期刊
SCHIZOPHRENIA BULLETIN
卷 45, 期 1, 页码 233-246出版社
OXFORD UNIV PRESS
DOI: 10.1093/schbul/sby021
关键词
psychosis; schizophrenia; antibody; biomarker; inflammation
类别
资金
- Wellcome Trust [105758/Z/14/Z]
- NIHR Academic Clinical Fellowship
- National Institutes of Health
- Michael J. Fox Foundation
- Osteopathic Heritage Foundation
- GlaxoSmithKline
- Foundation Venture Capital Group
- Boye Foundation
- NIHR Maudsley Biomedical Research Centre at South London & Maudsley NHS Foundation Trust
- Institute of Psychiatry, Psychology and Neuroscience, King's College London
- Wellcome Trust [105758/Z/14/Z] Funding Source: Wellcome Trust
Blood-based biomarker discovery for psychotic disorders has yet to impact upon routine clinical practice. In physical disorders antibodies have established roles as diagnostic, prognostic and predictive (theranostic) biomarkers, particularly in disorders thought to have a substantial autoimmune or infective aetiology. Two approaches to antibody biomarker identification are distinguished: a top-down approach, in which antibodies to specific antigens are sought based on the known function of the antigen and its putative role in the disorder, and emerging bottom-up or omics approaches that are agnostic as to the significance of any one antigen, using high-throughput arrays to identify distinctive components of the antibody repertoire. Here we review the evidence for antibodies (to self-antigens as well as infectious organism and dietary antigens) as biomarkers of diagnosis, prognosis, and treatment response in psychotic disorders. Neuronal autoantibodies have current, and increasing, clinical utility in the diagnosis of organic or atypical psychosis syndromes. Antibodies to selected infectious agents show some promise in predicting cognitive impairment and possibly other symptom domains (eg, suicidality) within psychotic disorders. Finally, infectious antibodies and neuronal and other autoantibodies have recently emerged as potential biomarkers of response to anti-infective therapies, immunotherapies, or other novel therapeutic strategies in psychotic disorders, and have a clear role in stratifying patients for future clinical trials. As in nonpsychiatric disorders, combining biomarkers and large-scale use of bottom-up approaches to biomarker identification are likely to maximize the eventual clinical utility of antibody biomarkers in psychotic disorders.
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