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精神疾病中的神经免疫生物标志物

Neuroimmune Biomarkers in Mental Illness.

作者信息

Herron James W, Nerurkar Louis, Cavanagh Jonathan

机构信息

Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.

Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.

出版信息

Curr Top Behav Neurosci. 2018;40:45-78. doi: 10.1007/7854_2018_45.

Abstract

Exploration of neuroimmune mechanisms is vital to the understanding of the pathogenesis and pathophysiology of mental disorders. Inflammatory and immune mechanisms are increasingly understood to underpin a number of neuropsychiatric disorders, with an ever-expanding evidence base drawn from basic science to large-scale epidemiological data. Unravelling of these mechanisms should lead to biomarker discovery and potential new avenues for therapeutics that modulate immunological mechanisms. Identification of neuroimmune biomarkers is vital to improving diagnosis, stratification and treatment of mental disorders. There is an urgent clinical need for new therapeutic approaches with poor treatment response and treatment resistance a major problem for many psychiatric disorders including depression and schizophrenia. Neurodegenerative psychiatric disorders such as Alzheimer's also have clear neuroimmune underpinnings and manifest an urgent clinical need for improvements in diagnosis and research towards transformative disease-modifying treatments. This chapter provides some background on the role of the neuroimmune system in mental illness, exploring the role for biomarkers, in addition to reviewing the current state of knowledge in this exciting field. We also reflect on the inherent challenges and methodological pitfalls faced by research in this field, including the complexity of conceptualising multidimensional mental disorders and the dynamic shifting sands of the immune system.

摘要

探索神经免疫机制对于理解精神障碍的发病机制和病理生理学至关重要。炎症和免疫机制越来越被认为是多种神经精神障碍的基础,从基础科学到大规模流行病学数据,证据基础不断扩大。揭示这些机制应能发现生物标志物,并为调节免疫机制的治疗开辟潜在的新途径。识别神经免疫生物标志物对于改善精神障碍的诊断、分层和治疗至关重要。对于许多精神疾病(包括抑郁症和精神分裂症)而言,治疗反应不佳和治疗抵抗是主要问题,因此临床上迫切需要新的治疗方法。诸如阿尔茨海默病等神经退行性精神障碍也有明确的神经免疫基础,并且在诊断和针对变革性疾病修饰治疗的研究方面表现出迫切的临床需求。本章提供了一些关于神经免疫系统在精神疾病中作用的背景知识,探讨了生物标志物的作用,此外还回顾了这个令人兴奋的领域的当前知识状态。我们还思考了该领域研究面临的固有挑战和方法陷阱,包括将多维精神障碍概念化的复杂性以及免疫系统动态变化的情况。

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