Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan,
Department of Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland.
Neuropsychobiology. 2019;77(1):49-56. doi: 10.1159/000493740. Epub 2018 Oct 18.
The aim of this study was to evaluate serum levels of the antineuronal antibodies anti-N-methyl-D-aspartate receptor (NMDAR) and anti-glutamic acid decarboxylase (GAD), and insulin-like growth factor 1 (IGF-1), in patients with bipolar disorder (BD), during manic and depressive episodes and in remission compared to euthymic patients receiving long-term lithium therapy.
Serum levels of anti-NMDAR and anti-GAD 450/620 antibodies, as well as IGF-1, were measured using the ELISA method in 19 manic and 17 depressed patients both in an acute episode and in remission after the episode. All of the subjects were under pharmacological treatment. The control group included 18 euthymic BD patients receiving lithium for 9-44 years (mean 22 ± 11) in whom a single measurement was performed.
Serum levels of anti-NMDAR antibodies were higher in acute manic episodes than in lithium-treated patients. Serum levels of anti-GAD 450/620 antibodies were higher in acute manic and depressive episodes compared to remission after the respective episode. Their values in both acute manic and depressive episodes were higher than those in lithium-treated patients. Serum levels of IGF-1 were higher in acute manic episodes and in remission after mania than in lithium-treated patients.
Higher levels of anti-NMDAR and anti-GAD antibodies during episodes may point to an abnormality in the glutamatergic system in BD. Increased levels of IGF-1 during an acute manic episode and in remission after mania may constitute a compensatory mechanism against excitotoxicity. Lower levels of anti-NMDAR, anti-GAD antibodies, and IGF-1 during long-term lithium treatment may reflect normalization of this processes, contributing to mood stabilization.
本研究旨在评估抗 N-甲基-D-天冬氨酸受体（NMDAR）和抗谷氨酸脱羧酶（GAD）抗体以及胰岛素样生长因子 1（IGF-1）在双相情感障碍（BD）患者中的血清水平，包括在躁狂和抑郁发作期间以及缓解期，并与接受长期锂治疗的病情稳定患者进行比较。
采用 ELISA 法检测 19 例躁狂发作和 17 例抑郁发作患者在急性发作和发作后缓解期的血清抗 NMDAR 和抗 GAD 450/620 抗体以及 IGF-1 水平。所有患者均接受药物治疗。对照组包括 18 例病情稳定的接受锂治疗 9-44 年（平均 22±11 年）的 BD 患者，仅进行了单次测量。
急性躁狂发作时血清抗 NMDAR 抗体水平高于锂治疗组。急性躁狂和抑郁发作时血清抗 GAD 450/620 抗体水平高于各自发作后的缓解期。在急性躁狂和抑郁发作时，其水平均高于锂治疗组。急性躁狂发作和躁狂缓解后血清 IGF-1 水平高于锂治疗组。
发作期间谷氨酸能系统异常可能导致抗 NMDAR 和抗 GAD 抗体水平升高。急性躁狂发作和躁狂缓解后 IGF-1 水平升高可能构成对抗兴奋性毒性的代偿机制。长期锂治疗期间抗 NMDAR、抗 GAD 抗体和 IGF-1 水平降低可能反映了这些过程的正常化，有助于稳定情绪。
