The paradigm used for neuropsychiatric diagnosis and patient management is primarily based upon clinical interviews to stratify patients within adopted classifications. This paradigm has the caveat of not including information derived from biological or pathophysiological mechanisms. Our approach involves the construction of a multianalyte hypermap, versus analyzing single markers either alone or in groups. Using clusters of biomarkers reflective of different physiologic parameters (e.g. HPA axis vs. metabolic vs. inflammatory markers), the patient’s biomarker measurements are used to create hyperspace vectors for subsets of MDD patients. Patients from community psychiatric practices were referred for testing based upon the clinician’s discretion. The majority of patients had recurring depressive symptoms consistent with MDD and/or were difficult to manage or were non-compliant. Many had co-morbidities with MDD. Serum levels of 10 biomarkers (Alpha-1 Antitrypsin, Acylation Stimulating Protein, BDNF, Cortisol, EGF, Myeloperoxidase, Prolactin, Resistin, S100B and sTNFRII) were determined by immunoassay. MDD patients generally had large vectors representing HPA axis expression and variable levels of markers reflective of the inflammatory response. Enhanced HPA axis expression was observed with comorbid chronic pain. Biomarker hypermapping indicates that there is sufficient diversity of biomarker expression in populations of MDD patients as well as in normal subjects. Thus, the application of biomarker hypermapping may identify potential sub-populations and can be useful in patient characterization and stratification.
John Bilello, PhD; Katie Smith, PhD; Linda Thurmond, PhD; Bo Pi, PhD
Ridge Diagnostics Inc.