Department of Psychiatry, Østfold Hospital, Fredrikstad, Norway.
J Psychiatr Res. 2011 Dec;45(12):1608-16. doi: 10.1016/j.jpsychires.2011.08.003. Epub 2011 Sep 1.
Elevated levels of inflammation are reported in bipolar disorders (BP), but how this relates to affective symptoms is unclear. We aimed to determine if immune markers that consistently have been reported elevated in BP were associated with depressive and manic symptoms, and if this was specific for BP.
From a catchment area, 112 BP patients were included together with 153 schizophrenia (SCZ) patients and 239 healthy controls. Depression and mania were assessed and the patients were grouped into depressed, neutral, and elevated mood. We measured the immune markers tumor necrosis factor receptor 1 (sTNF-R1), interleukin 1 receptor antagonist (IL-1Ra), interleukin 6 (IL-6), high sensitive C-reactive protein (hsCRP), osteoprotegerin (OPG) and von Willebrand factor (vWf) which have been found increased in severe mental disorders.
In BP all inflammatory markers were lowest in depressed state, with significant group differences after control for confounders with respect to TNF-R1 (p = 0.04), IL-1Ra (p = 0.02), OPG (p = 0.004) and IL-6 (p = 0.005). STNF-R1 was positively correlated with the item elevated mood (p = 0.02) whereas sad mood was negatively correlated with OPG (p = 0.0003), IL-1Ra (p = 0.001) and IL-6 (p = 0.006). Compared to controls the neutral mood group had significantly higher levels of OPG (p = 0.0003) and IL-6 (p = 0.005), and the elevated mood group had higher levels of TNF-R1 (p = 0.000005) and vWf (p = 0.002). There were no significant associations between affective states orsymptoms in SCZ.
The current associations between inflammatory markers and affective symptomatology in BP and not SCZ suggest that immune related mechanisms are associated with core psychopathology of BP.
有报道称双相情感障碍（BP）患者体内炎症水平升高，但目前尚不清楚这与情感症状有何关系。本研究旨在确定是否有免疫标志物在 BP 中持续升高，并与抑郁和躁狂症状相关，且这种相关性是否具有 BP 特异性。
从一个集水区中纳入 112 名 BP 患者，153 名精神分裂症（SCZ）患者和 239 名健康对照者。评估抑郁和躁狂症状，根据患者的情绪状态将其分为抑郁、中性和情绪升高。我们测量了肿瘤坏死因子受体 1（sTNF-R1）、白细胞介素 1 受体拮抗剂（IL-1Ra）、白细胞介素 6（IL-6）、高敏 C 反应蛋白（hsCRP）、骨保护素（OPG）和血管性血友病因子（vWf）等免疫标志物，这些标志物在严重精神障碍中被发现升高。
在 BP 患者中，所有炎症标志物在抑郁状态下最低，在控制了混杂因素后，TNF-R1（p=0.04）、IL-1Ra（p=0.02）、OPG（p=0.004）和 IL-6（p=0.005）组间存在显著差异。sTNF-R1 与情绪升高项目呈正相关（p=0.02），而悲伤情绪与 OPG（p=0.0003）、IL-1Ra（p=0.001）和 IL-6（p=0.006）呈负相关。与对照组相比，中性情绪组的 OPG（p=0.0003）和 IL-6（p=0.005）水平显著升高，而情绪升高组的 TNF-R1（p=0.000005）和 vWf（p=0.002）水平升高。SCZ 患者的情绪状态或症状与炎症标志物之间无显著相关性。
BP 患者炎症标志物与情感症状之间的关联，而非 SCZ 患者的关联，提示免疫相关机制与 BP 的核心精神病理学相关。
