In a ground-breaking paper1 published in Nature this year, University of Virginia researchers reported the discovery of a lymphatic drainage system in the central nervous system (CNS), which it was previously believed to lack.
“There is growing evidence, such as the Nature paper, that there is more normal trafficking between the immune system in the brain and that in the body than previously recognized,” Georgia Hodes,PhD, a research track assistant professor in the department of neuroscience at the Icahn School of Medicine at Mount Sinai in New York, told Psychiatry Advisor. She and her colleagues believe that chronic alterations of the peripheral immune system — even those that are non-pathological but still at the high end of the normal range — do indeed cross into the brain, where they can alter synaptic plasticity and result in mood disorders.
“There is dynamic communication between the brain and the immune system,” Jonathan P. Godbout, PhD, an associate professor in the department of neuroscience at Ohio State University, told Psychiatry Advisor. “These two systems talk to each other using many specialized pathways,” he says. One such pathway involves the release of inflammatory cytokines released during the immune system's response to illness, infection or other stressors. A multitude of studies2 have found higher levels of inflammation among patients with major depressive disorder, and recent findings from human and rodent studies offer a more nuanced understanding of this connection.
“Cytokines released as part of the inflammatory response can get into the brain and alter the function of neurotransmitters like serotonin, dopamine and glutamate, all of which play a role in depression,” said Andrew H. Miller, MD, a professor of psychiatry and behavioral sciences and research director of psychiatric oncology at Emory University School of Medicine. Because of these effects, cytokines can disrupt brain circuits that govern motivation, motor activity, anxiety, arousal and alarm, leading to “many of the symptoms that characterize depression and anxiety disorders,” he told Psychiatry Advisor.
A breakthrough study connected a poor immune system to the risk of developing serious mental health problems. Findings showed that immune system treatments helped many mental health patients get better.
According to the Professor Ian Hickie from the Brain and Mind Centre at the University of Sydney, the connection between mental health issues and a weak immune system is stronger compared to previous assumptions.
The research is a joint venture between the University and Meeting for Minds (M4M), a charity base in Perth, Australia. It can lead to new treatments in the field of mental health.
Elle McCabe is one of the study's beneficiaries who suffered from headaches, stomach pain and nausea. The symptoms of her mental illness manifested when her immune system was weakened by a viral infection.
She was 16 years old when she had a psychotic event. She was also in bed most of the time and suffered from "constant, chronic pain."
Due to her condition, she had few relationships and no social life. Apart from her family and close friends, her condition kept her from studying and working.
When she started treatments on her immune system, her mental health gradually improved. This treatment involved a combination of medicines and plasma infusion that focused on improving the compromised immune system.
McCabe shared that the treatment changed her life and enabled her to study full-time. She is doing well compared to the past when reading proved to be a struggle.
Apart from having a great social life, she also had been in a 4-year relationship. The treatment also enabled her to work part-time and even have her own business.
"The key issue there is what's driving the mental ill health is not so much a change in the brain, but a change in the immune system, an auto-immune disease that's causing the aberrant behavior," said Hickie.
In the past, researchers didn't have the lab tests or technologies to confirm the connection when in fact several of these mental health issues are linked to a weak immune system.
Hickie added that finding the right combination or tailor-fit therapies for individual patients proves to be the current challenge. Some patients might need suppression, while some might require a boost.
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