{
  "abstract": "Adolescent-onset schizophrenia (AOS) is marked by severe symptoms and cognitive impairments, yet its peripheral immune profile remains insufficiently characterized. This cross-sectional study aimed to develop composite immune pathway indices integrating serum B cell-activating factor (BAFF), a proliferation-inducing ligand (APRIL), interleukin (IL)-23, and IL-17 levels to reflect immune dysfunction. We examined 93 patients with first-episode, antipsychotic-naive AOS and 40 healthy controls. Five indices were constructed: immune homeostasis protection index (IHPI), BAFF-APRIL immune ratio (BAIR), immune drive-attenuation ratio (IDA), Th17 decoupling index (TDI), and full immune imbalance index (FIII). Serum BAFF (t = −3.324, P = 0.001) and APRIL (t = −3.687, P < 0.001) were significantly reduced and IL-23 was increased (Z = −2.777, P = 0.005), whereas IL-17 remained unchanged (P = 0.292) in patients with AOS. BAIR did not differ between groups (P = 0.741). IHPI was significantly reduced in patients with AOS (t = −5.203, P < 0.001), whereas IDA, TDI, and FIII were elevated (all P < 0.001). Serum IL-23 was independently associated with Positive and Negative Syndrome Scale total score (β = 0.321, P = 0.002) and general psychopathology subscale score (β = 0.320, P = 0.001). In healthy controls, serum BAFF predicted immediate memory (β = 0.408, P = 0.009) and Repeatable Battery for the Assessment of Neuropsychological Status total score (β = 0.444, P = 0.005), an association not observed in patients with AOS. Among composite indices, IHPI achieved the best discriminative performance (AUC = 0.751, sensitivity: 69.9%, and specificity: 72.5%), outperforming individual biomarkers. These findings indicated that dual peripheral immune dysregulation in AOS was characterized by attenuated B cell trophic support and upstream IL-23/Th17 activation, and suggested that composite immune indices may provide incremental diagnostic value over single cytokines.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Psychiatry, Lianyungang Psychiatric Hospital, The Fourth People’s Hospital of Lianyungang, The Affiliated Hospital of KangDa College of Nanjing Medical University, Lianyungang, 222003 China",
    "Xuzhou Medical University, Xuzhou, 221004 China",
    "The First Clinical Medical College of Xuzhou Medical University, Xuzhou, 221004 China",
    "Department of Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, 215137 China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Haidong Yang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Lingshu Luan"
    },
    {
      "affs": [
        2
      ],
      "name": "Yubing Han"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Sijin Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Man Yang"
    },
    {
      "affs": [
        3
      ],
      "name": "Xiaobin Zhang",
      "orcid": "0000-0002-0577-5951"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5kdz0w0vyygfq.bib",
  "cited_by": 0,
  "doi": "10.1038/s41398-026-04343-5",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13710852/",
  "id": "5kdz0w0vyygfq",
  "issns": [
    "2158-3188"
  ],
  "landing_url": "https://doi.org/10.1038/s41398-026-04343-5",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Article"
    ],
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      "openalex",
      "2803|Tryptophan and brain disorders"
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  "openalex": "W7171767071",
  "pdf_url": "https://www.nature.com/articles/s41398-026-04343-5_reference.pdf",
  "pmcid": "PMC13710852",
  "pmid": "42934216",
  "published": "2026-07-30",
  "publisher": "Nature Publishing Group",
  "ris": "https://research.draconitic.com/paper/5kdz0w0vyygfq.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:44Z",
      "native_id": "PMC13710852",
      "source": "pmc",
      "url": "https://doi.org/10.1038/s41398-026-04343-5"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2803|Tryptophan and brain disorders",
      "subfield": "psychiatry"
    }
  ],
  "title": "Dual immune dysregulation in adolescent-onset schizophrenia: attenuated B cell trophic support and elevated IL-23/Th17 inflammation are diagnostic and clinical biomarkers",
  "title_text": "Dual immune dysregulation in adolescent-onset schizophrenia: attenuated B cell trophic support and elevated IL-23/Th17 inflammation are diagnostic and clinical biomarkers",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:21:44Z",
  "url": "https://research.draconitic.com/paper/5kdz0w0vyygfq",
  "venue": "Translational Psychiatry",
  "versions": []
}