Metabolomics Biomarkers for Precision Psychiatry

Abstract

The treatment of psychiatric disorders remains a significant challenge in part due to imprecise diagnostic criteria and incomplete understanding of the molecular pathology involved. Current diagnostic and pharmacological treatment guidelines use a uniform approach to address each disorder even though psychiatric clinical presentation and prognosis within a disorder are known to be heterogeneous. Limited therapeutic success highlights the need for a precision medicine approach in psychiatry, termed precision psychiatry. To practice precision psychiatry, it is essential to research and develop multiple omics-based biomarkers that consider environmental factors and careful phenotype determination. Metabolomics, which lies at the endpoint of the "omics cascade," allows for detection of alterations in systems-level metabolites within biological pathways, thereby providing insights into the mechanisms that underlie various physiological conditions and pathologies. The eicosanoids, a family of metabolites derived from oxygenated polyunsaturated fatty acids, play a key role in inflammatory mechanisms and have been implicated in psychiatric disorders such as anorexia nervosa and depression. This review (1) provides background on the current clinical challenges of psychiatric disorders, (2) gives an overview of metabolomics application as a tool to develop improved biomarkers for precision psychiatry, and (3) summarizes current knowledge on metabolomics and lipidomic findings in common psychiatric disorders, with a focus on eicosanoids. Metabolomics is a promising tool for precision psychiatry. This research has great potential for both discovering biomarkers and elucidating molecular mechanisms underlying psychiatric disorders.

Metabolomics and cardiovascular imaging: a combined approach for cardiovascular ageing

“…The disadvantage of targeted metabolomics is that clinically important analytes can be overlooked. Metabolomics techniques have been applied to the study of human disease with novel findings that have helped our understanding of insulin resistance and diabetes, 9,10 chronic kidney disease, 11,12 depression, 13,14 and cardiovascular disease (CVD). [15][16][17][18][19][20][21]…”

Biomarkers in Psychiatry: Concept, Definition, Types and Relevance to the Clinical Reality

“…Several studies have focused on the identification of potential metabolomics biomarkers in different psychiatric diseases [for review see (85)(86)(87)(88)]. For example, urinary metabolomics have been proposed to be potential useful tools for the identification of pathways that may be involved in the mechanism of action of specific treatments.…”

‘Precision psychiatry’ needs to become part of ‘personalized psychiatry’

“…The advent of 'omics' techniques has contributed to foster our understanding of the neurobiology of major mental disorders [5,10,15,[19][20][21][22][23][24]. OMICS sciences are systems biology related fields that involve multiple levels, such as genomics, metagenomics, epigenomics, transcriptomics, proteomics, metabolomics, and lipidomics.…”

“…Progresses in metabolomics, which looks at system-level metabolites, as well as progresses in lipidomics, which looks at the complete lipid profile of an organism, also raised the hope for an acceleration in biomarker discovery. For instance, the eicosanoids, a family of metabolites derived from oxygenated polyunsaturated fatty acids, have been found to play an important role in inflammatory mechanisms and possibly in psychiatric disorders [19,20], thus highlighting the important role of the inflammation pathways in the search of biomarkers for psychiatric disorders [19,20]. In addition, the advent of pharmacogenomics, the study of how genes influence an individual's response to drug treatment, has led to the development of assays, that provide clinicians valid information to decide the treatment, basing on the patient's unique genome [3].…”