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Poletti S, Mazza MG, Benedetti F. Inflammatory mediators in major depression and bipolar disorder. Transl Psychiatry 2024; 14:247. [PMID: 38851764 PMCID: PMC11162479 DOI: 10.1038/s41398-024-02921-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 06/10/2024] Open
Abstract
Major depressive disorder (MDD) and bipolar disorder (BD) are highly disabling illnesses defined by different psychopathological, neuroimaging, and cognitive profiles. In the last decades, immune dysregulation has received increasing attention as a central factor in the pathophysiology of these disorders. Several aspects of immune dysregulations have been investigated, including, low-grade inflammation cytokines, chemokines, cell populations, gene expression, and markers of both peripheral and central immune activation. Understanding the distinct immune profiles characterizing the two disorders is indeed of crucial importance for differential diagnosis and the implementation of personalized treatment strategies. In this paper, we reviewed the current literature on the dysregulation of the immune response system focusing our attention on studies using inflammatory markers to discriminate between MDD and BD. High heterogeneity characterized the available literature, reflecting the heterogeneity of the disorders. Common alterations in the immune response system include high pro-inflammatory cytokines such as IL-6 and TNF-α. On the contrary, a greater involvement of chemokines and markers associated with innate immunity has been reported in BD together with dynamic changes in T cells with differentiation defects during childhood which normalize in adulthood, whereas classic mediators of immune responses such as IL-4 and IL-10 are present in MDD together with signs of immune-senescence.
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Affiliation(s)
- Sara Poletti
- Psychiatry and Clinical Psychobiology Unit, Division of Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Mario Gennaro Mazza
- Psychiatry and Clinical Psychobiology Unit, Division of Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology Unit, Division of Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Shkundin A, Halaris A. IL-8 (CXCL8) Correlations with Psychoneuroimmunological Processes and Neuropsychiatric Conditions. J Pers Med 2024; 14:488. [PMID: 38793070 PMCID: PMC11122344 DOI: 10.3390/jpm14050488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/26/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024] Open
Abstract
Interleukin-8 (IL-8/CXCL8), an essential CXC chemokine, significantly influences psychoneuroimmunological processes and affects neurological and psychiatric health. It exerts a profound effect on immune cell activation and brain function, suggesting potential roles in both neuroprotection and neuroinflammation. IL-8 production is stimulated by several factors, including reactive oxygen species (ROS) known to promote inflammation and disease progression. Additionally, CXCL8 gene polymorphisms can alter IL-8 production, leading to potential differences in disease susceptibility, progression, and severity across populations. IL-8 levels vary among neuropsychiatric conditions, demonstrating sensitivity to psychosocial stressors and disease severity. IL-8 can be detected in blood circulation, cerebrospinal fluid (CSF), and urine, making it a promising candidate for a broad-spectrum biomarker. This review highlights the need for further research on the diverse effects of IL-8 and the associated implications for personalized medicine. A thorough understanding of its complex role could lead to the development of more effective and personalized treatment strategies for neuropsychiatric conditions.
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Affiliation(s)
| | - Angelos Halaris
- Department of Psychiatry and Behavioral Neurosciences, Loyola University Chicago Stritch School of Medicine, Loyola University Medical Center, Maywood, IL 60153, USA;
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Bender LV, Wirowski N, Lobato AS, Jansen K, Cardoso TDA, Mondin TC, Oses JP, Kapczinski F, Souza LDDM, Silva RAD, Pedrotti Moreira F. The role of metabolic syndrome as a mediator in the relationship between CCL11 levels and the presence of a mood episode with mixed features in young adults with bipolar disorder. J Psychiatr Res 2024; 175:343-349. [PMID: 38761516 DOI: 10.1016/j.jpsychires.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/02/2024] [Accepted: 05/02/2024] [Indexed: 05/20/2024]
Abstract
Mixed features presentation in bipolar disorder (BD) represents the most severe form of the disease. BD may lead to cognitive and functional deterioration, a process known as neuroprogression, which appears to be exacerbated by increased serum levels of CCL11, a neuroprogression-related cytokine. Metabolic syndrome (MetS) is highly prevalent in BD, and it is known that the presence of MetS may increase inflammation, which may contribute to increased CCL11 levels, and consequently impact on the severity of the disorder. What is not known is whether the MetS mediates the association between CCL11 levels and the presence of mood episodes with mixed features in BD. Therefore, the aim of this study was to investigate the mediating effect of MetS on the relationship between CCL11 levels and the presence of mood episodes with mixed features in BD, in a population-based study. This is a cross-sectional study that included 184 young adults, 92 with BD and 92 populational controls, matched by sex and age. BD diagnosis was assessed using the Mini International Neuropsychiatric Interview - PLUS. Mood episodes with mixed features was defined according to DSM-IV and DSM-5 criteria. MetS was defined according to the National Cholesterol Education Program (NCEP/ATP III). Substance use was assessed through the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). CCL11 serum levels were analyzed using the multiplex analysis method Luminex 200™ system. The mediation model was tested using the MedMod module of the JAMOVI 2.4.8 software. Mediation analysis indicated a trend towards significance of MetS mediating the association between CCL11 and the presence of a mood episode with mixed features in BD (p = 0.065). Individuals with BD presenting with a mood episode with mixed features and MetS may have accelerated neuroprogression due to the influence of MetS on CCL11 levels, therefore, assessing for MetS occurrence in this population and implementing early interventions to prevent its development may be effective ways of delaying cognitive impairments related to this cytokine.
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Affiliation(s)
- Letícia Vasques Bender
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Natalia Wirowski
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | | | - Karen Jansen
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Taiane de Azevedo Cardoso
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | | | - Jean Pierre Oses
- Post Graduation Program in Biochemistry and Prospecting. Visiting Researcher, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Flávio Kapczinski
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Mood disorders Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil
| | | | - Ricardo Azevedo da Silva
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Fernanda Pedrotti Moreira
- Post Graduation Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil.
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Aso Y, Iijima T, Jojima T, Saito M, Tanuma D, Kase M, Sakurai S, Tomaru T, Usui I. High serum levels of CCL11/Eotaxin-1 are associated with diabetic sensorimotor polyneuropathy and peripheral nerve function but not with cardiac autonomic neuropathy in people with type 2 diabetes. Postgrad Med 2024; 136:318-324. [PMID: 38660919 DOI: 10.1080/00325481.2024.2347196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/19/2024] [Indexed: 04/26/2024]
Abstract
AIMS To investigate whether higher serum CCL11/Eotaxin-1, a biomarker for aging and neurodegenerative and neuroinflammatory disorders, is associated with diabetic sensorimotor polyneuropathy (DSPN), peripheral nerve dysfunction, and cardiac autonomic neuropathy in people with type 2 diabetes. METHODS This cross-sectional study included 106 patients with type 2 diabetes and 40 healthy controls, matched for the age and sex distribution of the diabetes group as a whole. The CC chemokines CCL11/Eotaxin-1 and CCL22/MDC were measured in fasting serum samples. DSPN and peripheral nerve function were assessed by neurological examination and nerve conduction studies, and cardiac autonomic function, by heart rate variability (HRV) and corrected QT (QTc) time. The cardio-ankle vascular index (CAVI) was measured as a marker for arterial stiffness. RESULTS Serum CCL11/Eotaxin-1 levels were significantly higher in diabetic patients than in healthy controls (183 ± 63.5 vs. 113.1 ± 38.5 pg/ml, p < 0.001), but serum CCL22/MDC levels were not significantly different between the two groups. In the diabetes group, the serum CCL11/Eotaxin-1 level was positively correlated with ulnar and sural nerve conduction velocities (p = 0.0009, p = 0.0208, respectively) and sensory nerve action potential (p = 0.0083), and CAVI (p = 0.0005), but not with HRV indices or QTc time, and serum CCL22/MDC was not significantly correlated with any indices of nerve conduction. In a model adjusted for age and duration of diabetes, serum CCL11/Eotaxin-1 was still associated with ulnar nerve conduction velocity (p = 0.02124). Serum CCL11/Eotaxin-1, but not CCL22/MDC, was significantly higher in patients with than in those without DSPN (208.2 ± 71.6 vs. 159.1 ± 45.1 pg/ml, respectively; p < 0.0001). CONCLUSIONS Serum CCL11/Eotaxin-1 is elevated in patients with DSPN and is associated with peripheral nerve dysfunction, in particular sensory nerve conduction velocity, suggesting that serum CCL11/Eotaxin-1 may be a potential biomarker for DSPN. CLINICAL TRIAL REGISTRATION University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN000040631).
