Blood-based biomarkers predicting response to antidepressants

Abstract

Major depressive disorder is a common, serious and in some cases, life-threatening condition and affects approximately 350 million people globally. Although there is effective treatment available for it, more than 50% of the patients fail to respond to the first antidepressant they receive. The selection of a distinct treatment is still exclusively based on clinical judgment without incorporating lab-derived objective measures. However, there is growing evidence of biomarkers that it helps to improve diagnostic processes and treatment algorithms. Here genetic markers and blood-based biomarkers of the monoamine pathways, inflammatory pathways and the hypothalamic-pituitary-adrenal (HPA) axis are reviewed. Promising findings arise from studies investigating inflammatory pathways and immune markers that may identify patients suitable for anti-inflammatory based treatment regimes. Next, an early normalization of a disturbed HPA axis or depleted neurotrophic factors may predict stable treatment response. Genetic markers within the serotonergic system may identify patients who are vulnerable because of stressful life events, but evidence for guiding treatment regimes still is inconsistent. Therefore, there is still a great need for studies investigating and validating biomarkers for the prediction of treatment response to facilitate the treatment selection and shorten the time to remission and thus provide personalized medicine in psychiatry.

Genistein Improves the Major Depression through Suppressing the Expression of miR-221/222 by Targeting Connexin 43

“…Major depression is a serious disorder that has enormous consequences for the quality of life, and is one of the most prevalent forms of mental illness [ 17 ]. Patients suffered from major depression have high rates of morbidity and mortality, with profound economic and social consequences [ 18 ]. Moreover, the major depression not only affects 5% of the population, but also the numbers are increasing every year.…”

Depressive symptoms and neurotrophin levels in ostomy patients

“…The present study showed a BDNF decrease and NT-3 increase levels in serum from ostomy patients when compared to healthy controls. Several studies suggest that BDNF is involved in depression 33,34 . Previous study showed that depressed patients present decreased BDNF expression, and antidepressants up-regulate the BDNF expression 35 .…”

Precision pharmacotherapy: psychiatry’s future direction in preventing, diagnosing, and treating mental disorders

“…As reported above, mental disorders have a modest to high heritability; also, treatment response and the appearance of adverse effects have been shown to be genetically linked. 108 – 111 An extensive literature covers the association of common genetic markers with the response, adverse effects, and metabolism of antidepressants and antipsychotics. 112 – 114 Genetic variants involved in metabolism of antidepressants or antipsychotics (CYP/CYP450 isoenzymes), drug transport ( ABCB1 ), glucocorticoid signaling ( FKBP5 ), and serotonin neurotransmission ( SLC6A4 and HTR2A ) were among those included in the first pharmacogenetic assays that have been clinically applied.…”