Tech & Innovation in Healthcare

Could blood tests lead to personalized depression treatment? Find out.

Traditional methods of diagnosing depression and other mental illnesses are subjective, which can lead to misdiagnoses. Researchers have discovered biomarkers in the blood that can provide objective results that allow physicians to correctly diagnose their patient’s condition and develop a personalized treatment plan.

Learn more about the research behind blood tests for mental illnesses and how it could affect clinicians in the future.

What Are Blood Biomarkers?

“Blood biomarkers are molecules in the blood whose levels change in relation to disease state, severity, and response to treatment,” says Alexander B. Niculescu, III, MD, PhD, professor of psychiatry and medical neuroscience, Indiana University School of Medicine, Indianapolis, Indiana. An example of a blood biomarker is glucose or hemoglobin A1C in patients diagnosed with diabetes.

Several studies in recent years have explored identifying blood biomarkers that can be linked to depression in patients. Researchers in two such studies tracked biomarkers using platelets and ribonucleic acid (RNA) to explore the diagnostic accuracy and treatment efficacy.

Track Treatment Efficacy With Platelets

Researchers led by Mark Rasenick, PhD, distinguished professor of physiology & biophysics and psychiatry, director of the Biomedical Neuroscience Training Program, research career scientist at the Jesse Brown VAMC, University of Illinois Chicago College of Medicine, co-founder, president, and chief scientific officer at Pax Neuroscience, discovered a biomarker that’s simple to measure using platelets in the blood.

He explained that when a patient is depressed, the Gs alpha protein biomarker gets stuck in cholesterol-rich lipid rafts, which causes a decrease in adenylyl cyclase. Adenylyl cyclase is a small molecule within a cell that’s produced in response to neurotransmitters, such as epinephrine and serotonin. When the patient is taking an antidepressant that’s working, “Gs alpha moves out of the lipid raft and has a more facile activation of adenylyl cyclase,” Dr. Rasenick says.

Resource: You can read the full documentation of Dr. Rasenick’s study at www.nature.com/articles/s41380-021-01399-1.epdf?sharing_token=zaLpH2e8jby8GrUgxbm2xdRgN0jAjWel9jnR3ZoTv0NFns6VhikYT67qpP6phAqbMoyLydhg5OixPVOVEtZR3eLIXryl7vctBFYTNqriwkqx2MnAFkPUXiZXuCghuyIgkh3y4eKqD2Dd-7pGFm2n6V_tjoKbas1jN2Vgi7LP--k=.

Since platelets in the blood survive for only about a week, researchers discovered that biomarker activity can be observed within a shorter timeframe. This means a patient who starts antidepressant medication may not feel the effects of the medicine right away, but if their body is responding to the treatment, their physician could see the biomarker activity a week after starting treatment.

Recognize the Potential of RNA Biomarkers

Researchers led by Dr. Niculescu, have built on their previous research over the past two decades to develop a blood test that uses RNA biomarkers. The most recent study took place over four years and involved more than 300 participants, as researchers explored if a blood test could show the severity of a patient’s depression, the risk of severe depression in the future, and the risk of bipolar disorder in the future.

Resource: Take a look at the study documentation at www.nature.com/articles/s41380-021-01061-w.

“Our blood tests can also uncover future risk of disease and distinguish if it is just depression versus depression which is part of bipolar disorder,” Dr. Niculescu explains. Because of the combination of lack of objective testing and the perceived stigma of mental illness, mood disorders are often underdi­agnosed or misdiagnosed. An example of misdiagnosis would be a provider diagnosing a patient with depression rather than bipolar disorder, and that misdiagnosis can result in ineffective treatment that can make the patient’s outcome worse.

Developing a blood test that can distinguish between depression and bipolar disorder is crucial to helping healthcare providers match treatments that meet their patients’ needs. In mental health disorders where self-reporting by patients or clinical impressions from healthcare professionals are subjective and not as reliable, the blood test could deliver objective monitoring of the patient as well as precise, personalized treatments.

Manage Mental Illnesses Effectively

If a patient is presenting symptoms of depression, then their doctor could use the blood test to receive an objective diagnosis confirmation. Currently, traditional methods of diagnosing depression usually involve a clinical interview, psychological testing, or both. These methods “are more subjective and therefore have a greater chance of bias affecting a clinician’s diagnosis,” says Matthew Boland, PhD, licensed psychologist, researcher, university instructor, mental health educator, Health Psychology Associates and University Instructor, Reno, Nevada.

However, a blood test for mental illnesses would deliver an objective result that allows providers to diagnose the patient and provide an ideal course of treatment. “Objective information is needed to better assess people with mental health challenges, to match them with the right medications, and to monitor response to treatment,” Dr. Niculescu says.

Using blood tests for depression and other mental illnesses can also allow physicians to see if the medications they’ve prescribed their patients are helping. Regarding Dr. Rasenick’s research, his team is hoping they’ll be able to extend the study to examine the efficacy of treatment options. “Those people who are going to get better, they’ll show biomarker response within a week. So rather than waiting two months, the biomarker will give an early indication of antidepressant response,” Dr. Rasenick says.

These blood tests may also help match the patient to the ideal depression treatment, including therapy. “Therapy with a psychologist could be just as useful as a drug depending on the subject. But frankly, I suspect we’d see the same chemical change in anyone who gets better,” Dr. Rasenick continues.

The experts Tech & Innovation in Healthcare spoke to are split as to whether the blood test becomes a normal component of a blood panel taken for a physical, but the tests’ accessibility may help healthcare professionals and researchers more readily identify and treat depression and other illnesses effectively. “Although the use of blood tests to diagnose mental health conditions is still new, it may even help to develop new medications to treat multiple conditions,” Dr. Boland says.