"I was completely surprised."When psychiatrist Dr. James Murrough teamed up with dermatologist Dr. Emma Guttman-Yassky to investigate how the immune system might contribute to depression, he didn't expect to find a promising treatment. In their study, published in February in the journal Molecular Psychiatry, Murrough, Guttman-Yassky and their colleagues uncovered similarities in the immune systems of people with depression and people with eczema, the most common form of which is called atopic dermatitis. Those similarities showed up in the "type 2 pathway," an immune response that involves immune cells called T helper 2 (Th2) cells. When working well, type 2 immunity wards off parasites. But in inflammatory conditions like allergies, asthma and eczema, the pathway's activity goes haywire in the absence of a parasitic infection. Seeing that this pathway was also ramped up in depression, the team then used computer modeling to predict which existing drugs might subdue that activity. They tested a few promising medicines in lab animals. Ultimately, they found that dupilumab — an antibody used to treat eczema and other inflammatory conditions — helped resolve the symptoms in a mouse model of depression. Live Science spoke with Murrough, who directs the Depression and Anxiety Center for Discovery and Treatment at the Icahn School of Medicine at Mount Sinai, and Guttman-Yassky, the health system chair of the department of dermatology at Mount Sinai. Their team is now preparing to launch a small trial of dupilumab in people with treatment-resistant depression, whose conditions haven't improved with other forms of therapy. Information about the trial will soon be available on the Mount Sinai website.The scientists chatted with us about their recent study, upcoming trial and long-term hopes for this research.
