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Biological marker for schizophrenia discovered

Posted by Mr. SadPuppyDog on October 9, 2002, at 11:43:44

http://www.ama-assn.org/sci-pubs/amnews/pick_01/hlsc0219.htm


Researchers say they have found a biological marker for the mental illness, but experts say it's a long way from being clinically useful.
By Victoria Stagg Elliott, AMNews staff. Feb. 19, 2001. Additional information


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Physicians dream of simple diagnostics for complex mental illnesses. Although many experts doubt it will ever be possible, some scientists think they may be on track to finding a blood marker that will predict, or at least diagnose, schizophrenia.

Researchers in Israel found a chemical difference in the white blood cells of schizophrenics that may eventually lead to the development of a commercially available blood test. If it were to become a reality, it could replace the standard six months of observation needed for diagnosis.

Scientists from the immunology department of the Weizmann Institute of Science in Rehovot found that when compared with healthy controls, schizophrenics had elevated levels of D3-receptor mRNA, according to a report in the Jan. 16 Proceedings of the National Academy of Sciences.

"Early detection of schizophrenia can lead to better treatment and better prognosis," said Tal Ilani, lead author of the study and a graduate student at the institute.

Their research will now expand to include patients with other mental illnesses, and they predict that a version of the test they are using in their work may be more widely available within the next few years.

"Although these results seem very significant, they are still preliminary, and a lot of work has to be done before any commercial blood test can be developed," said Ilani.

Schizophrenia experts said a simple blood test for the difficult-to-diagnose condition was an idea that -- if it worked -- would greatly simplify physicians' work with the mentally ill. "Any psychiatrist, especially those who work with schizophrenics, is really looking for the insulin of schizophrenia," said Carol Tamminga, MD, professor of psychiatry and pharmacology at the University of Maryland School of Medicine in Baltimore.

Experts cautioned, however, that although this research was provocative, the results were far too preliminary to be relevant and that the study itself was deeply flawed.

For example, the study did not make clear whether the biological difference was caused by the condition or the medication to treat it.

"Every scientist would say for sure that upregulation of the dopamine receptors was caused by the anti-psychotic drugs," said Dr. Tamminga.

"Nobody would say there couldn't be a hidden signal, but you couldn't see that because of the drug-induced upregulation."

Also, the study was small: 14 schizophrenics and 11 controls.

"It's un-understandably small," said Rex W. Cowdry, MD, medical director for the National Alliance for the Mentally Ill. "It's not as if schizophrenia is a rare disease."

Some went so far as to accuse the publication of being scientifically irresponsible for publishing what they believed was a study that provided a great deal of hope not supported by science. "The PNAS is one of the prestigious journals in the world," said Dr. Tamminga. "The need is so great, and people who can't judge the nature of the science will read it and think there's a blood test for schizophrenia. So, the next time there's an insanity defense in the court, some lawyer will demand that somebody get a D3 mRNA test. An article like this can wreak so much havoc."

Experts added that the possibility of a simple diagnostic method may well be impossible. Dopamine and its receptors have long been suspected culprits in the development of schizophrenia, but no one believes that's the only factor.

Some researchers are looking at environment and viral infections, while others have been attempting to sort out the genetics that cause predisposition. None of the research has yet resulted in a viable genetic test. "Nobody would say that what they have is something that's firm enough to use as a diagnostic or even a predictor," said Dr. Tamminga.

Few also believe that schizophrenia will turn out to have only one variety.

"I expect that we will see schizophrenias," said Dr. Cowdry. "There will not be one single entity."

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ADDITIONAL INFORMATION:
Markers for mental illness
Objective: To determine the correlation between the D3 dopamine receptor in white blood cells and schizophrenia.
Participants: Fourteen patients with schizophrenia from Tirat Hacarmel Mental Health Hospital in Haifa, Israel, and Beer Yaacov Mental Health Centers in Beer Yaacov, Israel.
Method: RNA was isolated from the 14 patients and compared with samples from 11 healthy control subjects.
Results: Signals for D3-receptor mRNA were significantly higher in patients with schizophrenia than in healthy controls.
Conclusion: D3-receptor mRNA levels in peripheral blood lymphocytes may function as convenient and reliable peripheral markers for schizophrenia and thus assist in diagnosis.


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