Millett Caitlin E, Mukherjee Dahlia, Reider Aubrey, Can Adem, Groer Maureen, Fuchs Dietmar, Postolache Teodor T, Kelleher Shannon L, Saunders Erika F H
Department of Psychiatry, Penn State College of Medicine and Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA; Department of Neural and Behavioral Sciences, Penn State College of Medicine and Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA.
Department of Psychiatry, Penn State College of Medicine and Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA.
Psychiatry Res. 2017 Sep;255:52-58. doi: 10.1016/j.psychres.2017.05.022. Epub 2017 May 17.
Bipolar disorder (BD) is a recurrent, episodic mood disorder for which there are no current diagnostic, prognostic or theranostic biomarkers. Two peripheral markers of the acute phase immune response, zinc and neopterin, are consistently associated with severity of depression in literature. Given gender differences in clinical presentation of BD and in inflammatory processes, we aimed to explore the interaction between gender and immune biomarkers to predict mood severity in BD. Participants with DSM IV BD I and II were recruited through the Pennsylvania Psychiatric Institute during an acute mood episode. Healthy controls (HC) were recruited through advertisements. Participants fasted for at least 6h when blood was drawn for biomarkers. We found that zinc concentrations were significantly lower in the BD group at baseline (p<.05), and there was also a significant interaction between gender and zinc (p<.05), associated with depression severity. Also, we found a significant interaction between gender and neopterin, associated with mania severity (p<.05). We found that mania severity was associated with neopterin in men, while depression severity was positively associated with zinc in women. Our report bears replication in larger samples and highlights the potential for differences in the underlying pathophysiology between men and women with BD.
双相情感障碍（BD）是一种复发性发作性情绪障碍，目前尚无诊断、预后或治疗诊断生物标志物。急性期免疫反应的两个外周标志物，锌和蝶呤，在文献中一直与抑郁严重程度相关。鉴于BD临床表现和炎症过程存在性别差异，我们旨在探讨性别与免疫生物标志物之间的相互作用，以预测BD患者的情绪严重程度。在急性情绪发作期间，通过宾夕法尼亚精神病学研究所招募了符合《精神疾病诊断与统计手册》第四版（DSM-IV）标准的BD I型和II型患者。通过广告招募健康对照（HC）。采集生物标志物血样时，参与者至少禁食6小时。我们发现，BD组基线时锌浓度显著较低（p<0.05），性别与锌之间也存在显著交互作用（p<0.05），与抑郁严重程度相关。此外，我们发现性别与蝶呤之间存在显著交互作用，与躁狂严重程度相关（p<0.05）。我们发现，男性的躁狂严重程度与蝶呤相关，而女性的抑郁严重程度与锌呈正相关。我们的报告有待在更大样本中重复验证，并突出了BD男性和女性潜在病理生理学差异的可能性。
