Over one century ago, Russian immunologist Élie Metchnikoff deduced that a healthy gut environment could help combat senility and suggested that the good bacteria found in yogurt would increase a person’s longevity, contradicting the idea that “the only good microbe is a dead one”. Based on a close functional and anatomical link, the immune and nervous systems act effectively in a highly reciprocal manner, evidence that justified the wider credibility gained by this relatively new branch of science, called psychoneuroimmunology.
It is precisely in this field that José Oliveira has done a fascinating work on how our immune system can determine our mental health. After obtaining his graduation in Medicine, at the University of Coimbra (Portugal), he started his residency in Psychiatry at the Centro Hospitalar Psiquiátrico de Lisboa. Interested in the immunogenetics of psychiatric disorders and on its potential interactions with environmental risk factors – such as perinatal infection and childhood adversity –, he completed his PhD thesis in the Translational Psychiatry laboratory at the Mondor Institut for Biomedical Research, in Paris. In 2014, José Oliveira won a travel grant to the 22nd European Congress of Psychiatry (taking place in Munich, Germany), owing to the scientific merit of the abstract submitted. According to ResearchGate, he has authored/co-authored eighteen publications.
Evolutionarily speaking, the immune-brain loop has evolved in an intricate manner to help sense danger and to mount an appropriate adaptive response. Today, investigators have managed to understand how behavioral and psychological events can influence our immune system, yet the reverse of this cross-talk remains controversial. At this point, the psychiatry intern and neuroscientist José Oliveira has advanced to unravel the link between a poor immune system and mental illness. His latest article – Is it time for immunopsychiatry in psychotic disorders? –, written with three other collaborators and published this year, on March 18th, interestingly suggests a possible “two-hit” model in which the immunogenetic background of susceptibility (priming event) may amplify environmental risk factors, including infections and psychosocial stress, leading to the manifestation of a broad range of psychiatric symptoms (triggering event). In agreement with multiple lines of evidence that support the autoimmune involvement in neuropsychiatric illnesses, such as schizophrenia or bipolar disease, this article proposes that immune dysfunction may precede the onset of psychiatric disorders.
Such research has undoubtedly far-reaching public health implications, from how the microbiome influences brain development to the impact of immune dysregulation on disorder severity and comorbidities. The challenge now is to find the right combination of therapies for an individual and, the ultimate goal, to use immuno-inflammatory pathways to set up an innovative treatment, closer to personalized medicine based on stratified clinical trials.
All of this converges on a critical, striking, take home message: the bidirectional immune-to-brain interactions are highly modulated by psychological factors, which influence immunity and immune system-mediated disease. Differences in immunogenetic background, in turn, may establish susceptible/protective patterns of response to harmful biological effects, thus determining future clinical profiles in a deeper way than heretofore suspected. With his lecture on psychoneuroimmunology, Dr. José Oliveira shall unveil a bit more of the intricate mystery that is Psychiatry.