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Affiliation(s)
- Yoshimasa Aso
- Department of Endocrinology and Metabolism, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Toshie Iijima
- Department of Endocrinology and Metabolism, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Teruo Jojima
- Department of Endocrinology and Metabolism, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Masahiro Saito
- Department of Endocrinology and Metabolism, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Dai Tanuma
- Department of Endocrinology and Metabolism, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Masato Kase
- Department of Endocrinology and Metabolism, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Shintaro Sakurai
- Department of Endocrinology and Metabolism, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Takuya Tomaru
- Department of Endocrinology and Metabolism, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Isao Usui
- Department of Endocrinology and Metabolism, Dokkyo Medical University, Mibu, Tochigi, Japan
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Dey R, Bishayi B. Microglial Inflammatory Responses to SARS-CoV-2 Infection: A Comprehensive Review. Cell Mol Neurobiol 2023; 44:2. [PMID: 38099973 DOI: 10.1007/s10571-023-01444-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/08/2023] [Indexed: 12/18/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is primarily a respiratory disease causing a worldwide pandemic in the year of 2019. SARS-CoV-2 is an enveloped, positive-stranded RNA virus that could invade the host through spike protein and exhibits multi-organ effects. The Brain was considered to be a potential target for SARS-CoV-2 infection. Although neuropsychiatric symptoms and cognitive impairments were observed in COVID-19 patients even after recovery the mechanism of action is not well documented. In this review, the contribution of microglia in response to SARS-CoV-2 infection was discussed aiming to design a therapeutic regimen for the management of neuroinflammation and psycho-behavioral alterations. Priming of microglia facilitates the hyper-activation state when it interacts with SARS-CoV-2 known as the 'second hit'. Moreover, the microgliosis produces reactive free radicals and pro-inflammatory cytokines like IL-1β, IFN-γ, and IL-6 which ultimately contribute to a 'cytokine storm', thereby increasing the occurrence of cognitive and neurological dysfunction. It was reported that elevated CCL11 may be responsible for psychiatric disorders and ROS/RNS-induced oxidative stress could promote major depressive disorder (MDD) and phenotypic switching. Additionally, during SARS-CoV-2 infection microglia-CD8+ T cell interaction may have a significant role in neuronal cell death. This cytokine-mediated cellular cross-talking plays a crucial role in pro-inflammatory and anti-inflammatory balance within the COVID-19 patient's brain. Therefore, all these aspects will be taken into consideration for developing novel therapeutic strategies to combat SARS-CoV-2-induced neuroinflammation.
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Affiliation(s)
- Rajen Dey
- Department of Medical Laboratory Technology, School of Allied Health Sciences, Swami Vivekananda University, Telinipara, Barasat-Barrackpore Rd, Bara Kanthalia, West Bengal, 700121, India.
| | - Biswadev Bishayi
- Immunology Laboratory, Department of Physiology, University of Calcutta, University Colleges of Science and Technology, 92 APC Road, Calcutta, West Bengal, 700009, India
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Petruso F, Giff A, Milano B, De Rossi M, Saccaro L. Inflammation and emotion regulation: a narrative review of evidence and mechanisms in emotion dysregulation disorders. Neuronal Signal 2023; 7:NS20220077. [PMID: 38026703 PMCID: PMC10653990 DOI: 10.1042/ns20220077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Emotion dysregulation (ED) describes a difficulty with the modulation of which emotions are felt, as well as when and how these emotions are experienced or expressed. It is a focal overarching symptom in many severe and prevalent neuropsychiatric diseases, including bipolar disorders (BD), attention deficit/hyperactivity disorder (ADHD), and borderline personality disorder (BPD). In all these disorders, ED can manifest through symptoms of depression, anxiety, or affective lability. Considering the many symptomatic similarities between BD, ADHD, and BPD, a transdiagnostic approach is a promising lens of investigation. Mounting evidence supports the role of peripheral inflammatory markers and stress in the multifactorial aetiology and physiopathology of BD, ADHD, and BPD. Of note, neural circuits that regulate emotions appear particularly vulnerable to inflammatory insults and peripheral inflammation, which can impact the neuroimmune milieu of the central nervous system. Thus far, few studies have examined the link between ED and inflammation in BD, ADHD, and BPD. To our knowledge, no specific work has provided a critical comparison of the results from these disorders. To fill this gap in the literature, we review the known associations and mechanisms linking ED and inflammation in general, and clinically, in BD, ADHD, and BD. Our narrative review begins with an examination of the routes linking ED and inflammation, followed by a discussion of disorder-specific results accounting for methodological limitations and relevant confounding factors. Finally, we critically discuss both correspondences and discrepancies in the results and comment on potential vulnerability markers and promising therapeutic interventions.
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Affiliation(s)
| | - Alexis E. Giff
- Department of Neuroscience, School of Life Sciences, École Polytechnique Fédérale de Lausanne, Switzerland
| | - Beatrice A. Milano
- Sant’Anna School of Advanced Studies, Pisa, Italy
- University of Pisa, Pisa, Italy
| | | | - Luigi Francesco Saccaro
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Switzerland
- Department of Psychiatry, Geneva University Hospital, Switzerland
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Jackson NA, Jabbi MM. Integrating biobehavioral information to predict mood disorder suicide risk. Brain Behav Immun Health 2022; 24:100495. [PMID: 35990401 PMCID: PMC9388879 DOI: 10.1016/j.bbih.2022.100495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 11/25/2022] Open
Abstract
The will to live and the ability to maintain one's well-being are crucial for survival. Yet, almost a million people die by suicide globally each year (Aleman and Denys, 2014), making premature deaths due to suicide a significant public health problem (Saxena et al., 2013). The expression of suicidal behaviors is a complex phenotype with documented biological, psychological, clinical, and sociocultural risk factors (Turecki et al., 2019). From a brain disease perspective, suicide is associated with neuroanatomical, neurophysiological, and neurochemical dysregulations of brain networks involved in integrating and contextualizing cognitive and emotional regulatory behaviors. From a symptom perspective, diagnostic measures of dysregulated mood states like major depressive symptoms are associated with over sixty percent of suicide deaths worldwide (Saxena et al., 2013). This paper reviews the neurobiological and clinical phenotypic correlates for mood dysregulations and suicidal phenotypes. We further propose machine learning approaches to integrate neurobiological measures with dysregulated mood symptoms to elucidate the role of inflammatory processes as neurobiological risk factors for suicide.
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Affiliation(s)
- Nicholas A. Jackson
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, USA
- Institute for Neuroscience, The University of Texas at Austin, USA
| | - Mbemba M. Jabbi
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, USA
- Mulva Clinics for the Neurosciences
- Institute for Neuroscience, The University of Texas at Austin, USA
- Department of Psychology, The University of Texas at Austin, USA
- Center for Learning and Memory, The University of Texas at Austin, USA
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Dion-Albert L, Bandeira Binder L, Daigle B, Hong-Minh A, Lebel M, Menard C. Sex differences in the blood-brain barrier: Implications for mental health. Front Neuroendocrinol 2022; 65:100989. [PMID: 35271863 DOI: 10.1016/j.yfrne.2022.100989] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/07/2022] [Accepted: 02/19/2022] [Indexed: 12/13/2022]
Abstract
Prevalence of mental disorders, including major depressive disorder (MDD), bipolar disorder (BD) and schizophrenia (SZ) are increasing at alarming rates in our societies. Growing evidence points toward major sex differences in these conditions, and high rates of treatment resistance support the need to consider novel biological mechanisms outside of neuronal function to gain mechanistic insights that could lead to innovative therapies. Blood-brain barrier alterations have been reported in MDD, BD and SZ. Here, we provide an overview of sex-specific immune, endocrine, vascular and transcriptional-mediated changes that could affect neurovascular integrity and possibly contribute to the pathogenesis of mental disorders. We also identify pitfalls in current literature and highlight promising vascular biomarkers. Better understanding of how these adaptations can contribute to mental health status is essential not only in the context of MDD, BD and SZ but also cardiovascular diseases and stroke which are associated with higher prevalence of these conditions.
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Affiliation(s)
- Laurence Dion-Albert
- Department of Psychiatry and Neuroscience, Faculty of Medicine and CERVO Brain Research Center, Université Laval, Quebec City, Canada
| | - Luisa Bandeira Binder
- Department of Psychiatry and Neuroscience, Faculty of Medicine and CERVO Brain Research Center, Université Laval, Quebec City, Canada
| | - Beatrice Daigle
- Department of Psychiatry and Neuroscience, Faculty of Medicine and CERVO Brain Research Center, Université Laval, Quebec City, Canada
| | - Amandine Hong-Minh
- Smurfit Institute of Genetics, Trinity College Dublin, Lincoln Place Gate, Dublin 2, Ireland
| | - Manon Lebel
- Department of Psychiatry and Neuroscience, Faculty of Medicine and CERVO Brain Research Center, Université Laval, Quebec City, Canada
| | - Caroline Menard
- Department of Psychiatry and Neuroscience, Faculty of Medicine and CERVO Brain Research Center, Université Laval, Quebec City, Canada.
