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Antibodies in the Diagnosis, Prognosis, and Prediction of Psychotic Disorders

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 i...

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Autores principales: Pollak, Thomas A, Rogers, Jonathan P, Nagele, Robert G, Peakman, Mark, Stone, James M, David, Anthony S, McGuire, Philip
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293207/
https://www.ncbi.nlm.nih.gov/pubmed/29474698
http://dx.doi.org/10.1093/schbul/sby021
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author Pollak, Thomas A
Rogers, Jonathan P
Nagele, Robert G
Peakman, Mark
Stone, James M
David, Anthony S
McGuire, Philip
author_facet Pollak, Thomas A
Rogers, Jonathan P
Nagele, Robert G
Peakman, Mark
Stone, James M
David, Anthony S
McGuire, Philip
author_sort Pollak, Thomas A
collection PubMed
description 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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spelling pubmed-62932072018-12-19 Antibodies in the Diagnosis, Prognosis, and Prediction of Psychotic Disorders Pollak, Thomas A Rogers, Jonathan P Nagele, Robert G Peakman, Mark Stone, James M David, Anthony S McGuire, Philip Schizophr Bull Regular Articles 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. Oxford University Press 2019-01 2018-02-21 /pmc/articles/PMC6293207/ /pubmed/29474698 http://dx.doi.org/10.1093/schbul/sby021 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Regular Articles
Pollak, Thomas A
Rogers, Jonathan P
Nagele, Robert G
Peakman, Mark
Stone, James M
David, Anthony S
McGuire, Philip
Antibodies in the Diagnosis, Prognosis, and Prediction of Psychotic Disorders
title Antibodies in the Diagnosis, Prognosis, and Prediction of Psychotic Disorders
title_full Antibodies in the Diagnosis, Prognosis, and Prediction of Psychotic Disorders
title_fullStr Antibodies in the Diagnosis, Prognosis, and Prediction of Psychotic Disorders
title_full_unstemmed Antibodies in the Diagnosis, Prognosis, and Prediction of Psychotic Disorders
title_short Antibodies in the Diagnosis, Prognosis, and Prediction of Psychotic Disorders
title_sort antibodies in the diagnosis, prognosis, and prediction of psychotic disorders
topic Regular Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293207/
https://www.ncbi.nlm.nih.gov/pubmed/29474698
http://dx.doi.org/10.1093/schbul/sby021
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