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Nuevo test sanguíneo podría revolucionar el diagnóstico temprano de la esquizofrenia
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La esquizofrenia, un trastorno mental severo que afecta aproximadamente al 1 % de la población mundial, ha desafiado históricamente a los clínicos por su complejidad diagnóstica, que se basa fundamentalmente en criterios clínicos y entrevistas estructuradas. Sin embargo, una investigación publicada en Scientific Reports por científicos del Instituto de Investigación Glyco-core (iGCORE) de la Universidad de Nagoya presenta una innovación que podría cambiar este paradigma: la detección en sangre del ácido polisiálico como biomarcador confiable para la esquizofrenia.
El ácido polisiálico es un glicano ácido único que se localiza predominantemente en regiones cerebrales asociadas con la memoria y las emociones. Aunque en condiciones normales también circula en la sangre en niveles bajos, estudios recientes han evidenciado que su concentración se encuentra significativamente aumentada en pacientes con esquizofrenia.
Según explicó el profesor Chihiro Sato, autor correspondiente del estudio, “las células cancerosas liberan exosomas y otras sustancias que ingresan al torrente sanguíneo y aumentan la concentración de ácido polisiálico”. Esta observación condujo al equipo de investigadores a explorar si un fenómeno similar podía observarse en los trastornos psiquiátricos, específicamente en la esquizofrenia.
Un método basado en ELISA con mayor precisión
La técnica desarrollada por el equipo de Nagoya se fundamenta en un ELISA tipo sándwich (Enzyme-Linked Immunosorbent Assay), un método ampliamente utilizado en inmunodiagnóstico. La innovación clave radica en el uso de dos anticuerpos diseñados para aumentar la especificidad del ensayo: uno positivo, que se une al ácido polisiálico, y otro negativo, una versión mutada del primero, incapaz de unirse al glicano por la pérdida de afinidad estructural.
Este enfoque diferencial permite restar la señal inespecífica producida por el anticuerpo negativo de la obtenida por el anticuerpo positivo, lo que maximiza la precisión en la cuantificación del ácido polisiálico en sangre. Esta mejora es especialmente relevante, dado que los glicanos suelen presentar estructuras complejas y altamente heterogéneas que dificultan su medición con técnicas convencionales.
Resultados diferenciales en esquizofrenia y otras enfermedades
Los resultados del estudio mostraron un aumento claro y significativo de los niveles de ácido polisiálico en muestras de sangre de pacientes con esquizofrenia, en comparación con personas sanas y con pacientes que padecían polineuropatía desmielinizante inflamatoria crónica (CIDP, por sus siglas en inglés). Este hallazgo sugiere que la presencia elevada de este glicano puede ser específica para ciertas patologías, reforzando su valor como herramienta diferencial en el diagnóstico clínico.
El estudio no solo abre una vía de identificación temprana y objetiva de la esquizofrenia, sino que también permite distinguirla de otras condiciones neurológicas o psiquiátricas con síntomas solapados, mediante un procedimiento no invasivo y reproducible.
Implicaciones clínicas y terapéuticas
Desde el punto de vista clínico, la implementación de esta prueba podría ofrecer ventajas significativas:
- Diagnóstico precoz: La detección de ácido polisiálico en sangre podría complementar la evaluación clínica en fases tempranas del trastorno.
- Monitoreo terapéutico: El seguimiento de los niveles de este glicano podría utilizarse para evaluar la respuesta al tratamiento.
- Diferenciación diagnóstica: Su especificidad respecto a otras patologías neurológicas permite reducir diagnósticos erróneos.
A largo plazo, este descubrimiento también tiene implicaciones terapéuticas. Al identificar el mecanismo por el cual el ácido polisiálico aumenta en sangre, posiblemente a través de vesículas extracelulares como exosomas liberados por células neuronales o gliales, se abren nuevas hipótesis sobre el papel de los glicanos en la neuroinflamación, la plasticidad sináptica y el deterioro cognitivo observado en la esquizofrenia.
Perspectivas futuras e investigación en curso
El equipo del iGCORE ya plantea nuevas líneas de investigación. “Descubrir más sobre el mecanismo subyacente al aumento de los niveles de ácido polisiálico en sangre en diversas enfermedades podría conducir al desarrollo de nuevas opciones de tratamiento para estas enfermedades”, afirmó el profesor Sato.
Además, se evalúa la aplicabilidad de este biomarcador en otras enfermedades mentales como el trastorno bipolar, el autismo y algunas formas de demencia, donde se han observado patrones alterados de expresión glicoproteica.
En paralelo, el hallazgo podría tener implicaciones en oncología, dado que algunas células tumorales también producen ácido polisiálico, esta molécula podría convertirse en una diana diagnóstica y terapéutica compartida entre enfermedades neurológicas y neoplásicas.
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