New study to examine link between the immune system and psychosis

Crick group leader Katharina Schmack has been awarded over £5million from Wellcome to study the effects of antipsychotic drugs on the immune system. 

If we can show causal links, our work could guide future targeted immune-based interventions for psychosis.
Katharina Schmack

This is part of a multi-mullion pound programme of research funded by Wellcome into understanding what drives positive change in mental health. The study, lasting eight years, will be led by Katharina and an interdisciplinary team of scientists and experts - Adrian Hayday, head of the Crick’s Immunosurveillance Laboratory, Tom Pollak, Consultant Neuropsychiatrist and Clinical Lecturer at Kings College London, and Thomas Kabir, a lived experience expert at the McPin Foundation.

Manifesting in symptoms such as hallucinations and delusions, psychosis is a syndrome most commonly associated with schizophrenia, but also other mental health conditions including bipolar disorder and depression. 

Unfortunately, pharmacological treatments have barely changed since the 1950s and remain derivatives of the original dopamine blockers. Many people don't remain on the medication due to side effects, and even for those who do, it can be hard to return to activities like full-time work.

There's a real need to understand the biology of this syndrome so that researchers can find more effective ways to treat it. And Katharina and team believe the immune system may hold clues to how this condition is caused and how people respond to treatments.

“Recent years have brought on a wealth of evidence that, at least in some cases, psychosis may be caused by immune responses against the brain, and that the drugs we use to treat psychosis may regulate this immune disbalance,” says Katharina.

“This has been difficult to investigate because the immune system is very complex and it’s challenging to know tease apart causes and consequences of disease. Thanks to brand-new methods in immunology and neuroscience, we now have a chance to tackle this.”

The team will investigate blood and cerebrospinal fluid from people with psychosis, and use machine-learning to identify the treatment-relevant immune processes. They will combine this with mouse models to test which immune processes are causes rather than consequences of improvements seen with antipsychotic drugs. 

“We want to find out whether and how antipsychotics modulate the immune disbalance in psychosis, adds Katharina. “If we can show causal links, our work could guide future targeted immune-based interventions for psychosis.”

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