Immune processes and risk of psychosis

There is an ongoing and dramatic growth in understanding of the ways in which the central nervous system and immune systems interact. From developments in glial biology through to fundamental discoveries such as brain lymphatic drainage and glymphatic circulation, the notion of brain immune privilege is undergoing considerable refinement. This basic science is emerging alongside novel clinical fields with potential relevance to psychiatry including antibody-mediated encephalopathies, maternal immune activation, and maternofetal antibody transfer models of neurodevelopmental disorders. Furthermore, robust findings of immune loci in genome-wide association studies are beginning to be contextualized in functional studies. Here, we review immunological and inflammatory findings associated with the development and maintenance of psychotic disorders, from classical epidemiological findings on psychotic risk relating to winter birth and maternal infection to biomarker studies of inflammatory mediators and recent immunogenetic developments. We consider the current diagnostic and therapeutic implications and potential future approaches of translational significance.