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Özaslan A, Güney E, Gülbahar Ö, Büyüktaskin D, Arslan B. Increased Serum Level of CCL5 in Children with Attention‑Deficit/Hyperactivity Disorder: First Results about Serum Chemokines. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2022; 20:109-117. [PMID: 35078953 PMCID: PMC8813316 DOI: 10.9758/cpn.2022.20.1.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/26/2020] [Accepted: 12/30/2020] [Indexed: 12/02/2022]
Abstract
Objective Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder and its aetiology is not fully understood. This study aimed to determine whether the CCL5 and CCL11 influence the ADHD aetiology by comparing serum CCL5 and CCL11 levels of children with ADHD and typical development. Methods This study included 45 (27 males, mean age = 8.9 ± 1.7 years) treatment-naive patients diagnosed with ADHD and 35 (20 males, mean age = 8.8 ± 1.6 years) healthy controls. Participants ranged in age between 6−12 years and completed the Conners Teacher Rating Scale that assesses ADHD presentation and severity. CCL5 and CCL11 serum levels were also measured using enzyme-linked immunosorbent assay kits. Results Significantly higher serum CCL5 levels were found in children with ADHD compared to healthy controls (p < 0.001). No significant difference was found between the mean serum CC11 level of the patients and controls (p = 0.93). In addition, there was no significant correlation between the serum CCL5 and CCL11 levels and predominant presentations of ADHD and disease severity. Conclusion This study suggests that there are higher levels of serum CCL5 in drug naive children with ADHD, this findings suggest that CCL5 might play a role in the pathophysiology of ADHD. Moreover, these changes in peripheral blood may have therapeutic value. In addition, these results help to understand the role of chemokines in elucidating the etiopathogenesis of ADHD. Our results can be considered as the first step in investigating the role of CCL5 in ADHD, and further research is needed to support these initial findings.
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Affiliation(s)
- Ahmet Özaslan
- Department of Child and Adolescent Psychiatry, Ankara, Turkey
| | - Esra Güney
- Department of Child and Adolescent Psychiatry, Ankara, Turkey
| | - Özlem Gülbahar
- Department of Medical Biochemistry, Gazi University Medical Faculty, Ankara, Turkey
| | - Dicle Büyüktaskin
- Department of Child and Adolescent Psychiatry, Ankara, Turkey
- Department of Child and Adolescent Psychiatry, Cizre State Hospital, Şırnak, Turkey
| | - Burak Arslan
- Department of Medical Biochemistry, Erciş Şehit Rıdvan Çevik State Hospital, Van, Turkey
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Zazula R, Dodd S, Dean OM, Berk M, Bortolasci CC, Verri WA, Vargas HO, Nunes SOV. Cognition-immune interactions between executive function and working memory, tumour necrosis factor-alpha (TNF-alpha) and soluble TNF receptors (sTNFR1 and sTNFR2) in bipolar disorder. World J Biol Psychiatry 2022; 23:67-77. [PMID: 33949291 DOI: 10.1080/15622975.2021.1925152] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study examined cognition-immune interactions, specifically executive function, working memory, peripheral levels of tumour necrosis factor-alpha (TNF-α), and soluble tumour necrosis factor receptors-1 and -2 (sTNFR1 and 2) levels in bipolar disorder (BD) patients in comparison with controls. METHODS Thirty-one BD participants and twenty-seven controls participated in the study. The neurocognitive assessment was performed through three of CogState Research BatteryTM tasks for executive function and working memory. Plasma levels of TNF-α, sTNFR1, and sTNFR2 were measured after overnight fasting. Sociodemographic data and symptom severity of depression and mania were assessed. RESULTS BD presented a significantly worse performance in the working memory task (p = .005) and higher levels of TNF-α (p = .043) in comparison to controls. A trend level of significance was found for sTNFR1 between groups (p = .082). Among BD participants, there were significant correlations between sTNFR2 and neurocognitive tasks (Groton Maze Learning Task: ρ = .54, p = .002; Set-Shifting Task: ρ = .37, p = .042; and the Two-Back Task: ρ = -.49, p = .005), and between sTNFR1 and mania, depression and anxiety symptoms (respectively ρ = .37, p = .038; ρ = -.38, p = .037; and ρ = .42, p = .002). CONCLUSION TNF-α and its receptors might be an important variable in cognitive impairment in BD. Future studies might focus on the development of anti-inflammatory therapeutic targets for cognitive dysfunction in BD.
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Affiliation(s)
- Robson Zazula
- Federal University for Latin American Integration, Foz do Iguacu, Brazil.,Londrina State University, Health Sciences Graduate Program, Londrina, Brazil.,Deakin University, iMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, Australia
| | - Seetal Dodd
- Deakin University, iMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, Australia.,Centre of Youth Mental Health, University of Melbourne, Parkville, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Olivia M Dean
- Deakin University, iMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, Australia.,Centre of Youth Mental Health, University of Melbourne, Parkville, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Australia.,Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia
| | - Michael Berk
- Deakin University, iMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, Australia.,Centre of Youth Mental Health, University of Melbourne, Parkville, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Australia.,Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.,Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Australia
| | - Chiara C Bortolasci
- Deakin University, iMPACT, the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Geelong, Australia
| | - Waldiceu A Verri
- Department of Pathology, Londrina State University, Londrina, Brazil
| | - Heber O Vargas
- Londrina State University, Health Sciences Graduate Program, Londrina, Brazil
| | - Sandra O V Nunes
- Londrina State University, Health Sciences Graduate Program, Londrina, Brazil
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Wu X, Chen Z, Liao Y, Yang Z, Liang X, Guan N, Gan Z. Are serum levels of inflammatory markers associated with the severity of symptoms of bipolar disorder? Front Psychiatry 2022; 13:1063479. [PMID: 36741577 PMCID: PMC9894870 DOI: 10.3389/fpsyt.2022.1063479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/28/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND To explore the relationship between serum levels of inflammatory markers and symptomatic severity of bipolar disorder (BD). MATERIALS AND METHODS A cross-sectional study was conducted on 126 BD patients with current depressive episode (BDD), 102 BD patients with current mixed or (hypo)manic episode (BDM) and 94 healthy controls (HC). All participants were drug-naïve and had no current active physical illness associated with inflammatory response or history of substance abuse. Fasting serum levels of CRP, leptin (LEP), adiponectin (ADP), visfatin (VIS), TNF-α, IL-2, IL-6, IL-10, IL-17), and monocyte chemoattractant protein-1 (MCP-1) were measured with enzyme-linked immunosorbent assay (ELISA). Symptomatic severity of BD was assessed with HAMD-17 and YMRS. Generalized linear model was used to determine the association between the serum levels of inflammatory markers and symptomatic severity of BD. RESULTS The serum levels of IL-6, IL-10 and IL-17, and the IL-6/IL-10 ratio were significantly lower in mild BDD than in HC. In moderate BDD, the serum levels of MCP, IL-6 and IL-17 were significantly lower than in HC. In severe BDD, the serum level of ADP, MCP-1, IL-10 and IL-17and the IL-17/IL-10 ratio were significantly lower than in HC. The serum levels of TNF-α and the IL-6/IL-10 ratio were significantly higher in mild BDM than in HC. In moderate BDM, the serum level of VIS, IL-2, and IL-17 were significantly higher than in HC, but the IL-6/IL-10 ratio was significantly lower than in control. In severe BDM, the serum levels of IL-6 and IL-17 and the ratios of IL-6/IL-10 and IL-17/IL-10 were significantly lower than in HC, but the neutrophil/lymphocyte ratio was significantly higher than in HC. CONCLUSION In BDD, immune-inhibition is persistently predominant, while in mild-to-moderate BDM, immune system is activated but inhibited in severe BDM. The dynamic change of serum inflammatory markers suggests that alteration of peripheral inflammatory markers in BD is state-dependent instead of trait-marked.
