Rasit Tahsin Mood Disorders Outpatient Unit, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey.
J Affect Disord. 2010 Nov;126(3):458-62. doi: 10.1016/j.jad.2010.04.027.
The pathophysiology of bipolar disorder is not thoroughly understood. Several studies have investigated the possible role of cytokines in psychiatric disorders, based on their role in neuro-immune modulation; however, findings in studies on bipolar disorder remain limited and contradictory, and most studies have focused on either manic or depressive episodes. These studies suggest that both manic and depressive episodes could be pro-inflammatory states. The present study aimed to determine whether there are enduring differences in cytokine levels-unrelated to the effects of medication-between euthymic bipolar patients and healthy controls.
The study included 31 euthymic bipolar patients-16 medication-free (MF) and 15 on lithium monotherapy (LM) and 16 healthy volunteers in whom serum cytokine levels were measured. The 3 groups were homogenous in terms of age, gender, and ethnicity. IFN-γ, TNF-α, IL-2, IL-4, IL-5, and IL-10 levels were measured in all groups using flow cytometry.
There were no differences in cytokine levels between MF euthymic bipolar patients and healthy controls. TNF-α and IL-4 levels in LM euthymic bipolar patients were higher than in both the MF euthymic bipolar patients and controls.
The small and strictly selected study sample could limit the generalizability of the findings.
Cytokine production in MF euthymic bipolar patients was similar to that in healthy controls. The present study shows that the pro-inflammatory state resolves in euthymia and that lithium had an influence on the cytokine profile, which could create a confounding factor while investigating disease- related immunopathology of bipolar disorder.
双相情感障碍的病理生理学尚未完全阐明。一些研究基于细胞因子在神经免疫调节中的作用，探讨了其在精神疾病中的可能作用；然而，双相情感障碍研究的结果仍然有限且相互矛盾，大多数研究集中在躁狂或抑郁发作上。这些研究表明，躁狂和抑郁发作都可能是促炎状态。本研究旨在确定在病情稳定的双相情感障碍患者和健康对照者之间，细胞因子水平是否存在与药物作用无关的持久差异。
该研究纳入了 31 名病情稳定的双相情感障碍患者，其中 16 名未服用药物（MF），15 名服用锂单药治疗（LM），16 名健康志愿者，测量了他们的血清细胞因子水平。3 组在年龄、性别和种族方面均具有同质性。使用流式细胞术测量了所有组别的 IFN-γ、TNF-α、IL-2、IL-4、IL-5 和 IL-10 水平。
MF 病情稳定的双相情感障碍患者与健康对照者的细胞因子水平无差异。LM 病情稳定的双相情感障碍患者的 TNF-α 和 IL-4 水平高于 MF 病情稳定的双相情感障碍患者和对照组。
严格选择的小样本研究可能限制了研究结果的普遍性。
MF 病情稳定的双相情感障碍患者的细胞因子产生与健康对照者相似。本研究表明，促炎状态在病情稳定时得到缓解，锂对细胞因子谱有影响，这可能在研究双相情感障碍的疾病相关免疫病理学时造成混杂因素。
