Department of Psychiatry, Süleyman Demirel University Medicine Faculty, Isparta 32260, Turkey.
Department of Child and Adolescent Psychiatry, Süleyman Demirel University Medicine Faculty, Isparta, Turkey.
J Affect Disord. 2020 Apr 1;266:37-42. doi: 10.1016/j.jad.2020.01.117. Epub 2020 Jan 23.
The etiology in bipolar disorder has not been fully understanding. There are limited data regarding the relationship between the permeability of intestinal and blood-brain barrier (BBB), and bipolar disorder etiology. Zonulin is regarded as a non-invasive biomarker for intestinal permeability. Claudin-5 is an important part of BBB permeability. In this study, we assumed that there may be a deterioration in serum zonulin and claudin-5 levels in patients with bipolar disorder and this may affect the severity of the disease.
Forty-one bipolar disorder patients (21 patients in remission and 20 patients with manic episodes) and 41 healthy controls were included in this study. The patients were administered Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HDRS) to determine the severity of manic and depressive symptoms, respectively. Venous blood samples were collected, and serum zonulin and claudin-5 levels were measured.
The mean serum zonulin and claudin-5 levels in patients were significantly higher than healthy controls. There is no difference zonulin and claudın-5 levels between patients with manic episodes and patients in remission.
This study's small sample size limits the generalization of these outcomes to a larger population. Also, a major limitation of our study is lack of evaluations of gut microbiota in patients with bipolar disorder and controls.
In conclusion, the current research indicates that zonulin and claudin-5 are increased in patients with bipolar disorder and this finding may contribute to the role of intestinal permeability or BBB in the pathogenesis of bipolar disorder.
双相情感障碍的病因尚未完全阐明。关于肠道和血脑屏障（BBB）通透性与双相情感障碍病因之间的关系，数据有限。紧密连接蛋白-5（Claudin-5）是 BBB 通透性的重要组成部分，而结合蛋白（zonulin）被认为是肠道通透性的非侵入性生物标志物。在这项研究中，我们假设双相情感障碍患者的血清结合蛋白和紧密连接蛋白-5 水平可能会恶化，这可能会影响疾病的严重程度。
本研究纳入了 41 名双相情感障碍患者（21 名缓解期患者和 20 名躁狂发作患者）和 41 名健康对照者。使用 Young 躁狂评定量表（YMRS）和汉密尔顿抑郁评定量表（HDRS）评估患者的躁狂和抑郁严重程度。采集静脉血样，检测血清结合蛋白和紧密连接蛋白-5 水平。
患者的血清结合蛋白和紧密连接蛋白-5 水平明显高于健康对照组。躁狂发作患者和缓解期患者的结合蛋白和紧密连接蛋白-5 水平无差异。
本研究的样本量较小，限制了这些结果在更大人群中的推广。此外，本研究的一个主要局限性是缺乏对双相情感障碍患者和对照组肠道微生物群的评估。
综上所述，目前的研究表明，双相情感障碍患者的结合蛋白和紧密连接蛋白-5 增加，这一发现可能有助于肠道通透性或 BBB 在双相情感障碍发病机制中的作用。
