From the laboratory, into the clinic

The first topic, the role of neuroinflammation in a range of psychiatric disorders, was a popular one. This correspondent was heartened to see so many people attending a session at 7:45am on a Sunday morning. Dr Dina Popovic made a case for the role of a cytokine-mediated immune response in the pathology of bipolar I disorder. She thinks, in a sub-population of patients at least, immune modulation is present and could play a role in the aetiology of the condition.

Allostatic load

Dr Popovic went on to discuss the theory of allostatic load – the ‘wear and tear’ on the brain from episodes in bipolar disorder that causes progressive neural and physical dysfunction (mediated in part by an inflammatory response).¹ Treatments to prevent these episodes could stop this cycle of inflammation and damage and, in turn, arrest the course of the condition.

Where to next?

In the lively Q&A session that followed, neuroinflammation seemed a promising avenue of research. There were several possible topics to pursue – both in the laboratory and the clinic – to see whether this field has a therapeutic future role in bipolar disorder and other psychiatric disorders.

A different topic, a similar aim

Meanwhile, on the other side of the sprawling Amsterdam congress complex, the conversation was focussed on genes rather than immune cells. Specifically micro RNAs (miRNAs) and their role in mood disorder aetiology and treatment.

Small but significant

Best said with an Italian accent, miRNAs are currently “quietly unexplored in psychiatric medicine,”according to session Chair Dr Bocchio-Chiavetto. Tiny intracellular messengers, miRNAs are short, non-coding RNAs with a major role in post-transcriptional gene expression. Four talks delved into their emerging role in controlling gene expression in various mood disorders, bipolar I among them.²

A role in pathophysiology and in treatment?

As the talks progressed, current, compelling evidence was presented for the role of miRNAs in the pathophysiology of different mood disorders. They have a putative role in modulating biological pathways in brain function through the up- and down-regulation of gene expression. A long potential list of target miRNAs and genes were discussed, including – in a coincidental nod to the day’s earlier session – ones that modulate the inflammatory response in the CNS.

Data was also presented supporting the role of miRNAs in the non-response to current pharmacological interventions, as well as their potential as drug targets for future therapies.

Blood clues to brain blues

Finally, discussion turned to the potential role of miRNAs as biomarkers in peripheral tissues. miRNAs are released from within CNS cells into the periphery. Despite their size, miRNAs remain highly stable in blood, serum and saliva – allowing the possibility to act as tiny messengers in the periphery for events in the CNS at the fraction of the cost of other, more invasive techniques.²

An exciting glimpse into the potential future of bipolar I disorder research. Until next time, your correspondent