Diagnostics & Imaging Week

With the reality that the practice of medicine is often an art and not a science, in psychiatry particularly, matching the correct drug to the correct patient and his or her illness — even in such serious illnesses as schizophrenia — is frequently a hit-or-miss proposition.

Now comes Curidium Medica (London), which focuses on the analysis of central nervous system disorders to identify targeted medicines to treat patients more effectively.

The company this week said it has confirmed, in the second of two studies it had done, the existence of four "unique and statistically significantly different" subgroups of schizophrenia and bipolar disorder types in a study of post-mortem brain samples.

To accomplish this, Curidium used its automated analysis tool, Homomatrix, which uses pattern recognition tools and sequences of mathematical algorithms, along with statistical methods, to analyze large sets of gene expression and biological data from heterogeneous populations.

In the study, using Homomatrix, the gene expression profiles of 90 schizophrenic/bipolar disorder patients and matched controls were analyzed, the company said.

Those expression profiles were the result of a genome-wide screening of more than 22,000 gene probes using Affymetrix's (Santa Clara, California) Genechip technology with data obtained from the Stanley Medical Research Institute (Chevy Chase, Maryland).

The study results demonstrated that each patient/control was again a member of only one of the four subgroups and each subgroup was associated with a unique and finite number of genes. The genes identified in each subgroup include "known and novel" drug targets, and the company said it is "in the process" of mapping the gene networks and submitting the necessary patents for its findings.

"These results confirm the potential power of our Homomatrix tool to identify diagnostic targets and directly tie these to a potential treatment for a patient subgroup," Anne Bruinvels, CEO of Curdium told Diagnostics & Imaging Week.

Curidium said it is in the process of analyzing gene expression data from blood samples of a separate and different group of schizophrenia/bipolar disorder patients and controls as the next step towards the development of a potential diagnostic test for such patients as a companion to the most appropriate drug treatments.

"Rather than looking at schizophrenic patients as a single patient population, we can actually start to look now at different patient subgroups with different gene expression profiles," Bruinvels told MDD. "[I]t is known that schizophrenia and bipolar disorder are believed to be heterogeneous disorders. And it's currently that on the basis of their clinical symptoms that [physicians] try to differentiate between different types of the disease."

In both society and the medical community, these two diseases are thought to be "generally heterogeneous and complex and multi-factorial," she said.

In its discoveries, the company, Bruinvels said, could ultimately held the key to improved drug development and companion diagnostic tests for those drugs, much liked the HercepTest is used for women with breast cancer in deciding whether or not they are likely to respond to the drug, Herceptin.

In some cases, it could be a matter of taking existing drugs and testing them in these new gene expression subgroups to determine if they are effective for either of these two diseases. The gene expression profiles "relate to different disease mechanisms," according to Bruinvels.

"We believe that obviously the technology we've developed and the information that we develop allows us to start with the development of drugs that are then specific for patient subgroups. It may also mean that some of the currently used drugs can be better directed. But we believe that [new] clinical trials are needed for that."

However, it's better to use information such as what Curidium has generated using Homomatrix when a company is "developing a drug from scratch," she said.

Curidium, which has six employees, was founded in 2001.

Schizophrenia is a psychotic disorder characterized in the "active" phase by hallucinations, delusions, disorganized thoughts/speech, disorganized or catatonic behavior and apathy. The company said it is estimated that 1% of the general population suffers from schizophrenia.

Bipolar affective disorder, sometimes still referred to as manic-depressive illness, is a mental illness involving episodes of serious mania and depression, or extreme swings from high and low moods. The company said it is estimated that 0.5% of the general population suffers from the disorder.