Neuroimmunology Flashcards

1
Q

Immunopsychiatry / Neuroimmunology

A

Study of the connection between the brain and the immune system

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2
Q

Basic Premise of the Immunopsychiatry Lecture

A

Autoimmune response to infection is associated with a transdiagnostic biological vulnerability to psychiatric disorders

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3
Q

Evidence for Immunopsychiatry link

A

i) Infection,
ii) autoimmune disorders and
iii) elevated markers of inflammation
are all risk factors for later psychiatric disorders

And other way round: stress disorder -> increased risk of autoimmune disease

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4
Q

What kinds of psychiatric disorders are implicated in neuroimmunology?

A

Mood disorders, stress disorders, Schizophrenia, and more

Thought to induce ‘transdiagnostic vulnerability’, rather than any specific disorder

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5
Q

Increased risk of Schizophrenia following hospitalisation with infection?

A

50% higher

Even more if the infection was bacterial

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6
Q

Autoimmune diseases

A

Over 100 of them

In brain, blood, nerves, muscles, bones, lungs, skin etc.

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7
Q

True or False: the link between psychosis and immunology has only recently been noticed

A

False

Long history in medicine going back over 100 years

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8
Q

Evidence for Plausible Causal Link (infection -> psychiatric disorders)

A

Immunological inflammation induces fatigue, withdrawal, depression-like symptoms etc. Potentially evolutionary advantageous behaviour induced by immune system

Increased biomarkers of inflammation in the blood and CSF found for many psychiatric disorders. Specifically increased levels of cytokines found in patients with SCZ and especially MDD

Cytokines given as a cancer treatment; been found to increase depression in these patients

Animal models: administration of immune stimuli and cytokines induces depression-like symptoms in mice. Similar results with SCZ

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9
Q

Causation Problem

A

Chickens, eggs, yada yada: causation is not clear, probably bidirectional

Immune response could be defending against an oncoming disorder: maybe we only see the people who have an unsuccessful response

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10
Q

Two types of immunity

A

Innate immunity: rapid response to infection
T cells and many more

Adaptive immunity: slow response to infection
T cells, B cells, antibodies

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11
Q

NMDA receptor (NDMAR)

[Expect a question on this!]

A

Glutamate system

‘Coincidence detector’ crucial for learning and memory

NDMAR antibodies (especially in CA1 area in hippocampus) can cause reduced NMDAR density

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12
Q

Anti-NMDA receptor encephalitis

[Expect a question on this!]

A

Classic neuropsychiatric syndrome: brain inflammation caused by antibodies

Killed cuddly Berlin boi, Knut

80% female, mean onset 21 years

Typical progression: viral infection -> psychiatric symptoms (esp. psychosis) -> coma -> long-term deficits

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13
Q

Neuroimmunological effects of anti-NMDA receptor encephalitis

A

Possible link between a (‘paraneoplastic’) subtype of the condition and developing various psychiatric symptoms

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14
Q

Clinical Relevance of it all

A

Diagnosis?
Using immunological biomarkers? Maybe, but it’s difficult. Likely that by the time you find out that inflammation caused SCZ, it happened 15 years ago so info is not that helpful

Therapy?
Some evidence that some anti-inflammatory treatments (including cytokine inhibitors) could be effective for SCZ or especially MDD.
Might find ‘inflammatory subtypes’ for whom this kind of treatment works.

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