious agents. Therefore, an enhancement of anti-inflammatory signaling in schizophrenia might not simply be said to be either advantageous or disadvantageous, but rather should be interpreted and dealt with in a context-dependent manner. Increased awareness of the multiple roles of anti-inflammatory signaling may readily help to reduce additional health burdens in schizophrenia, and at the same time, may provide opportunities to further explore the benefits associated with anti-inflammatory strategies in the symptomatological and/or preventive treatment of this disorder. (C) 2011 Elsevier Inc. All rights reserved.