Researchers at the Indiana University School of Medicine, Indianapolis, have developed a blood test composed of RNA biomarkers to discern a patient’s depression severity as well as the risk of future severe depression and bipolar disorder. Moreover, the blood test informs personalized medication choices for patients, according to a study published online ahead of print in Molecular Psychiatry.
“Through this work, we wanted to develop blood tests for depression and for bipolar disorder, to distinguish between the two and to match people to the right treatments,” said lead author Alexander B. Niculescu, MD, PhD. “Blood biomarkers are emerging as important tools in disorders, where subjective self-report by an individual or a clinical impression of a health care professional are not always reliable.”
The study, which occurred over 4 years and involved more than 300 participants, involved a four-step approach of discovery, prioritization, validation, and testing, researchers explained.
They began by following and observing patients during both high and low mood states. Investigators recorded changes in blood biomarkers between participants’ highs and lows. Next, they cross-validated and prioritized their observations using large databases created from previous studies, and then validated the top 26 candidate biomarkers in independent cohorts of patients with severe depression or mania. Finally, biomarkers were tested again in additional independent cohorts to determine their strength in predicting current and future symptoms.
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“These blood tests can open the door to precise, personalized matching with medications and objective monitoring of response to treatment,” said Dr. Niculescu.
The work is ready for translation into clinical practice and in new drug development, said Dr. Niculescu. He and his team have previously investigated blood biomarkers that track suicidality, pain, post-traumatic stress disorder, and Alzheimer’s disease.
“We have pioneered the area of precision medicine in psychiatry over the last 2 decades, particularly over the last 10 years. This study represents a current state-of-the-art outcome of our efforts,” said Dr. Niculescu. “This is part of our effort to bring psychiatry from the 19th century into the 21st century, to help it become like other contemporary fields such as oncology. Ultimately, the mission is to save and improve lives.”
—Jolynn Tumolo
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