Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, 38026National Cheng Kung University, Tainan, Taiwan.
Institute of Behavioral Medicine, College of Medicine, 38026National Cheng Kung University, Tainan, Taiwan.
Int J Immunopathol Pharmacol. 2022 Jan-Dec;36:3946320221084835. doi: 10.1177/03946320221084835.
Patients with bipolar disorder (BD) exhibit an inflamed condition that is associated with metabolic disturbance and cognitive impairment. Whether inflammation, represented by C-reactive protein (CRP), is causally associated with BD and influences treatment outcome has not been established.
We examined whether CRP is a causal factor for the risk of BD in drug-naïve, depressed BD patients and investigated whether polymorphisms in and life event changes influence cognitive function in BD patients receiving valproate (VPA) treatment.
Our results showed that BD patients had significantly higher CRP levels and worse cognitive function than the controls, while the frequencies of single nucleotide polymorphisms in BD patients and in controls were not different. In addition, the life event scale score was higher for BD patients than for controls. Furthermore, the genotypes of polymorphisms and the interactions between polymorphisms of and life event scale score had a significant influence on cognitive performance in BD patients after 12 weeks of VPA treatment.
Our study demonstrated the clinical utility of the application of functional genetics in clarifying the interactions among CRP, life event stress, and BD and suggested the important roles of gene-environment interactions in developing treatment strategies for BD.
双相情感障碍(BD)患者存在炎症状态,与代谢紊乱和认知障碍有关。代表 C 反应蛋白(CRP)的炎症是否与 BD 有因果关系,并影响治疗结果尚不清楚。
我们研究了 CRP 是否是初发、抑郁的 BD 患者发生 BD 的风险因素,还研究了在接受丙戊酸钠(VPA)治疗的 BD 患者中, 基因多态性和生活事件变化是否会影响认知功能。
我们的结果表明,BD 患者的 CRP 水平显著高于对照组,认知功能更差,而 BD 患者和对照组的 单核苷酸多态性频率没有差异。此外,BD 患者的生活事件量表评分高于对照组。此外,在 VPA 治疗 12 周后, 基因多态性的基因型以及 基因多态性与生活事件量表评分之间的相互作用对 BD 患者的认知表现有显著影响。
本研究证明了功能性遗传学在阐明 CRP、生活事件应激与 BD 之间相互作用的临床应用价值,并提示了 基因-环境相互作用在制定 BD 治疗策略中的重要作用。