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Affiliation(s)
- Xiuhua Wu
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhongcheng Chen
- Department of Laboratory Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yingtao Liao
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhihua Yang
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaolin Liang
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Nianhong Guan
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhaoyu Gan
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
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Poletti S, Mazza MG, Calesella F, Vai B, Lorenzi C, Manfredi E, Colombo C, Zanardi R, Benedetti F. Circulating inflammatory markers impact cognitive functions in bipolar depression. J Psychiatr Res 2021; 140:110-116. [PMID: 34107379 DOI: 10.1016/j.jpsychires.2021.05.071] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/05/2021] [Accepted: 05/29/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cognitive impairment is a core feature of bipolar disorder, with a prevalence of about 64.4% during episodes and 57.1% in euthymia. Recent evidences suggest that cognitive deficits in BD may follow immune dysfunction and elevated levels of inflammatory cytokines have been reported during periods of depression, mania and euthymia, suggesting the presence of a chronic, low-grade inflammatory state. The aim of the study is to investigate if immune/inflammatory markers and especially chemokines associate to cognitive performances. METHODS Seventy-six consecutively admitted inpatients with a depressive episode in course of bipolar disorder performed a neuropsychological evaluation with the Brief Assessment of Cognition in Schizophrenia and plasma blood levels of cytokines, chemokines and growth factors were analyzed with Luminex technology. RESULTS Higher levels of IL-1β, IL-6, CCL2, CCL4, CCL5, CXCL10, and bFGF are associated with the likelihood of having a poor cognitive performance. LIMITATIONS Limitation include the lack of a group of healthy controls and the lack of information regarding previous psychopharmacological treatments, alcohol and tobacco use. CONCLUSIONS Our results confirm the importance of chemokines in bipolar disorder and suggest that inflammatory markers suggestive of a low-grade inflammatory state could contribute to the neurocognitive deficits observed in depressed patients.
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Affiliation(s)
- Sara Poletti
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy.
| | - Mario Gennaio Mazza
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Federico Calesella
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Benedetta Vai
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Cristina Lorenzi
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Elena Manfredi
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Cristina Colombo
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
| | - Raffaella Zanardi
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Francesco Benedetti
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy; University Vita-Salute San Raffaele, Milano, Italy
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Guidara W, Messedi M, Maalej M, Naifar M, Khrouf W, Grayaa S, Maalej M, Bonnefont-Rousselot D, Lamari F, Ayadi F. Plasma oxysterols: Altered level of plasma 24-hydroxycholesterol in patients with bipolar disorder. J Steroid Biochem Mol Biol 2021; 211:105902. [PMID: 33901658 DOI: 10.1016/j.jsbmb.2021.105902] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 04/09/2021] [Accepted: 04/20/2021] [Indexed: 12/13/2022]
Abstract
Cholesterol and its oxygenated metabolites, including oxysterols, are intensively investigated as potential players in the pathophysiology of brain disorders. Altered oxysterol levels have been described in patients with numerous neuropsychiatric disorders. Recent studies have shown that Bipolar disorder (BD) is associated with the disruption of cholesterol metabolism. The present study was aimed at investigating the profile of oxysterols in plasma, their ratio to total cholesterol and their association with clinical parameters in patients with BD. Thirty three men diagnosed with BD and forty healthy controls matched for age and sex were included in the study. Oxysterol levels were measured by isotope-dilution ultra-performance liquid chromatography-tandem mass spectrometry. Significantly higher levels were observed for cholestane-3β,5α,6β-triol, 27-hydroxycholesterol (27-OHC) and Cholestanol in patients with BD. The concentration of 24-hydroxycholesterol (24-OHC) was significantly lower in patients compared to controls. 24-OHC was also negatively correlated to MAS subscale score (r =-0.343; p = 0.049). In patients, 24-OHC was inversely correlated with age (r = -0.240; p = 0.045). Multivariate analysis found that BD acute decompensation was independently related to the rise in plasma 24-OHC (p = 0.002; OR = 0.966, 95 % CI [0.945 - 0.987]). However, the 24-OHC assay relevance as a biomarker of this disease deserves further investigation in other studies.
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Affiliation(s)
- Wassim Guidara
- Laboratory of Research "Molecular Basis of Human Diseases", LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia.
| | - Meriam Messedi
- Laboratory of Research "Molecular Basis of Human Diseases", LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Manel Maalej
- Psychiatry C-department, University of Sfax & Hédi Chaker Hospital, Sfax, Tunisia
| | - Manel Naifar
- Laboratory of Research "Molecular Basis of Human Diseases", LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia; Laboratory of Biochemistry, University of Sfax & Habib Bourguiba Hospital, Sfax, Tunisia
| | - Walid Khrouf
- AP-HP, Sorbonne University, La Pitié-Salpêtrière University Hospital, Department of Metabolic Biochemistry, Paris, France
| | - Sahar Grayaa
- Laboratory of Research "Molecular Basis of Human Diseases", LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Mohamed Maalej
- Psychiatry C-department, University of Sfax & Hédi Chaker Hospital, Sfax, Tunisia
| | - Dominique Bonnefont-Rousselot
- AP-HP, Sorbonne University, La Pitié-Salpêtrière University Hospital, Department of Metabolic Biochemistry, Paris, France; UTCBS, U1267 Inserm, UMR 8258 CNRS, Université de Paris, Paris, France
| | - Foudil Lamari
- AP-HP, Sorbonne University, La Pitié-Salpêtrière University Hospital, Department of Metabolic Biochemistry, Paris, France
| | - Fatma Ayadi
- Laboratory of Research "Molecular Basis of Human Diseases", LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia; Laboratory of Biochemistry, University of Sfax & Habib Bourguiba Hospital, Sfax, Tunisia
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Guglielmo R, Miskowiak KW, Hasler G. Evaluating endophenotypes for bipolar disorder. Int J Bipolar Disord 2021; 9:17. [PMID: 34046710 PMCID: PMC8160068 DOI: 10.1186/s40345-021-00220-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Phenotypic heterogeneity is a major impediment to the elucidation of the neurobiology and genetics of bipolar disorder. Endophenotype could help in reducing heterogeneity by defining biological traits that are more direct expressions of gene effects. The aim of this review is to examine the recent literature on clinical, epidemiological, neurobiological, and genetic findings and to select and evaluate candidate endophenotypes for bipolar disorder. Evaluating putative endophenotype could be helpful in better understanding the neurobiology of bipolar disorder by improving the definition of bipolar-related phenotypes in genetic studies. In this manner, research on endophenotypes could be useful to improve psychopathological diagnostics in the long-run by dissecting psychiatric macro phenotypes into biologically valid components. MAIN BODY The associations among the psychopathological and biological endophenotypes are discussed with respect to specificity, temporal stability, heritability, familiarity, and clinical and biological plausibility. Numerous findings regarding brain function, brain structure, neuropsychology and altered neurochemical pathways in patients with bipolar disorder and their relatives deserve further investigation. Overall, major findings suggest a developmental origin of this disorder as all the candidate endophenotypes that we have been able to select are present both in the early stages of the disorder as well as in subjects at risk. CONCLUSIONS Among the stronger candidate endophenotypes, we suggest circadian rhythm instability, dysmodulation of emotion and reward, altered neuroimmune state, attention and executive dysfunctions, anterior cingulate cortex thickness and early white matter abnormalities. In particular, early white matter abnormalities could be the result of a vulnerable brain on which new stressors are added in young adulthood which favours the onset of the disorder. Possible pathways that lead to a vulnerable brain are discussed starting from the data about molecular and imaging endophenotypes of bipolar disorder.
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Affiliation(s)
- Riccardo Guglielmo
- Psychiatry Research Unit, Fribourg Network for Mental Health (RFSM), University of Fribourg, Chemin du Cardinal-Journet 3, 1752, Villars-sur-Glâne, Switzerland.,Department of Neuroscience, Institute of Psychiatry, Catholic University Medical School, Largo Francesco Vito 1, 00168, Rome, Italy
| | - Kamilla Woznica Miskowiak
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Gregor Hasler
- Psychiatry Research Unit, Fribourg Network for Mental Health (RFSM), University of Fribourg, Chemin du Cardinal-Journet 3, 1752, Villars-sur-Glâne, Switzerland.
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A peripheral inflammatory signature discriminates bipolar from unipolar depression: A machine learning approach. Prog Neuropsychopharmacol Biol Psychiatry 2021; 105:110136. [PMID: 33045321 DOI: 10.1016/j.pnpbp.2020.110136] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/04/2020] [Accepted: 10/06/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Mood disorders (major depressive disorder, MDD, and bipolar disorder, BD) are considered leading causes of life-long disability worldwide, where high rates of no response to treatment or relapse and delays in receiving a proper diagnosis (~60% of depressed BD patients are initially misdiagnosed as MDD) contribute to a growing personal and socio-economic burden. The immune system may represent a new target to develop novel diagnostic and therapeutic procedures but reliable biomarkers still need to be found. METHODS In our study we predicted the differential diagnosis of mood disorders by considering the plasma levels of 54 cytokines, chemokines and growth factors of 81 BD and 127 MDD depressed patients. Clinical diagnoses were predicted also against 32 healthy controls. Elastic net models, including 5000 non-parametric bootstrapping procedure and inner and outer 10-fold nested cross-validation were performed in order to identify the signatures for the disorders. RESULTS Results showed that the immune-inflammatory signature classifies the two disorders with a high accuracy (AUC = 97%), specifically 92% and 86% respectively for MDD and BD. MDD diagnosis was predicted by high levels of markers related to both pro-inflammatory (i.e. IL-1β, IL-6, IL-7, IL-16) and regulatory responses (IL-2, IL-4, and IL-10), whereas BD by high levels of inflammatory markers (CCL3, CCL4, CCL5, CCL11, CCL25, CCL27, CXCL11, IL-9 and TNF-α). CONCLUSIONS Our findings provide novel tools for early diagnosis of BD, strengthening the impact of biomarkers research into clinical practice, and new insights for the development of innovative therapeutic strategies for depressive disorders.
