Discuss Bipolar
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Study results show that bipolar disorder (BD) patients in a manic state have increased levels of proinflammatory cytokines, which seem to be related to mood state.
“This study provides further support to investigate the immune system as a target for further treatment development,” say Flávio Kapczinski (Hospital de Clinicas de Porto Alegre, UFRGS, Brazil) and co-authors.
Previous studies have suggested that an association of mania and bipolar depression with a proinflammatory state. However, such studies have not compared cytokine levels in all phases of BD.
The researchers therefore compared cytokine levels examined by flow cytometry involved in th1/Th2 balance, such as tumor necrosis factor-?, interleukin (IL)-2, IL-4, IL-6, IL-10, and intereferon (IFN)-?, in 61 medicated patients with bipolar I disorder and 25 healthy individuals. Of the patients, 14 were in euthymic state, 23 in manic, and 24 in depressive episodes.
Kapczinski and team found that only IL-4 levels were increased in euthymic patients compared with healthy controls who showed no median increase in any of the cytokines measured (2.10 vs 0.00 pg/ml, respectively).
The authors say that this finding should be interpreted with caution as there was no control of the time of euthymia to inclusion in the study.
Manic patients had increased levels of IL-2 (3.20 pg/ml), IL-4 (1.90 pg/ml), and IL-6 (3.30 pg/ml) compared with controls. Patients in a depressive episode showed only increased IL-6 (2.20 pg/ml) levels relative to those seen in healthy individuals.
“Demonstration of similar levels of the majority of proinflammatory cytokines between euthymic bipolar patients and control individuals could be an indication that inflammatory changes may probably be associated with acute mood episodes, especially acute mania,” says the team.
Mood symptoms were positively correlated with IL-6 and IL-2 levels, as were manic symptoms indicated by the Young Mania Rating Scale. Depressive symptoms, as indicated by the Hamilton Depression Rating Scale, were positively correlated only with IL-6.
“Studies comparing cytokine levels in medicated versus unmedicated BD patients, and also before and after pharmacological treatment are warranted,” conclude the researchers.
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