The Role of Inflammatory Markers for Diagnostics and Optimization of Therapy in Psychiatry

Abstract

Background: the results of studying the role of neuroinflammation in the pathogenesis of chronic mental disorders guide the scientific search for ways to apply conceptual notions to clinical practice. The aim: to present an overview of clinical and biological studies conducted jointly by clinicians and employees of the Laboratory of Neuroimmunology of the FSBSI “Mental Health Research Centre” and aimed at determination of the significance of immune biomarkers for the diagnosis, prognosis and treatment of various types of mental pathology. Method: the methodological equipment of this study is provided by the use of the original “Neuro-immuno-test” medical technology, developed at the FSBSI “Mental Health Researh Centre”, in comparison with the clinical data. Results and discussion: summarizing the results of many years of research showed that various inflammatory markers, determined in the blood of patients, can be used to assess the level of inflammation in the brain. Studies in various groups of patients showed that the level of these markers reflected the severity and acuteness of the pathological process in the brain and correlated with the characteristics of the clinical symptoms of patients. The most significant for an objective assessment of the clinical status of patients and the prognosis of the course of the disease are not individual inflammatory markers, but their combinations and ratios. It was found that the quantitative change in immunological parameters was ahead of the change in clinical indicators, confirming their prognostic significance. Elevated blood markers at the stages of the disease, preceding the development of pronounced clinical symptoms, can serve as an objective criterion for the presence of a current pathological process in the brain of patients with a high risk of manifestation of endogenous psychosis. The conducted immunological studies using the “Neuro-Immuno-Test” technology revealed different activation of the immune system in patients with cognitive impairment of varying severity, i.e. from mild cognitive impairment to dementia in Alzheimer's disease (AD). Conclusion: differences in immunophenotypes, which have certain quantitative and qualitative features of the spectrum of inflammatory and autoimmune markers, found using the “Neuro-Immuno-Test”, are extremely important both for diagnosis and prognosis, and for therapy optimization.