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Inflammation-Related Changes in Mood Disorders and the Immunomodulatory Role of Lithium. Int J Mol Sci 2021; 22:ijms22041532. [PMID: 33546417 PMCID: PMC7913492 DOI: 10.3390/ijms22041532] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 12/11/2022] Open
Abstract
Mood disorders are chronic, recurrent diseases characterized by changes in mood and emotions. The most common are major depressive disorder (MDD) and bipolar disorder (BD). Molecular biology studies have indicated an involvement of the immune system in the pathogenesis of mood disorders, and showed their correlation with altered levels of inflammatory markers and energy metabolism. Previous reports, including meta-analyses, also suggested the role of microglia activation in the M1 polarized macrophages, reflecting the pro-inflammatory phenotype. Lithium is an effective mood stabilizer used to treat both manic and depressive episodes in bipolar disorder, and as an augmentation of the antidepressant treatment of depression with a multidimensional mode of action. This review aims to summarize the molecular studies regarding inflammation, microglia activation and energy metabolism changes in mood disorders. We also aimed to outline the impact of lithium on these changes and discuss its immunomodulatory effect in mood disorders.
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CCL11 levels in drug-naive bipolar patients: The role of sex and smoking status. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2020. [DOI: 10.1016/j.jadr.2020.100002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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18
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Cyclooxygenase Inhibition Safety and Efficacy in Inflammation-Based Psychiatric Disorders. Molecules 2020; 25:molecules25225388. [PMID: 33217958 PMCID: PMC7698629 DOI: 10.3390/molecules25225388] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 12/21/2022] Open
Abstract
According to the World Health Organization, the major psychiatric and neurodevelopmental disorders include major depression, bipolar disorder, schizophrenia, and autism spectrum disorder. The potential role of inflammation in the onset and progression of these disorders is increasingly being studied. The use of non-steroidal anti-inflammatory drugs (NSAIDs), well-known cyclooxygenase (COX) inhibitors, combined with first-choice specific drugs have been long investigated. The adjunctive administration of COX inhibitors to classic clinical treatments seems to improve the prognosis of people who suffer from psychiatric disorders. In this review, a broad overview of the use of COX inhibitors in the treatment of inflammation-based psychiatric disorders is provided. For this purpose, a critical analysis of the use of COX inhibitors in the last ten years of clinical trials of the major psychiatric disorders was carried out.
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Edberg D, Hoppensteadt D, Walborn A, Fareed J, Sinacore J, Halaris A. Plasma MCP-1 levels in bipolar depression during cyclooxygenase-2 inhibitor combination treatment. J Psychiatr Res 2020; 129:189-197. [PMID: 32763585 DOI: 10.1016/j.jpsychires.2020.06.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 06/01/2020] [Accepted: 06/14/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Neuroinflammation plays a role in the pathophysiology of Bipolar Disorder Depression (BDD) and altered levels of inflammatory mediators, such as monocyte chemoattractant protein-1 (MCP-1, aka CCL2) have been reported. This study reports specifically on MCP-1 levels, as a potential marker of BDD and/or treatment response in patients receiving combination treatment with the cyclooxygenase-2 inhibitor, celecoxib (CBX). METHODS In this randomized, 10-week, double-blind, two-arm, placebo-controlled study, 47 patients with treatment resistant BDD received either escitalopram (ESC) + CBX, or ESC + placebo (PBO). Plasma MCP-1 levels were measured at 3 time points in the BDD subjects, and in a healthy control (HC) group. Depression severity was quantified using the Hamilton Depression Scale (HAMD-17). RESULTS The CBX group had significantly lower HAMD-17 scores vs. PBO at week 4 (P = 0.026) and week 8 (P = 0.002). MCP-1 levels were not significantly different in BDD vs. HC subjects at baseline (P = 0.588), nor in CBX vs. PBO groups at week 8 (P = 0.929). Week 8 HAMD-17 scores and MCP-1 levels were significantly negatively correlated in treatment non-responders to CBX or PBO (P = 0.050). Non-responders had significantly lower MCP-1 levels vs. responders at weeks 4 (P = 0.049) and 8 (P = 0.014). MCP-1 was positively correlated with pro-inflammatory analytes in the PBO group and with anti-inflammatory analytes in the CBX group. CONCLUSIONS Combination treatment reduced treatment resistance and augmented antidepressant response. Baseline plasma MCP-1 levels were not altered in BDD patients. Since non-responders had lower levels of MCP-1, elevated MCP-1 may indicate a better response to CBX + SSRI treatment.
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Affiliation(s)
- David Edberg
- Department of Psychiatry and Behavioral Neuroscience, Loyola University Stritch School of Medicine, Chicago, IL, USA
| | - Debra Hoppensteadt
- Department of Pathology, Loyola University Stritch School of Medicine, Chicago, IL, USA
| | - Amanda Walborn
- Department of Pathology, Loyola University Stritch School of Medicine, Chicago, IL, USA
| | - Jawed Fareed
- Department of Pathology, Loyola University Stritch School of Medicine, Chicago, IL, USA
| | - James Sinacore
- Department of Public Health Sciences, Loyola University Stritch School of Medicine, Chicago, IL, USA
| | - Angelos Halaris
- Department of Psychiatry and Behavioral Neuroscience, Loyola University Stritch School of Medicine, Chicago, IL, USA.
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CCL-11 or Eotaxin-1: An Immune Marker for Ageing and Accelerated Ageing in Neuro-Psychiatric Disorders. Pharmaceuticals (Basel) 2020; 13:ph13090230. [PMID: 32887304 PMCID: PMC7558796 DOI: 10.3390/ph13090230] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/27/2020] [Accepted: 08/31/2020] [Indexed: 12/16/2022] Open
Abstract
Background: CCL-11 (eotaxin) is a chemokine with an important role in allergic conditions. Recent evidence indicates that CCL-11 plays a role in brain disorders as well. This paper reviews the associations between CCL-11 and aging, neurodegenerative, neuroinflammatory and neuropsychiatric disorders. Methods: Electronic databases were searched for original articles examining CCL-11 in neuropsychiatric disorders. Results: CCL-11 is rapidly transported from the blood to the brain through the blood-brain barrier. Age-related increases in CCL-11 are associated with cognitive impairments in executive functions and episodic and semantic memory, and therefore, this chemokine has been described as an “Endogenous Cognition Deteriorating Chemokine” (ECDC) or “Accelerated Brain-Aging Chemokine” (ABAC). In schizophrenia, increased CCL-11 is not only associated with impairments in cognitive functions, but also with key symptoms including formal thought disorders. Some patients with mood disorders and premenstrual syndrome show increased plasma CCL-11 levels. In diseases of old age, CCL-11 is associated with lowered neurogenesis and neurodegenerative processes, and as a consequence, increased CCL-11 increases risk towards Alzheimer’s disease. Polymorphisms in the CCL-11 gene are associated with stroke. Increased CCL-11 also plays a role in neuroinflammatory disease including multiple sclerosis. In animal models, neutralization of CCL-11 may protect against nigrostriatal neurodegeneration. Increased production of CCL-11 may be attenuated by glucocorticoids, minocycline, resveratrol and anti-CCL11 antibodies. Conclusions: Increased CCL-11 production during inflammatory conditions may play a role in human disease including age-related cognitive decline, schizophrenia, mood disorders and neurodegenerative disorders. Increased CCL-11 production is a new drug target in the treatment and prevention of those disorders.
