Chan Man K, Gottschalk Michael G, Haenisch Frieder, Tomasik Jakub, Ruland Tillmann, Rahmoune Hassan, Guest Paul C, Bahn Sabine
Department of Chemical Engineering and Biotechnology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QT, United Kingdom.
Department of Chemical Engineering and Biotechnology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QT, United Kingdom; Department of Neuroscience, Erasmus MC, Wytemaweg 80, NL-3015 CN Rotterdam, The Netherlands.
Prog Neurobiol. 2014 Nov;122:45-72. doi: 10.1016/j.pneurobio.2014.08.002. Epub 2014 Aug 27.
Major psychiatric disorders such as schizophrenia, major depressive and bipolar disorders are severe, chronic and debilitating, and are associated with high disease burden and healthcare costs. Currently, diagnoses of these disorders rely on interview-based assessments of subjective self-reported symptoms. Early diagnosis is difficult, misdiagnosis is a frequent occurrence and there are no objective tests that aid in the prediction of individual responses to treatment. Consequently, validated biomarkers are urgently needed to help address these unmet clinical needs. Historically, psychiatric disorders are viewed as brain disorders and consequently only a few researchers have as yet evaluated systemic changes in psychiatric patients. However, promising research has begun to challenge this concept and there is an increasing awareness that disease-related changes can be traced in the peripheral system which may even be involved in the precipitation of disease onset and course. Converging evidence from molecular profiling analysis of blood serum/plasma have revealed robust molecular changes in psychiatric patients, suggesting that these disorders may be detectable in other systems of the body such as the circulating blood. In this review, we discuss the current clinical needs in psychiatry, highlight the importance of biomarkers in the field, and review a representative selection of biomarker studies to highlight opportunities for the implementation of personalized medicine approaches in the field of psychiatry. It is anticipated that the implementation of validated biomarker tests will not only improve the diagnosis and more effective treatment of psychiatric patients, but also improve prognosis and disease outcome.
精神分裂症、重度抑郁症和双相情感障碍等主要精神疾病严重、慢性且使人衰弱,与高疾病负担和医疗成本相关。目前,这些疾病的诊断依赖于基于访谈的主观自我报告症状评估。早期诊断困难,误诊频繁发生,且没有客观测试有助于预测个体对治疗的反应。因此,迫切需要经过验证的生物标志物来帮助满足这些未满足的临床需求。从历史上看,精神疾病被视为脑部疾病,因此只有少数研究人员评估过精神疾病患者的全身变化。然而,有前景的研究已开始挑战这一概念,人们越来越意识到疾病相关变化可以在外周系统中找到踪迹,外周系统甚至可能参与疾病的发病和病程。血清/血浆分子谱分析的越来越多的证据显示,精神疾病患者存在显著的分子变化,这表明这些疾病可能在身体的其他系统(如循环血液)中被检测到。在本综述中,我们讨论了精神病学当前的临床需求,强调了该领域生物标志物的重要性,并回顾了一系列有代表性的生物标志物研究,以突出在精神病学领域实施个性化医疗方法的机会。预计经过验证的生物标志物检测的实施不仅将改善精神疾病患者的诊断和更有效的治疗,还将改善预后和疾病结局。