Feeling sore: what immunology may teach us about psychiatric disorders

Curiosity about the link between inflammation and mental health was evident as delegates filled the room at this early morning scientific session at ECNP 2015.

A link between inflammation and mental health was first noted in the 19th century. In the last 10 years, interest in this subject has gathered pace, as epidemiological, genetic, preclinical and clinical data have all accumulated and demonstrate immune dysregulation in at least some patients with psychiatric disorders. A curiosity about this subject was clearly in evidence from the packed room in this early morning session, which saw many delegates sitting on the floor when there were no more chairs available. Professor Giulio Perugi, from the University of Pisa, Italy, appeared rather surprised. He claimed that, as an Italian, it was very hard for him to understand so many people making the effort to get to the conference centre for the 7:45 start! Nevertheless, our diligence was rewarded with his interesting thoughts on the subject of inflammation, autoimmunity and psychosis.

Accumulation of pathology

The relationship between psychiatric and autoimmune disorders or immune dysregulation may be related to their pathogenesis, possibly through shared genetic risk or common aetiologic factors such as infection. A genetic vulnerability combined with an external stressor such as infection early in life may combine to sensitise the immune systems, both in the periphery and the CNS. Once the inflammatory systems of the brain are activated, this can lead to neuronal damage, which may further increase stress on the brain and make further pathological changes more likely. Prof Perugi stated that research in this area points to models for the pathophysiology of psychosis based on genetic vulnerability in combination with another intervening stressor that may have at least as much clinical usefulness as the monoamine hypothesis.

A new road map to treatment?

On that basis, Prof Perugi cautioned that may be we are looking in the wrong place for the pathogenesis, and therefore approaches to treatment, for at least some patients with schizophrenia. If some instances of psychosis are not caused by a primary brain disorder, but rather brain pathology secondary to systemic inflammatory effects, then diagnosis and treatment may need to change. In the future, diagnosis on the basis of biological markers (if these could be defined) as well as or even instead of symptomatology could indicate that treatment with anti-inflammatory therapies was appropriate in a subset of patients.

 

Our correspondent’s highlights from the symposium are meant as a fair representation of the scientific content presented. The views and opinions expressed on this page do not necessarily reflect those of Otsuka and Lundbeck.

Country selection
We are registering that you are located in Brazil - if that's correct then please continue to Progress in Mind Brazil
You are leaving Progress in Mind
Le informazioni contenute nel nuovo sito prescelto possono non essere conformi al D.Ivo 219/06 che regola la pubblicità dei medicinali per uso umano e le opinioni espresse non riflettono necessariamente le posizioni dell’azienda, non sono da essa avvallate.
Accesso riservato a Operatori Sanitari
Per accedere si prega di registrarsi o, in caso sia già stato fatto, di autenticarsi
L’accesso a Progress in Mind Italia è consentito unicamente agli Operatori Sanitari (medici e farmacisti). I contenuti di questo sito sono prodotti da un team di Operatori Sanitari il cui obiettivo è presentare le ultime novità in ambito psichiatrico e neurologico, attraverso interviste, registrazioni audio/video di seminari con opinion leader, report e sintesi di congressi sia internazionali che nazionali. Per poter accedere al sito è quindi necessario registrarsi e fornire alcuni dati così da poter verificare che l‘utente sia un Operatore Sanitario.
Hello
Please confirm your email
We have just sent you an email, with a confirmation link.
Before you can gain full access - you need to confirm your email.
The information on this site is exclusively intented for health care professionals.
All the information included in the Website is related to products of the local market and, therefore, directed to health professionals legally authorized to prescribe or dispense medications with professional practice. The technical information of the drugs is provided merely informative, being the responsibility of the professionals authorized to prescribe drugs and decide, in each concrete case, the most appropriate treatment to the needs of the patient.
Congress
Register for access to Progress in Mind in your country