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Misiak B, Bartoli F, Carrà G, Małecka M, Samochowiec J, Jarosz K, Banik A, Stańczykiewicz B. Chemokine alterations in bipolar disorder: A systematic review and meta-analysis. Brain Behav Immun 2020; 88:870-877. [PMID: 32278851 DOI: 10.1016/j.bbi.2020.04.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 12/20/2022] Open
Abstract
We aimed to perform a systematic review and meta-analysis of studies examining the levels of chemokines in peripheral blood of patients with bipolar disorder (BD) and healthy controls. Meta-analysis was based on random-effects models with Hedges' g as the effect size estimate. We included 13 eligible studies (1221 BD patients and 663 controls). The following chemokines were analysed: interleukin-8 (IL-8), monocyte-chemoattractant protein-1 (MCP-1), eotaxin-1, eotaxin-2 and interferon-γ-induced protein 10 (IP-10). The levels of IL-8 (N = 8, g = 0.26, 95%CI: 0.11-0.41, p < 0.001), MCP-1 (N = 8, g = 0.40, 95%CI: 0.18-0.63), eotaxin-1 (N = 3, g = 0.55, 95%CI: 0.21-0.89, p = 0.001) and IP-10 (N = 4, g = 0.95, 95%CI: 0.67-1.22, p < 0.001) were significantly higher in BD patients as compared with controls. Subgroup analyses revealed that elevated levels of IL-8 (N = 5, g = 0.75, 95%CI: 0.42-1.07, p < 0.001) and MCP-1 (N = 4, g = 0.57, 95%CI: 0.28-0.86, p < 0.001) appeared only in BD patients during their depressive phase. Illness duration was associated with significantly lower levels of IL-8 in meta-regression analysis. In turn, elevated levels of IP-10 were present during euthymia (N = 2, g = 0.76, 95%CI: 0.43-1.10, p < 0.001) but not depression (N = 2, g = 1.81, 95%CI: -0.16 to 3.77, p = 0.072). The analysis of eotaxin-1 levels was mainly based on studies of euthymic BD patients (N = 3). Our results suggest that chemokine alterations in BD might be related to mood state. Elevated levels of IL-8 and MCP-1 might be specific to depression. Available evidence indicates that increased levels of eotaxin-1 and IP-10 appear in euthymia; however, more studies are needed to address these alterations in other mood states.
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Affiliation(s)
- Błażej Misiak
- Department of Genetics, Wroclaw Medical University, Marcinkowskiego 1 Street, 50-368 Wroclaw, Poland.
| | - Francesco Bartoli
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy; Department of Mental Health & Addiction, ASST Nord Milano, Milano, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy; Department of Mental Health & Addiction, ASST Nord Milano, Milano, Italy; Division of Psychiatry, University College London, London, UK
| | - Monika Małecka
- Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26 Street, 71-460 Szczecin, Poland
| | - Konrad Jarosz
- Department of Clinical Nursing, Pomeranian Medical University, Żołnierska 48 Street, 71-210 Szczecin, Poland
| | - Anna Banik
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, Ostrowskiego 30b Street, 53-238 Wroclaw, Poland
| | - Bartłomiej Stańczykiewicz
- Department of Nervous System Diseases, Wroclaw Medical University, Bartla 5 Street, 51-618 Wroclaw, Poland
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Benedetti F, Aggio V, Pratesi ML, Greco G, Furlan R. Neuroinflammation in Bipolar Depression. Front Psychiatry 2020; 11:71. [PMID: 32174850 PMCID: PMC7054443 DOI: 10.3389/fpsyt.2020.00071] [Citation(s) in RCA: 133] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 01/27/2020] [Indexed: 12/31/2022] Open
Abstract
Bipolar disorder (BD) is a leading cause of worldwide disability among mood disorders. Pathological mechanisms are still vastly unclear, and current treatments with conventional medications are often unsatisfactory in maintaining symptoms control and an adequate quality of life. Consequently, current research is focusing on shedding new light on disease pathogenesis, to improve therapeutic effectiveness. Recent evidence has suggested a prominent role of inflammation in mood disorders. Elevated levels of peripheral proinflammatory mediators have been reported in BD, as well as in other mood disorders, and people with systemic autoimmune diseases have an increased risk of developing BD. These immunological alterations are stable, and current medications are unable to alter peripheral concentrations even when clinical improvement is evident. These findings have also been replicated in the central nervous system (CNS) milieu, whereas genetic studies have shown that these immune alterations are not due to the disorder itself, being detectable before the illness onset. Moreover, these inflammatory modifications seem to be affected by and linked to other biomarkers of the disorder, such as alterations of white matter (WM) microstructure, metabolism, kynurenine pathway, and circadian rhythmicity. Finally, these immune variations seem to be useful as predictors of therapeutic responsiveness to medications, and in discriminating between clinically different outcomes. The objective of this review is to summarize available evidence on the connection between inflammation and BD, focusing on peripheral inflammatory markers and recent findings on their connection with other typical features of BD, to outline a general overview of the disorder. Moreover, it is meant to analyze the issues with data gathering and interpretation, given the partially contradictory and inconsistent nature of results.
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Affiliation(s)
- Francesco Benedetti
- Psychiatry and Clinical Psychobiology Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele Hospital, Milano, Italy.,University Vita-Salute San Raffaele, Milano, Italy
| | - Veronica Aggio
- Psychiatry and Clinical Psychobiology Unit, Division of Neuroscience, IRCCS Ospedale San Raffaele Hospital, Milano, Italy.,PhD Program in Molecular Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Maria Luisa Pratesi
- Clinical Neuroimmunology Unit, Institute of Experimental Neurology, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Giacomo Greco
- Clinical Neuroimmunology Unit, Institute of Experimental Neurology, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Roberto Furlan
- Clinical Neuroimmunology Unit, Institute of Experimental Neurology, IRCCS Ospedale San Raffaele, Milano, Italy
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Postmortem evidence of brain inflammatory markers in bipolar disorder: a systematic review. Mol Psychiatry 2020; 25:94-113. [PMID: 31249382 DOI: 10.1038/s41380-019-0448-7] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 03/08/2019] [Accepted: 03/18/2019] [Indexed: 12/16/2022]
Abstract
Bipolar disorder (BD) is a chronic affective disorder with extreme mood swings that include mania or hypomania and depression. Though the exact mechanism of BD is unknown, neuroinflammation is one of the numerous investigated etiopathophysiological causes of BD. This article presents a systematic review of the data regarding brain inflammation evaluating microglia, astrocytes, cytokines, chemokines, adhesion molecules, and other inflammatory markers in postmortem BD brain samples. This systematic review was performed according to PRISMA recommendations, and relevant studies were identified by searching the PubMed/MEDLINE, PsycINFO, EMBASE, LILACS, IBECS, and Web of Science databases for peer-reviewed journal articles published by March 2019. Quality of included studies appraised using the QUADAS-2 tool. Among the 1814 articles included in the primary screening, 51 articles measured inflammatory markers in postmortem BD brain samples. A number of studies have shown evidence of inflammation in BD postmortem brain samples. However, an absolute statement cannot be concluded whether neuroinflammation is present in BD due to the large number of studies did not evaluate the presence of infiltrating peripheral immune cells in the central nervous system (CNS) parenchyma, cytokines levels, and microglia activation in the same postmortem brain sample. For example, out of 15 studies that evaluated microglia cells markers, 8 studies found no effect of BD on these cells. Similarly, 17 out of 51 studies evaluating astrocytes markers, 9 studies did not find any effect of BD on astrocyte cells, whereas 8 studies found a decrease and 2 studies presented both increase and decrease in different brain regions. In addition, multiple factors account for the variability across the studies, including postmortem interval, brain area studied, age at diagnosis, undergoing treatment, and others. Future analyses should rectify these potential sources of heterogeneity and reach a consensus regarding the inflammatory markers in postmortem BD brain samples.
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Valiati FE, Hizo GH, Pinto JV, Kauer-Sant`Anna M. The Possible Role of Telomere Length and Chemokines in the Aging Process: A Transdiagnostic Review in Psychiatry. CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2019. [DOI: 10.2174/1573400515666190719155906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:Psychiatric disorders are common, reaching a worldwide prevalence of 29.2%. They are associated with a high risk of premature death and with accelerated aging in clinical, molecular and neuroimaging studies. Recently, there is strong evidence suggesting a possible role of telomere length and chemokines in aging processes in psychiatric disorders.Objective:We aimed to review the literature on telomere length and chemokines and its association with early aging in mental illnesses on a transdiagnostic approach.Results:The review highlights the association between psychiatric disorders and early aging. Several independent studies have reported shorter telomere length and dysregulations on levels of circulating chemokines in schizophrenia, bipolar disorder, major depressive disorder, and anxiety disorders, suggesting a complex interaction between these markers in a transdiagnostic level. However, studies have investigated the inflammatory markers and telomere shortening separately and associated with a particular diagnosis, rather than as a transdiagnostic biological feature.Conclusion:There is consistent evidence supporting the relationship between accelerated aging, telomere length, and chemokines in mental disorders, but they have been studied individually. Thus, more research is needed to improve the knowledge of accelerated senescence and its biomarkers in psychiatry, not only individually in each diagnosis, but also based on a transdiagnostic perspective. Moreover, further research should try to elucidate how the intricate association between the chemokines and telomeres together may contribute to the aging process in psychiatric disorders.
