Barcelona snapshots

Prof. Michael Berk

Michael Berk psiquiatra Controversias Psiquiatria Barcelona
Deakin University, Austràlia
Ponència Noves dianes per al tractament de la depressió: inflamació, estrès oxidatiu i factors neurotròfics
Data Dissabte, 21 d'Abril 2018
Hora 9:45 a 10:30
Taula rodona Complexitats en Psiquiatria: trastorns afectius

BIOGRAFIA

Professor Michael Berk is currently a NHMRC Senior Principal research Fellow, and is Alfred Deakin Chair of Psychiatry at Deakin University and Barwon Health, where he heads the IMPACT Strategic Research Centre. He also is an Honorary Professorial Research fellow in the Department of Psychiatry, the Florey Institute for Neuroscience and Mental Health and Orygen Youth Health at Melbourne University, as well as in the School of Public Health and Preventive Medicine at Monash University.

He has published over 870 papers and is the 2nd highest cited bipolar disorder researcher in the world (Scopus), and is listed by Thompson Reuters as amongst the world’s most influential scientific minds. Data from SciVal shows he is Australia’s most highly cited researcher in the categories of neurosciences, and psychology and cognitive sciences over the five years between 2012 and 2017. He is past president of the International Society for Bipolar disorders and the Australasian Society or Bipolar and Depressive Disorders. His major interests are in the discovery and implementation of novel therapies, and risk factors and prevention of psychiatric disorders. He is the recipient of a number of national and international awards including the Brain & Behaviour (NARSAD) Colvin Award for Mood Disorders in 2015, and holds grants from the National Institutes of Health (US), Simon Autism Foundation, NHMRC CRE and project grants, Beyondblue and Stanley Medical Research Institute and is a lead investigator in a Collaborative Research Centre.

RESUM

There is abundant evidence that inflammatory and oxidative processes, altered neurogenesis and mitochondrial dysfunction play a role in the genesis and neuroprogression of bipolar disorder. There is evidence of increased inflammatory activity, oxidative stress, mitochondrial dysfunction as well as altered neurogenesis in most major neuropsychiatric disorders. The consequences of inflammatory and oxidative stress include lipid peroxidation, DNA fragmentation, telomere shortening, protein carbonylation, reduced neurogenesis and an increased vulnerability to apoptosis. Inflammatory and oxidative stress can lead to decreased BDNF and other trophic factors. In sum, these processes can further damage neurocircuitry and may lead to progression of the disorder. The role of the above pathways suggests a new range of therapeutic possibilities. Many of these are repurposed, and hence have established tolerability and safety profiles. The agent for which the largest amount of data is currently available is N-acetylcysteine. Positive placebo controlled data is currently available in bipolar disorder, depression and other disorders. Agents targeting inflammatory pathways additionally show promise. These include aspirin, minocycline, infliximab, celecoxib and statins, with largest current database for the latter two. Mitochondrial dysfunction also offers druggable targets, with the first trial in bipolar disorder completed. Lastly, some agents such as aspirin may have as preventive potential as part of integrated preventive programs targeting non-communicable disorders. These findings not only offer the promise of novel treatments, but serve as proof of principle of the role of inflammation and oxidative stress in the pathophysiology of bipolar disorder.

REFERÈNCIES

[web] Jacka FN et al (2017). A randomised controlled trial of dietary improvement for adults with major depression (the 'SMILES' trial)., BMC Med. 2017 Jan 30;15(1):23. doi: 10.1186/s12916-017-0791-y.

[PDF] Dean OM et al (2017). Adjunctive minocycline treatment for major depressive disorder: A proof of concept trial, Aust N Z J Psychiatry. 2017 Aug;51(8):829-840. doi: 10.1177/0004867417709357. Epub 2017 Jun 3.

[web] Berk M et al (2013). Aspirin: a review of its neurobiological properties and therapeutic potential for mental illness, BMC Medicine 2013 11:74, https://doi.org/10.1186/1741-7015-11-74

[web] Moylan S, Maes M, Wray NR, Berk M (2013). The neuroprogressive nature of major depressive disorder: pathways to disease evolution and resistance, and therapeutic implications, Mol Psychiatry. 2013 May;18(5):595-606. doi: 10.1038/mp.2012.33. Epub 2012 Apr 24.

[web] O'Neil A et al (2012). The impact of statins on psychological wellbeing: a systematic review and meta-analysis, BMC Medicine201210:154 https://doi.org/10.1186/1741-7015-10-154