Monfrim Xênia, Gazal Marta, De Leon Pâmela B, Quevedo Luciana, Souza Luciano D, Jansen Karen, Oses Jean P, Pinheiro Ricardo T, Silva Ricardo A, Lara Diogo R, Ghisleni Gabriele, Spessato Barbara, Kaster Manuella P
Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brazil.
Bipolar Disord. 2014 Nov;16(7):741-7. doi: 10.1111/bdi.12214. Epub 2014 May 26.
The aim of the present study was to investigate the relationship between peripheral levels of corticotropin-releasing hormone (CRH) and interleukin-1β (IL-1β) in individuals with bipolar disorder (BD) with and without suicide risk (SR), and controls.
A total of 120 young adults (40 controls, 40 subjects with BD without SR, and 40 subjects with BD with SR) were enrolled from a population-based study carried out in the city of Pelotas, Brazil. BD and SR were assessed through the Mini International Neuropsychiatric Interview (MINI 5.0), and peripheral markers were evaluated by enzyme-linked immunosorbent assay (ELISA).
Levels of CRH were significantly lower both in subjects with BD without SR (p = 0.04) and subjects with BD with SR (p = 0.02) when compared to controls. However, levels of IL-1β were increased in subjects with BD with SR (p = 0.05) when compared to controls. Sociodemographic and clinical variables, current mood episode, and use of psychiatric medications were not associated with changes in these markers. No correlation was found between peripheral levels of CRH and IL-1β (p = 0.60) in the population or in the BD with SR group (p = 0.88).
These results suggest that peripheral mechanisms linking stress hormones and the immune system might be critical patterns involved in suicidal behavior associated with BD.
本研究旨在调查有或无自杀风险（SR）的双相情感障碍（BD）患者以及对照组外周促肾上腺皮质激素释放激素（CRH）和白细胞介素-1β（IL-1β）水平之间的关系。
从巴西佩洛塔斯市开展的一项基于人群的研究中，共招募了120名年轻成年人（40名对照组、40名无自杀风险的BD患者以及40名有自杀风险的BD患者）。通过迷你国际神经精神访谈（MINI 5.0）评估BD和SR，并采用酶联免疫吸附测定（ELISA）评估外周标志物。
与对照组相比，无自杀风险的BD患者（p = 0.04）和有自杀风险的BD患者（p = 0.02）的CRH水平均显著降低。然而，与对照组相比，有自杀风险的BD患者的IL-1β水平升高（p = 0.05）。社会人口统计学和临床变量、当前情绪发作以及精神科药物的使用与这些标志物的变化无关。在总体人群或有自杀风险的BD患者组中，未发现CRH和IL-1β外周水平之间存在相关性（总体人群中p = 0.60，有自杀风险的BD患者组中p = 0.88）。
这些结果表明，将应激激素与免疫系统联系起来的外周机制可能是与BD相关的自杀行为所涉及的关键模式。
