Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, UNESC, Criciúma, SC, Brazil.
J Psychiatr Res. 2017 Sep;92:160-182. doi: 10.1016/j.jpsychires.2017.03.018. Epub 2017 Mar 29.
Bipolar disorder (BD) is a neuropsychiatric disorder that is characterized by a phasic course of affective episodes interspersed with a euthymic state. Epidemiological, clinical, genetic, post-mortem and preclinical studies have shown that inflammatory reactions and immune modulation play a pivotal role in the pathophysiology of BD. It is conceptualized that biomarkers of inflammation and immune responses should be employed to monitor the disease process in bipolar patients. The objective of this systematic review is to analyse the inflammatory markers involved in human studies and to explore each individual marker for its potential clinical application and summarize evidence regarding their role in BD. A systematic review of human studies to measure inflammatory markers was conducted, and the studies were identified by searching PubMed/MEDLINE, PsycINFO, EMBASE, and Web of Science databases for peer-reviewed journals that were published until September 2015. In this review, we included peripheral markers, genetic, post-mortem and cell studies with inflammatory biomarker analysis in BD. One hundred and two (102) papers met the inclusion criteria. The pro-inflammatory cytokines were elevated and the anti-inflammatory cytokines were reduced in BD patients, particularly during manic and depressive phases when compared to the controls. These changes tend to disappear in euthymia, indicating that inflammation may be associated with acute phases of BD. Even though there are promising findings in this field, further clinical studies using more established detection techniques are needed to clearly show the benefit of using inflammatory markers in the diagnosis, follow-up and prognosis of patients with BD.
双相情感障碍（BD）是一种神经精神障碍，其特征是情感发作的阶段性过程，其间穿插着心境正常状态。流行病学、临床、遗传、尸检和临床前研究表明，炎症反应和免疫调节在 BD 的病理生理学中起着关键作用。人们认为，炎症和免疫反应的生物标志物应该用于监测双相情感障碍患者的疾病过程。本系统综述的目的是分析人类研究中涉及的炎症标志物，并探讨每个标志物在其潜在临床应用中的作用，并总结其在 BD 中的作用的证据。对测量炎症标志物的人类研究进行了系统综述，并通过搜索 PubMed/MEDLINE、PsycINFO、EMBASE 和 Web of Science 数据库，以确定发表至 2015 年 9 月的同行评议期刊上的研究。在本综述中，我们纳入了外周标志物、遗传、尸检和细胞研究，以及 BD 中的炎症生物标志物分析。有 102 篇论文符合纳入标准。与对照组相比，BD 患者的促炎细胞因子升高，抗炎细胞因子降低，尤其是在躁狂和抑郁期。这些变化在心境正常时趋于消失，表明炎症可能与 BD 的急性发作有关。尽管这一领域有令人鼓舞的发现，但需要进一步的临床研究使用更成熟的检测技术，以清楚地显示在 BD 患者的诊断、随访和预后中使用炎症标志物的益处。
