Evidence map›Paper›PMID 30407606›Full record

SynthesisSchizophrenia bulletin2019

A Meta-analysis of Immune Parameters, Variability, and Assessment of Modal Distribution in Psychosis and Test of the Immune Subgroup Hypothesis.

Toby Pillinger, Emanuele F Osimo, Stefan Brugger, Valeria Mondelli, Robert A McCutcheon, Oliver D Howes

Open access · hybridAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Schizophrenia bulletin, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 95 papers, 18 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
95citing papers in PubMed, 18 pooled it
4.8field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

95 citing papers in PubMed, 18 syntheses or guidelines pooled it, 191 citations in OpenAlex.

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  12. White-matter free-water diffusion MRI in schizophrenia: a systematic review and meta-analysis.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2022
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35 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Toby PillingerInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Emanuele F OsimoDepartment of Psychiatry, University of Cambridge, Cambridge, UK.
Stefan BruggerInstitute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, UK.
Valeria MondelliInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Robert A McCutcheonInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Oliver D HowesInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
King's College London · GBUniversity College London · GBUniversity of Cambridge · GB

Funding

Medical Research Council MC-A656-5QD30Medical Research Council MC_U120097115Wellcome TrustWellcome Trust 094849/Z/10/ZWellcome Trust 200102/Z/15/Z
6 · The paper itself

Abstract

Immune parameters are elevated in psychosis, but it is unclear whether alterations are homogenous across patients or heterogeneity exists, consistent with the hypothesis that immune alterations are specific to a subgroup of patients. To address this, we examine whether antipsychotic-naïve first-episode psychosis patients exhibit greater variability in blood cytokines, C-reactive protein, and white cell counts compared with controls, and if group mean differences persist after adjusting for skewed data and potential confounds. Databases were searched for studies reporting levels of peripheral immune parameters. Means and variances were extracted and analyzed using multivariate meta-analysis of mean and variability of differences. Outcomes were (1) variability in patients relative to controls, indexed by variability ratio (VR) and coefficient of variation ratio (CVR); (2) mean differences indexed by Hedges g; (3) Modal distribution of raw immune parameter data using Hartigan's unimodality dip test. Thirty-five studies reporting on 1263 patients and 1470 controls were included. Variability of interleukin-6 (IL6) (VR = 0.19), tumor necrosis factor-α (TNFα) (VR = 0.36), interleukin-1β (VR = 0.35), interleukin-4 (VR = 0.55), and interleukin-8 (VR = 0.28) was reduced in patients. Results persisted for IL6 and IL8 after mean-scaling. Ninety-four percent and one hundred percent of raw data were unimodally distributed in psychosis and controls, respectively. Mean levels of IL6 (g = 0.62), TNFα (g = 0.56), interferon-γ (IFNγ) (g = 0.32), transforming growth factor-β (g = 0.53), and interleukin-17 (IL17) (g = 0.48) were elevated in psychosis. Sensitivity analyses indicated this is unlikely explained by confounders for IL6, IFNγ, and IL17. These findings show elevated cytokines in psychosis after accounting for confounds, and that the hypothesis of an immune subgroup is not supported by the variability or modal distribution.

Indexed as

Prodromal SymptomsCase-Control StudiesC-Reactive ProteinCytokinesHumansInterferon-gammaInterleukin-17Interleukin-1betaInterleukin-4Interleukin-6Interleukin-8Leukocyte CountLymphocyte CountModels, StatisticalPsychotic DisordersSchizophreniaC-Reactive ProteinCXCL8 protein, humanCytokinesIFNG protein, humanIL1B protein, humanIL4 protein, humanIL6 protein, humanInterferon-gammaInterleukin-17Interleukin-1betaInterleukin-4Interleukin-6Interleukin-8TNF protein, humanTransforming Growth Factor betaTumor Necrosis Factor-alphaimmuneinflammationpsychosisvariability

Identifiers

PMID30407606
PMCPMC6737479
OpenAlexW2900366804

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.