Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhagen, Denmark.
Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhagen, Denmark.
Brain Behav Immun. 2015 Jan;43:205-13. doi: 10.1016/j.bbi.2014.09.021. Epub 2014 Oct 14.
Inflammatory system dysregulation may be involved in the pathophysiology of bipolar disorder with peripheral cytokine levels varying between affective states; however, the evidence is based primarily on case-control studies and limited by methodological issues. The objectives of the present study were to assess alterations of peripheral cytokine levels between affective states in rapid cycling bipolar disorder patients and to compare these with levels in healthy control subjects. In a longitudinal design, repeated measurements of plasma levels of IL-6, IL-10, IL-18, IL-1β and TNF-α were obtained in affective states of varying polarity during 6-12 months in 37 rapid cycling bipolar disorder patients and compared with repeated measurements in 40 age- and gender matched healthy control subjects, using rigorous laboratory-, clinical- and statistical methodology. Adjusting for demographical, clinical- and lifestyle factors, levels of IL-6 (p<0.05) and IL-18 (p<0.005) were significantly elevated in rapid cycling bipolar disorder patients in a manic/hypomanic state, compared with a depressed and a euthymic state. Compared with healthy control subjects, unadjusted levels of IL-6 (p<0.05) and IL-18 (p<0.05) were elevated in manic/hypomanic bipolar disorder patients. Levels of IL-10 and IL-1β were undetectable in the majority of samples; high TNF-α assay variability was found. The results support a role for altered peripheral immune response signaling in rapid cycling bipolar disorder and suggest that IL-6 and IL-18 could be markers of manic episodes.
炎症系统失调可能与双相情感障碍的病理生理学有关，外周细胞因子水平在情感状态之间变化；然而，证据主要基于病例对照研究，并受到方法学问题的限制。本研究的目的是评估快速循环双相情感障碍患者在情感状态之间外周细胞因子水平的变化，并将其与健康对照组进行比较。在一项纵向设计中，对 37 例快速循环双相情感障碍患者在 6-12 个月的不同极性情感状态下进行了血浆 IL-6、IL-10、IL-18、IL-1β和 TNF-α水平的重复测量，并与 40 例年龄和性别匹配的健康对照组进行了重复测量，采用严格的实验室、临床和统计方法。在调整人口统计学、临床和生活方式因素后，与抑郁和轻躁狂状态相比，快速循环双相情感障碍患者在躁狂/轻躁狂状态下的 IL-6（p<0.05）和 IL-18（p<0.005）水平显著升高。与健康对照组相比，未经调整的 IL-6（p<0.05）和 IL-18（p<0.05）水平在躁狂/轻躁狂双相情感障碍患者中升高。IL-10 和 IL-1β的水平在大多数样本中无法检测到；高 TNF-α 测定的变异性较大。结果支持外周免疫反应信号改变在快速循环双相情感障碍中的作用，并表明 IL-6 和 IL-18 可能是躁狂发作的标志物。
