Golam Khandaker : More data from ALSPAC cohort. IL6 at 9 years positively associated with depression and psychotic symptoms at 18 years. Similar results for leptin (increases in tandem with IL-6). Negative association with LDL. #BAP2018
Khandaker: Finland cohort. High levels of CRP in middle adolescence, higher risk of hospitalisation for psychosis until 29. Similar findings in a Swedish study. Similar findings in London study for inflammation predicting depressive symptoms. #BAP2018
Khandaker: These longitudinal cohort studies show that inflammation in depression and psychosis not just due to stress of illness - they precede and predict, so could be causal. #BAP2018
Khandaker: Mendelian randomization studies based on idea that if biomarkers are truly associated with illness, should find genes involved in function biomarker associated with illness. #BAP2018
Khandaker: IL6R 358a polymorphism shown to impair IL6 signalling, downstream reduction of CRP levels. So hypothesise increased IL6 and associated lower CRP in ALSPAC - findings confirm. Protective for psychosis and depression. #BAP2018
Khandaker: However, analysis by George Davey Smith found association in opposite direction - IL6R 358a linked to greater risk of schizophrenia. #BAP2018
Khandaker: Why is all of this relevant? Greater inflammation linked to poor treatment response. Anti inflammatory drugs may be useful - in trials for chronic inflammatory conditions, improvement in depressive symptoms independent from improvement in core illness. #BAP2018
Khandaker: Negative trials for anti-inflammatory drugs, but sub analysis indicates effective in those with high levels of baseline inflammation. Need to test for benefits of stratifying patients. Current trial focused on those with inflammatory markers underway! #BAP2018
