New studies are investigating the link between psychiatric disorders and the immune system.
Treatments that modify the immune response, immunotherapy, are increasingly employed and researched to address many disease processes including autoimmune disorders and various types of cancer. However, the link between the immune system and the brain led to investigations regarding the role of immune function in mental health. Scientists found that the brain has a lymphatic system that links to the peripheral immune system. Also, T cells found in the meninges have an influence on cognition. The role of the immune system and effectiveness of immunotherapeutic approaches for psychiatric disorders have become important subjects of study.
Results of a number of studies suggest that inflammation may play a role in the development of psychiatric disorders. For instance, treatment with non-steroidal anti-inflammatory drugs (NSAIDs) improved the pathological process of psychiatric disorders in some patients, and blood cytokine levels associated with inflammation could be used to predict responses to NSAID treatment. A meta-analysis showed that certain inflammatory markers increase during psychotic episodes, including mania and depression, but not during clinically stable periods.
Cytokines, such as interferons and interleukins, are proteins released by immune cells and regulate the immune response. The use of monoclonal antibodies that target cytokines and their receptors provide a means to study the role of inflammation in psychiatric disorders without the off-target effects that occur with NSAID treatment. Results of a study using infliximab, a monoclonal antibody that targets tumor necrosis factor (TNF)-alpha, in patients with treatment-resistant depression showed inhibition of genes related to TNF signaling in infliximab responders.
Trials are currently ongoing to evaluate the treatment effectiveness of monoclonal antibodies targeting cytokines such as interleukins, TNF-alpha, and alpha 4 integrin (a cell adhesion molecule) in major depressive disorder, bipolar depression, and schizophrenia. Results of these studies will shed light on the link between the immune system and mental health. This new information will also provide clues to developing personalized medical approaches for patients with mental health disorders.
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Miller, Brian J, and Peter F Buckley. 2017. "Monoclonal Antibody Immunotherapy In Psychiatric Disorders". The Lancet Psychiatry 4 (1): 13-15. Elsevier BV. doi:10.1016/s2215-0366(16)30366-2.