Bringing the immune system to the forefront of psychiatry
The relationship between an imbalanced immune system and mood disorders such as depression has been known for some time. However, exactly how the immune system influences mood is unclear. Better understanding will help unlock the potential for personalised treatments.
Our pioneering work led to the identification of biological markers measured from simple blood samples that can predict outcomes and drug responses in patients. Then we established laboratory-based procedures to test and personalise treatment with novel antidepressants. One of these procedures included our first-in-human study which involved recreating inflammation in healthy volunteers like that seen in treatment-resistant depression. This helps us to test responses to novel antidepressants.
Depression in a dish
Our ‘depression in a dish’ model uses human brain cells to provide insights into the links between stress and depression. One of our most important discoveries is that a molecule produced by the immune system that increases inflammation (interleukin-1 beta) can reduce the formation of new brain cells.
By measuring genetic material of interleukin-1 beta in the blood of depressed patients, we identified that it predicted future response to conventional antidepressants. These findings led to funding from several sources, including industry, enabling us to develop new studies testing the effects of anti-inflammatory drugs on mood disorders.
These insights led to a clinical trial, supported by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, to examine the antidepressant effects of minocycline in patients with high levels of inflammation. Minocycline is a safe and widely used antibiotic with anti-inflammatory properties.
The study identified the level of inflammation at which minocycline gave greater improvement in depressive symptoms in patients with treatment-resistant depression, paving the way for successful use of a simple and accessible blood test to personalise treatment.
BBC news report on the role of inflammation in depression with Professor Carmine Pariante, NIHR Maudsley BRC theme lead for Affective Disorders and Interface with Medicine.
Patient and carer involvement
With the BRC Patient & Carer Involvement & Engagement team, we assessed patient and public acceptance of this novel treatment approach and reached out to clinical and lay-audiences in public education and dissemination activities. We received positive and supportive feedback from participants about the use of anti-inflammatory treatments for depression.
Our findings have fostered successful immunopsychiatry projects across different diagnoses within the Maudsley BRC and in collaboration with other universities (e.g., Manchester, Cardiff). The field of immunopsychiatry is growing internationally and represents an important step towards personalised treatment in psychiatry.
IMPACT AREAS:
Whole Person Care | Novel Diagnostics and Therapeutics | Industry Collaboration | National and International Collaboration | Personalising Treatment to Patients
