Hemmo A. Drexhage, MD, PhD

Professor emeritus Medical Immunology, Department of Immunology
Research on Immuno-Psychiatry and Immuno-Neuro-Endocrinology


MOODSTRATIFICATION - Combining immunology and psychiatry

Based on former research in the field of immuno- psychiatry we assume that at least part of the major mood disorders are the result of a systemic abnormal condition of imbalances in the T cell system and a proneness to inflammation. T cells play an important role in our immune responses to specific antigens. A vulnerable immune condition may also lead to various autoimmune diseases (such as Hashimoto’s thyroiditis – which is more frequent in patients with major mood disorders).

The consortium MOODSTRATIFICATION is coordinated by ErasmusMC and brings together 12 partners from 7 countries: psychiatrists, immunologists, epidemiologists and pharmaceutical industry. This multidisciplinary European research team is working on new ways of diagnosing and treating patients with a major depressive episode on the basis of monocyte, lymphocyte and cytokine immune profiles.

The hypothesis of our project is that a large proportion of severe mood disorders are the result of deviant immune reactions, caused by one or a combination of the following issues:

  1. (Inborn and acquired) T cell imbalances which result in
  2. mal development and malfunctioning of the brain, and
  3. flares of chronic inflammation, further impacting brain functioning;
  4. Childhood trauma leading to an even higher inflammatory state of the immune system.

We test and refine this novel concept by further exploring datasets of EU funded research MOODINFLAME (2008–2012) and PSYCH-AID (2013-2017).

We reflect on our hypothesis in more detail on the following page on our project website: immune neurological model

The aim of MOODSTRATIFICATION is not only to refine the hypotheses above, but also to develop simple blood tests to measure the above mentioned immune imbalances in clinical practice. As a follow up on the immune signatures found, various therapy trials will take place with T cell enforcing and anti-inflammatory treatments on patients with mood disorders and T cell imbalances.

MOODSTRATIFICATION has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 754740

Read more about MOODSTRATIFICATION and the former EU funded projects MOODINFLAME and PSYCH-AID that were coordinated by ErasmusMC on: www.moodstratification.eu

Group members

Consortium MOODSTRATIFICATION is coordinated by ErasmusMC, Department of Immunology:

  • Prof. dr. Hemmo Drexhage, consortium leader
  • Corina Boelhouwer, project manager
  • Virgil Dalm, internist-clinical immunologist
  • Olivia Manusama, PhD student
  • Annemarie Wijkhuijs, research analyst
  • Bernadette Wijnker-Holmes, liaison officer

The project is carried out by partners from 12 European research institutes in 7 different countries:

The Netherlands:Erasmus Medical Centre, Rotterdam (coördinator of the project)
Universitary Medical Centre Groningen (UMCG)
Belgium:Katholieke Universiteit Leuven (KU Leuven)
Advanced Practical Diagnostics (apDia nv)
Denmark:Aarhus University (AU)
France:Assistance Publique-Hôpitaux de Paris (AP-HP)
Germany:Westfällische Wilhelms Universität, Muenster (WWU)
Universitaet Ulm (UULM)
Ludwig-Maximilians-Universitaet Muenchen (LMU)
ItalyOspedale San Raffaele SRL (OSR)
IsraëlPRONTO Diagnostics (Pronto)

Selected Publications

(See for all publications Drexhage HA in PubMed)

Arteaga-Henríquez G, Simon MS, Burger B, Weidinger E, Wijkhuijs A, Arolt V, Birkenhager TK, Musil R, Müller N, Drexhage HA. Low-Grade Inflammation as a Predictor of Antidepressant and Anti-Inflammatory Therapy Response in MDD Patients: A Systematic Review of the Literature in Combination With an Analysis of Experimental Data Collected in the EU-MOODINFLAME Consortium. Front Psychiatry. 2019 Jul 9;10:458. doi: 10.3389/fpsyt.2019.00458. eCollection 2019

Müller N, Krause D, Barth R, Myint AM, Weidinger E, Stettinger W, Zill P, Drexhage HA, Schwarz MJ. (2019). Childhood Adversity and Current Stress are related to Pro- and Anti-inflammatory Cytokines in Major Depression. In: J Affect Disord. 2019 Apr 22;253:270-276. doi: 10.1016/j.jad.2019.04.088. [Epub ahead of print]

Poletti S, Leone G, Hoogenboezem TA, Ghiglino D, Vai B, de Wit H, Wijkhuijs AJM, Locatelli C, Colombo C, Drexhage HA, Benedetti F. (2019). Markers of neuroinflammation influence measures of cortical thickness in bipolar depression. In: Psychiatry Res Neuroimaging. 2019 Mar 30;285:64-66. doi: 10.1016/j.pscychresns.2019.01.009. Epub 2019 Jan 29.

Snijders G, Brouwer R, Kemner S, Bootsman F, Drexhage HA, Hillegers MHJ (2019). Genetic and environmental influences on circulating NK and T cells and their relation to bipolar disorder. In: Int J Bipolar Disord. 2019 Feb 10;7(1):4. doi: 10.1186/s40345-018-0139-3.

Drexhage HA (2019). Editorial: Activation and de-activation of inflammatory pathways. The disequilibrium of immune-neuro-endocrine networks in psychiatric disorders. Brain Behav Immun. 2019 Jan 22. pii: S0889-1591(19)30051-0. doi: 10.1016/j.bbi.2019.01.007. [Epub ahead of print].

Becking K, Haarman BCM, Grosse L, Nolen WA, Claes S, Arolt V, Schoevers RA, Drexhage HA (2018). The circulating levels of CD4+ t helper cells are higher in bipolar disorder as compared to major depressive disorder. In: J Neuroimmunol. 2018 Jun 15;319:28-36. doi: 10.1016/ j.jneuroim.2018.03.004. Epub 2018 Mar 21.

Haarman BCM, Burger H, Drexhage HA, Nolen WA, Riemersma-Van der Lek RF (2018).
The dysregulated brain – Consequences of spatial and temporal brain complexity for bipolar disorder pathophysiology and diagnosis. In: Tijdschr Psychiatr. 2018;60(2):105-113.

Counotte J, Drexhage HA, Wijkhuijs JM, Pot-Kolder R, Bergink V, Hoek HW, Veling W (2018).
Th17/T regulator cell balance and NK cell numbers in relation to psychosis liability and social stress reactivity. In: Brain Behav Immun. 2018 Mar;69:408-417.