Lu Yun-Rong, Rao Ying-Bo, Mou Yu-Jian, Chen Yan, Lou Han-Fen, Zhang Yu, Zhang Dan-Xuan, Xie Hai-Yan, Hu Li-Wei, Fang Ping
Department of Psychiatry, The Fourth Affiliated Hospital, Zhejiang University, School of Medicine, Yiwu.
Department of Psychiatry, The Second Affiliated Hospital, Medical School of Zhejiang University, Hangzhou.
Medicine (Baltimore). 2019 Feb;98(7):e14419. doi: 10.1097/MD.0000000000014419.
Immune system dysregulation plays a key role in the physiopathology of bipolar disorder (BD) and major depressive disorder (MDD). However, whether interleukins might be biomarkers to distinguish these 2 affective disorders is unclear. Here, we assessed the differences in serum levels of interleukin 6 (IL-6) and interleukin 8 (IL-8) as well as C-reactive protein (CRP) in patients with MDD and BD. In total, we enrolled 21 MDD patients, 26 BD patients, and 20 healthy controls. We collected a total of 35 samples from BD patients in 3 different phases, depression phase, manic phase, and remission stage, and 27 samples from MDD patients in acute and remission phases. Serum IL-6 and IL-8 levels were assessed with solid phase sandwich ELISA-based quantitative arrays, and CRP levels were determined with an automatic analyzer. Both serum IL-6 and IL-8 levels were elevated in BD patients but not MDD patients. Subgroup analysis indicated elevated serum IL-6 in both the depression and manic phases in BD patients. The serum CRP levels did not change in either BD or MDD patients. However, sex differences in CRP concentrations were observed in healthy controls. Furthermore, there were linear correlations between the CRP levels and Bech-Rafaelsen Mania Rating Scale (BRMS) scores in BD patients. IL-6 and IL-8 levels may serve as biomarkers to differentiate between MDD and BD patients, even when the clinical manifestations are atypical. IL-6 may be used for the differential diagnosis of MDD and depressive episodes in BD.
免疫系统失调在双相情感障碍（BD）和重度抑郁症（MDD）的病理生理过程中起关键作用。然而，白细胞介素是否可能作为区分这两种情感障碍的生物标志物尚不清楚。在此，我们评估了MDD和BD患者血清白细胞介素6（IL-6）、白细胞介素8（IL-8）以及C反应蛋白（CRP）水平的差异。我们总共纳入了21例MDD患者、26例BD患者和20名健康对照者。我们从BD患者的抑郁期、躁狂期和缓解期这3个不同阶段共收集了35份样本，从MDD患者的急性期和缓解期收集了27份样本。采用基于固相夹心ELISA的定量阵列评估血清IL-6和IL-8水平，用自动分析仪测定CRP水平。BD患者的血清IL-6和IL-8水平均升高，而MDD患者则未升高。亚组分析表明，BD患者在抑郁期和躁狂期血清IL-6均升高。BD和MDD患者的血清CRP水平均未改变。然而，在健康对照者中观察到CRP浓度存在性别差异。此外，BD患者的CRP水平与Bech-Rafaelsen躁狂量表（BRMS）评分之间存在线性相关性。即使临床表现不典型，IL-6和IL-8水平也可能作为区分MDD和BD患者的生物标志物。IL-6可用于MDD和BD抑郁发作的鉴别诊断。
