This article presents a meta-analysis of cytokine alterations in schizophrenia, focusing on clinical status and antipsychotic effects. The study included 40 studies, revealing that cytokines such as IL-1β, IL-6, and TGF-β are state markers, increasing during acute exacerbations and normalizing with antipsychotic treatment. In contrast, IL-12, IFN-γ, TNF-α, and sIL-2R are trait markers, remaining elevated even after treatment. The study also found no significant difference in IL-6 levels between stable medicated outpatients and controls. Cerebrospinal fluid levels of IL-1β were significantly lower in schizophrenia patients compared to controls. The findings suggest that cytokine abnormalities are associated with acute exacerbations of schizophrenia, independent of antipsychotic medications. However, most studies did not control for potential confounding factors like BMI and smoking. The study highlights the potential of cytokine levels as biomarkers for illness relapse and response to anti-inflammatory treatment in schizophrenia. The results support immune-cytokine hypotheses for schizophrenia, including the macrophage-T-lymphocyte theory, Th2-hypothesis, and microglial hypothesis. The study also discusses the limitations, including small sample sizes, high heterogeneity, and lack of control for confounding factors. Future research should focus on stratifying patients by clinical status and controlling for known confounding factors to better understand the role of cytokines in schizophrenia.This article presents a meta-analysis of cytokine alterations in schizophrenia, focusing on clinical status and antipsychotic effects. The study included 40 studies, revealing that cytokines such as IL-1β, IL-6, and TGF-β are state markers, increasing during acute exacerbations and normalizing with antipsychotic treatment. In contrast, IL-12, IFN-γ, TNF-α, and sIL-2R are trait markers, remaining elevated even after treatment. The study also found no significant difference in IL-6 levels between stable medicated outpatients and controls. Cerebrospinal fluid levels of IL-1β were significantly lower in schizophrenia patients compared to controls. The findings suggest that cytokine abnormalities are associated with acute exacerbations of schizophrenia, independent of antipsychotic medications. However, most studies did not control for potential confounding factors like BMI and smoking. The study highlights the potential of cytokine levels as biomarkers for illness relapse and response to anti-inflammatory treatment in schizophrenia. The results support immune-cytokine hypotheses for schizophrenia, including the macrophage-T-lymphocyte theory, Th2-hypothesis, and microglial hypothesis. The study also discusses the limitations, including small sample sizes, high heterogeneity, and lack of control for confounding factors. Future research should focus on stratifying patients by clinical status and controlling for known confounding factors to better understand the role of cytokines in schizophrenia.