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Affiliation(s)
- Fernanda Endler Valiati
- Laboratory of Molecular Psychiatry, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Gabriel Henrique Hizo
- Laboratory of Molecular Psychiatry, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Jairo Vinícius Pinto
- Laboratory of Molecular Psychiatry, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Márcia Kauer-Sant`Anna
- Laboratory of Molecular Psychiatry, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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Abstract
OBJECTIVE Although accumulating evidence supports the hypothesis that immune/inflammatory mechanisms are associated with the pathophysiology of bipolar disorder (BD), data about the profile of chemokines (chemotactic cytokines) and chemokine receptors are still scarce. The current study was designed to evaluate the expression of chemokine receptors on lymphocytes of patients with BD in comparison with controls. METHODS Thirty-three patients with type I BD (N = 21 in euthymia; N = 6 in mania/hypomania; N = 6 in depression) and 22 age- and sex-matched controls were subjected to clinical evaluation and peripheral blood draw. The expression of chemokine receptors CCR3, CCR5, CXCR4, and CXCR3 on CD4+ and CD8+ lymphocytes was assessed by flow cytometry. RESULTS Patients with BD had decreased percentage of CD4+CXCR3+ (p = 0.024), CD4+CCR3+ (p = 0.042), and CD4+CCR5+ (0.013) lymphocytes in comparison with controls. The percentage of both CD4+ and CD8+ lymphocytes expressing the chemokine receptor CXCR4 was similar in patients with BD and controls. Likewise, the percentages of CD8+CXCR3+, CD8+CCR3+, and CD8+CCR5+ lymphocytes were similar in patients with BD and controls. CONCLUSION Our findings reinforce the hypothesis that immune pathways, especially involving CD4+ lymphocytes, are involved in the physiopathology of BD.
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Ghafouri-Fard S, Oskooei VK, Omrani MD, Taheri M. Dysregulation of cytokine coding genes in peripheral blood of bipolar patients. J Affect Disord 2019; 256:578-583. [PMID: 31280083 DOI: 10.1016/j.jad.2019.06.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/28/2019] [Accepted: 06/29/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND The role of immune response dysregulation has been previously noticed in the pathogenesis of bipolar disorder (BD). METHODS In the current investigation, we compared expression levels of eight cytokines and a chemokine (CXCL8) in the peripheral blood of BD patients and healthy subjects. All BD patients were in euthymic phase. RESULTS We found higher expression of IL-1B, IL-10, IFN-G, TNF-a, TGF-B and IL-2 in male patients compared with male controls (ExR=3.44, P<0.0001, ExR=2.54, P<0.0001; ExR=2.39, P<0.0001; ExR=2.74, P<0.0001; ExR=2.32, P<0.0001; ExR=1.87, P = 0.04 respectively). For these cytokines, no significant differences were found between female patients and female controls. While expression of IL-6 was higher in male patients compared with male controls (ExR=2.07, P = 0.006), in female subjects the opposite trend was detected (ExR=0.44, P = 0.02). However, no significant difference was detected between female subjects. Expression levels of IL-17 were not different between patients and controls or between any subgroups of them. We found significant correlations between expression of IFN-G and age at disease onset (R = 0.25, P = 0.04) as well as expression of CXCL8 and both age of patients and age at disease onset (R = 0.26, P = 0.03; R = 0.25, P = 0.04). Moreover, inverse correlation was detected between expression of TNF-a and age in control group (R=-0.34, P = 0.008). CONCLUSION Combination of transcript levels of six genes could differentiate BD patients from healthy subjects with diagnostic power of 0.85 (Sensitivity=78%, Specificity=80% and P<0.0001). The current investigation highlights the role of cytokine coding genes in the pathogenesis of BD and potentiates them as diagnostic biomarkers.
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Affiliation(s)
- Soudeh Ghafouri-Fard
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Vahid Kholghi Oskooei
- Department of Laboratory Sciences, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran; Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Mir Davood Omrani
- Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Taheri
- Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Pantović-Stefanović M, Petronijević N, Dunjić-Kostić B, Velimirović M, Nikolić T, Jurišić V, Lačković M, Damjanović A, Totić-Poznanović S, Jovanović AA, Ivković M. sVCAM-1, sICAM-1, TNF-α and IL-6 levels in bipolar disorder type I: Acute, longitudinal and therapeutic implications. World J Biol Psychiatry 2019; 19:S41-S51. [PMID: 27841086 DOI: 10.1080/15622975.2016.1259498] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To explore the serum levels of soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular cell adhesion molecule-1 (sICAM-1), tumour necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in patients with bipolar disorder (BD), with regard to acute episode characteristics, course of the disorder and treatment. METHODS The study group consisted of 83 patients diagnosed with BD type I. The control group consisted of 73 healthy individuals, matched with the study group according to age, gender and body mass index. The serum levels of sVCAM-1, sICAM-1, TNF-α and IL-6 were measured by ELISA. RESULTS Compared with healthy controls, significantly elevated levels of IL-6 and sICAM-1 and significantly lower levels of TNF-α and sVCAM-1 were identified in acute and remission phases of BD. The acute serum levels of sVCAM-1 were associated with the type and severity of acute mood symptoms as well as with course of illness characteristics. TNF-α was associated with duration of untreated disorder and type of treatment. CONCLUSIONS BD is related to both acute and long-term alterations of immune mediators, including adhesion molecules. The potential immunomodulatory role of pharmacotherapeutic treatment is also to be considered in BD.
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Affiliation(s)
| | - Nataša Petronijević
- b School of Medicine, University of Belgrade , Belgrade , Serbia.,c Institute of Clinical and Medical Biochemistry , Belgrade , Serbia
| | | | - Milica Velimirović
- b School of Medicine, University of Belgrade , Belgrade , Serbia.,c Institute of Clinical and Medical Biochemistry , Belgrade , Serbia
| | - Tatjana Nikolić
- b School of Medicine, University of Belgrade , Belgrade , Serbia.,c Institute of Clinical and Medical Biochemistry , Belgrade , Serbia
| | - Vladimir Jurišić
- d School of Medicine, University of Kragujevac , Kragujevac , Serbia
| | - Maja Lačković
- a Clinic of Psychiatry , Clinical Centre of Serbia , Belgrade , Serbia.,b School of Medicine, University of Belgrade , Belgrade , Serbia
| | - Aleksandar Damjanović
- a Clinic of Psychiatry , Clinical Centre of Serbia , Belgrade , Serbia.,b School of Medicine, University of Belgrade , Belgrade , Serbia
| | - Sanja Totić-Poznanović
- a Clinic of Psychiatry , Clinical Centre of Serbia , Belgrade , Serbia.,b School of Medicine, University of Belgrade , Belgrade , Serbia
| | - Aleksandar A Jovanović
- a Clinic of Psychiatry , Clinical Centre of Serbia , Belgrade , Serbia.,b School of Medicine, University of Belgrade , Belgrade , Serbia
| | - Maja Ivković
- a Clinic of Psychiatry , Clinical Centre of Serbia , Belgrade , Serbia.,b School of Medicine, University of Belgrade , Belgrade , Serbia
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Ghoryani M, Faridhosseini F, Talaei A, Faridhosseini R, Tavakkol-Afshari J, Dadgar Moghaddam M, Azim P, Salimi Z, Marzouni HZ, Mohammadi M. Gene expression pattern of CCL2, CCL3, and CXCL8 in patients with bipolar disorder. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2019; 24:45. [PMID: 31160912 PMCID: PMC6540773 DOI: 10.4103/jrms.jrms_763_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 12/24/2018] [Accepted: 02/21/2019] [Indexed: 12/23/2022]
Abstract
Background Bipolar disorder (BD) is one of the most important psychiatric disorders in the world. There is evidence suggesting the role of inflammatory mediators such as chemokines in the etiology of BD. The objective of the current study was to evaluate the gene expression of CCL2, CCL3, and CXCL8 in patients with BD and compare them to healthy controls. Materials and Methods A total of 48 patients with confirmed BD and 48 healthy controls enrolled in this study. All patients were recruited from April to August 2016 at Ibn-Sina Psychiatric Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. RNA was extracted from the whole blood samples and then cDNA was synthesized. Gene expression of CCL2, CCL3, and CXCL8 was measured using SYBR® Green real-time polymerase chain reaction. The difference of delta-CT values between patients and healthy controls was compared with the independent samples t-tests. Results CCL2 and CXCL8 genes expressed at higher levels in patients with BD as compared to healthy controls, but not significant. On the contrary, we found lower expression levels for CCL3 gene in our patients compared to healthy controls, but the difference was not statistically significant. Conclusion Our findings do not show an association between the gene expression of CCL2, CCL3 and CXCL8 and BD. Increasing the sample size and evaluation on the gene expression of other chemokines in depression and mania phases of BD might be helpful to get a better conclusion.
