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Immune Aberrations in Obsessive-Compulsive Disorder: a Systematic Review and Meta-analysis

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Abstract

Some lines of evidence have indicated that immune dysregulation could play a role in the pathophysiology of obsessive-compulsive disorder (OCD). However, results have been inconsistent across studies. Thus, a systematic review and meta-analysis of studies measuring immune mediators in participants with OCD compared to healthy controls (HC) was conducted. The PubMed/MEDLINE, PsycINFO, and EMBASE electronic databases were systematically searched from inception through June 21, 2018. Sixteen studies met inclusion criteria comprising data from 1001 participants (538 with OCD and 463 were HCs). Levels of TNF-α, IL-6, IL-1β, IL-4, IL-10, and interferon-γ did not significantly differ between participants with OCD and healthy controls. In addition, the ex vivo production of TNF-α and IL-6 by isolated macrophages did not significantly differ between participants with OCD and HCs. Nevertheless, included studies have varied in methodological quality with the enrollment of samples that differed regarding medication status, the proper matching of OCD participants and HCs, age groups, and the presence of psychiatric comorbidities. In conclusion, an association between immune dysregulation and OCD remains unproven. Future studies should consider enrolling larger and more homogeneous samples with OCD.

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Author information

Author notes

  1. Brendon Stubbs and Andre F. Carvalho contributed equally to this work.

Authors and Affiliations

  1. Gerontology Research Center, Simon Fraser University, Vancouver, Canada

    Theodore D. Cosco

  2. Oxford Institute of Population Ageing, University of Oxford, Oxford, UK

    Theodore D. Cosco

  3. Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London, UK

    Toby Pillinger

  4. Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA

    Hadeer Emam

  5. Neurosciences Department, University of Padua, Padua, Italy

    Marco Solmi

  6. Padova Neuroscience Center, University of Padua, Padua, Italy

    Marco Solmi

  7. National Hospital for Neurology and Neurosurgery, Queen Square, London, UK

    Sanjay Budhdeo

  8. Institute of Neurology, University College London, London, UK

    Sanjay Budhdeo

  9. Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, London, UK

    A. Matthew Prina

  10. Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

    Michael Maes

  11. IMPACT Strategic Research Center, Deakin University, Geelong, Australia

    Michael Maes

  12. Department of Psychiatry and MRC Unit on Risk and Resilience in Mental Disorders, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa

    Dan J. Stein

  13. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK

    Brendon Stubbs

  14. Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London, UK

    Brendon Stubbs

  15. Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK

    Brendon Stubbs

  16. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Andre F. Carvalho

  17. Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada

    Andre F. Carvalho

  18. Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Andre F. Carvalho

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  1. Theodore D. Cosco
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  3. Hadeer Emam
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  7. Michael Maes
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  10. Andre F. Carvalho
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Corresponding author

Correspondence to Andre F. Carvalho.

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Conflict of Interest

DJS is supported by the Medical Research Council of South Africa and has received research grants and/or consultancy honoraria from Abbott, Astrazeneca, Eli-Lilly, GlaxoSmithKline, Jazz Pharmaceuticals, Johnson & Johnson, Lundbeck, Orion, Pfizer, Pharmacia, Roche, Servier, Solvay, Sumitomo, Takeda, Tikvah, and Wyeth. The other authors declare no conflict of interest.

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Cosco, T.D., Pillinger, T., Emam, H. et al. Immune Aberrations in Obsessive-Compulsive Disorder: a Systematic Review and Meta-analysis. Mol Neurobiol 56, 4751–4759 (2019). https://doi.org/10.1007/s12035-018-1409-x

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