14 Blood reveals psychiatric disorders <strong>Lundbeck</strong> researchers seek new knowledge of depression biology in patient blood samples.
<strong>Lundbeck</strong> Magazine 2009 15 You go to the doctor, have a blood sample taken, and the result reveals if you are predisposed for developing depression later in your life. While this may sound like science fiction, it may not be many years before it becomes reality. Scientists at <strong>Lundbeck</strong> Research USA in New Jersey are working towards a new means of diagnosing and treating depression, anxiety and a number of other brain disorders. “We are seeking to understand the basic mechanisms of depression with the aid of blood samples from patients who are receiving medical treatment,” says Irina Antonijevic, Psychiatrist and Director Translational Research at <strong>Lundbeck</strong> Research USA. Biomarkers in the blood “We observe how the medication affects specific biomarkers. We use this knowledge to attempt to understand the biology of the disorder, to enable us in future to develop better and more specific methods of treatment. At present, most patients with depression receive more or less the same treatment, which is not necessarily a good idea. There are simply no alternatives,” Irina states. Using biomarkers to clarify if a specific drug will benefit a specific patient is a new and groundbreaking view of treatment. Irina and her colleagues in both New Jersey and Valby primarily study biomarkers in the blood. “We are doing this, because blood samples are easy to obtain, and because there are standardized methods of preserving and measuring the messenger RNA (mRNA) content in blood. mRNA is an intermediate cellular product in the ‘translation’ of the genetic code into proteins, which is what we are studying in blood cells. It is still widely maintained that a disorder such as depression cannot be traced in the blood, but how do we know that? Depression clearly takes place in the brain, but then blood does flow through the brain,” Irina continues. High time “It is our theory that some critical changes we can measure in the blood also take place in the brain. We have begun using the method on blood samples from patients, and can already see different patterns in different groups of patients who all have depression or anxiety. Now we will attempt to find out if we can predict how patients with a specific mRNA profile will react to a specific treatment,” Irina explains. The hope is that it will someday be possible to predict which medication will work best on the individual patient on the basis of disease biology. “And it is high time that this happens. Doctors in the CNS field are now using substances that are based on discoveries made by sheer good luck. In some areas we have made very little progress during the last 50 years. The most we have done is to find medicines with fewer side effects. As a psychiatrist with many years of experience, it can make me very angry indeed when I consider the fact that we have no idea who will benefit from a drug and who will not,” Irina says. "What would make me happiest would be a totally new concept for a drug for treatment of a psychiatric disorder" Farewell to diagnoses She also hopes that the new knowledge will put an end to the current classification of diagnoses which, in her view, are both too general and too crude. “My dream is to change the whole system entirely, so biomarkers are used to diagnose patients. And that patients with the same biological deviation are treated in the same way, regardless of the diagnosis we may have given them. I would like to expand biomarker methods to include diagnosis of Alzheimer’s disease and schizophrenia and other CNS disorders. It is possible that the mRNA profiles of some patients with schizophrenia will resemble those of some patients who have depression. It may even prove to be possible to intervene with treatment when the first symptoms occur and prevent the disorder from developing, because it can be traced early on in the blood. We know that many adults who have depression have had anxiety as children or teenagers, and much evidence indicates that many brain disorders begin much earlier than has hitherto been thought.” From the clinic to the laboratory The work with biomarkers is also a step on the road towards translational medicine (TM), a concept which is currently high on the agenda of the pharmaceutical industry. TM involves transferring knowledge from work with patients in the clinical setting to cell and animal models in the laboratory. “We will use the information from patient’s blood in animal models, and study if the same biological changes take place in the animal. With time, this will give us a far better understanding of the mechanisms of the disorder we wish to treat. What would make me happiest would be a totally new concept for a drug for treatment of a psychiatric disorder: one that was developed on the basis of biological data from start to finish. Perhaps it will one day be possible to predict the risk of individuals developing depression and other CNS disorders and diseases on the basis of merely a blood sample. That would be wonderful,” says Irina Antonijevic. PHOTO: Joachim ladefoged
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