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Affiliation(s)
- Mohsen Ghoryani
- Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Laboratory Sciences, School of Para-Medical Sciences, Torbat Heydarieh University of Medical Sciences, Torbat Heydarieh, Iran
| | - Farhad Faridhosseini
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, 0Mashhad, Iran.,Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Talaei
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, 0Mashhad, Iran.,Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Faridhosseini
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jalil Tavakkol-Afshari
- Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Parisa Azim
- Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zanireh Salimi
- Department of Psychiatry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Zare Marzouni
- Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojgan Mohammadi
- Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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The Role of Chemokines in the Pathophysiology of Major Depressive Disorder. Int J Mol Sci 2019; 20:ijms20092283. [PMID: 31075818 PMCID: PMC6539240 DOI: 10.3390/ijms20092283] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 05/06/2019] [Accepted: 05/08/2019] [Indexed: 12/19/2022] Open
Abstract
Major depressive disorder (MDD) is a debilitating condition, whose high prevalence and multisymptomatic nature set its standing as a leading contributor to global disability. To better understand this psychiatric disease, various pathophysiological mechanisms have been proposed, including changes in monoaminergic neurotransmission, imbalance of excitatory and inhibitory signaling in the brain, hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis, and abnormalities in normal neurogenesis. While previous findings led to a deeper understanding of the disease, the pathogenesis of MDD has not yet been elucidated. Accumulating evidence has confirmed the association between chronic inflammation and MDD, which is manifested by increased levels of the C-reactive protein, as well as pro-inflammatory cytokines, such as Interleukin 1 beta, Interleukin 6, and the Tumor necrosis factor alpha. Furthermore, recent findings have implicated a related family of cytokines with chemotactic properties, known collectively as chemokines, in many neuroimmune processes relevant to psychiatric disorders. Chemokines are small (8–12 kDa) chemotactic cytokines, which are known to play roles in direct chemotaxis induction, leukocyte and macrophage migration, and inflammatory response propagation. The inflammatory chemokines possess the ability to induce migration of immune cells to the infection site, whereas their homeostatic chemokine counterparts are responsible for recruiting cells for their repair and maintenance. To further support the role of chemokines as central elements to healthy bodily function, recent studies suggest that these proteins demonstrate novel, brain-specific mechanisms including the modulation of neuroendocrine functions, chemotaxis, cell adhesion, and neuroinflammation. Elevated levels of chemokines in patient-derived serum have been detected in individuals diagnosed with major depressive disorder, bipolar disorder, and schizophrenia. Furthermore, despite the considerable heterogeneity of experimental samples and methodologies, existing biomarker studies have clearly demonstrated the important role of chemokines in the pathophysiology of psychiatric disorders. The purpose of this review is to summarize the data from contemporary experimental and clinical studies, and to evaluate available evidence for the role of chemokines in the central nervous system (CNS) under physiological and pathophysiological conditions. In light of recent results, chemokines could be considered as possible peripheral markers of psychiatric disorders, and/or targets for treating depressive disorders.
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Zhou YQ, Liu DQ, Chen SP, Sun J, Zhou XR, Xing C, Ye DW, Tian YK. The Role of CXCR3 in Neurological Diseases. Curr Neuropharmacol 2019; 17:142-150. [PMID: 29119926 PMCID: PMC6343204 DOI: 10.2174/1570159x15666171109161140] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 06/22/2017] [Accepted: 11/07/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Neurological diseases have become an obvious challenge due to insufficient therapeutic intervention. Therefore, novel drugs for various neurological disorders are in desperate need. Recently, compelling evidence has demonstrated that chemokine receptor CXCR3, which is a G protein-coupled receptor in the CXC chemokine receptor family, may play a pivotal role in the development of neurological diseases. The aim of this review is to provide evidence for the potential of CXCR3 as a therapeutic target for neurological diseases. METHODS English journal articles that focused on the invovlement of CXCR3 in neurological diseases were searched via PubMed up to May 2017. Moreover, reference lists from identified articles were included for overviews. RESULTS The expression level of CXCR3 in T cells was significantly elevated in several neurological diseases, including multiple sclerosis (MS), glioma, Alzheimer's disease (AD), chronic pain, human T-lymphotropic virus type 1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and bipolar disorder. CXCR3 antagonists showed therapeutic effects in these neurological diseases. CONCLUSION These studies provided hard evidence that CXCR3 plays a vital role in the pathogenesis of MS, glioma, AD, chronic pain, HAM/TSP and bipolar disorder. CXCR3 is a crucial molecule in neuroinflammatory and neurodegenerative diseases. It regulates the activation of infiltrating cells and resident immune cells. However, the exact functions of CXCR3 in neurological diseases are inconclusive. Thus, it is important to understand the topic of chemokines and the scope of their activity in neurological diseases.
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Affiliation(s)
- Ya-Qun Zhou
- Anesthesiology Institute, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dai-Qiang Liu
- Anesthesiology Institute, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shu-Ping Chen
- Anesthesiology Institute, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jia Sun
- Anesthesiology Institute, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xue-Rong Zhou
- Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cui Xing
- Department of Obstetrics & Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Da-Wei Ye
- Cancer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu-Ke Tian
- Anesthesiology Institute, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Vancassel S, Capuron L, Castanon N. Brain Kynurenine and BH4 Pathways: Relevance to the Pathophysiology and Treatment of Inflammation-Driven Depressive Symptoms. Front Neurosci 2018; 12:499. [PMID: 30140200 PMCID: PMC6095005 DOI: 10.3389/fnins.2018.00499] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 07/03/2018] [Indexed: 12/13/2022] Open
Abstract
The prevalence of depressive disorders is growing worldwide, notably due to stagnation in the development of drugs with greater antidepressant efficacy, the continuous large proportion of patients who do not respond to conventional antidepressants, and the increasing rate of chronic medical conditions associated with an increased vulnerability to depressive comorbidities. Accordingly, better knowledge on the pathophysiology of depression and mechanisms underlying depressive comorbidities in chronic medical conditions appears urgently needed, in order to help in the development of targeted therapeutic strategies. In this review, we present evidence pointing to inflammatory processes as key players in the pathophysiology and treatment of depressive symptoms. In particular, we report preclinical and clinical findings showing that inflammation-driven alterations in specific metabolic pathways, namely kynurenine and tetrahydrobiopterin (BH4) pathways, leads to substantial alterations in the metabolism of serotonin, glutamate and dopamine that are likely to contribute to the development of key depressive symptom dimensions. Accordingly, anti-inflammatory interventions targeting kynurenine and BH4 pathways may be effective as novel treatment or as adjuvants of conventional medications rather directed to monoamines, notably when depressive symptomatology and inflammation are comorbid in treated patients. This notion is discussed in the light of recent findings illustrating the tight interactions between known antidepressant drugs and inflammatory processes, as well as their therapeutic implications. Altogether, this review provides valuable findings for moving toward more adapted and personalized therapeutic strategies to treat inflammation-related depressive symptoms.
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Affiliation(s)
- Sylvie Vancassel
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), INRA, Bordeaux, France
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), Bordeaux University, Bordeaux, France
| | - Lucile Capuron
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), INRA, Bordeaux, France
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), Bordeaux University, Bordeaux, France
| | - Nathalie Castanon
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), INRA, Bordeaux, France
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), Bordeaux University, Bordeaux, France
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Brown GM, McIntyre RS, Rosenblat J, Hardeland R. Depressive disorders: Processes leading to neurogeneration and potential novel treatments. Prog Neuropsychopharmacol Biol Psychiatry 2018; 80:189-204. [PMID: 28433459 DOI: 10.1016/j.pnpbp.2017.04.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 04/01/2017] [Indexed: 12/18/2022]
Abstract
Mood disorders are wide spread with estimates that one in seven of the population are affected at some time in their life (Kessler et al., 2012). Many of those affected with severe depressive disorders have cognitive deficits which may progress to frank neurodegeneration. There are several peripheral markers shown by patients who have cognitive deficits that could represent causative factors and could potentially serve as guides to the prevention or even treatment of neurodegeneration. Circadian rhythm misalignment, immune dysfunction and oxidative stress are key pathologic processes implicated in neurodegeneration and cognitive dysfunction in depressive disorders. Novel treatments targeting these pathways may therefore potentially improve patient outcomes whereby the primary mechanism of action is outside of the monoaminergic system. Moreover, targeting immune dysfunction, oxidative stress and circadian rhythm misalignment (rather than primarily the monoaminergic system) may hold promise for truly disease modifying treatments that may prevent neurodegeneration rather than simply alleviating symptoms with no curative intent. Further research is required to more comprehensively understand the contributions of these pathways to the pathophysiology of depressive disorders to allow for disease modifying treatments to be discovered.
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Affiliation(s)
- Gregory M Brown
- Department of Psychiatry, University of Toronto, Centre for Addiction and Mental Health, 250 College St. Toronto, ON M5T 1R8, Canada.
| | - Roger S McIntyre
- Psychiatry and Pharmacology, University of Toronto, Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325, Toronto, ON M5T 2S8, Canada.
| | - Joshua Rosenblat
- Resident of Psychiatry, Clinician Scientist Stream, University of Toronto, Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325, Toronto, ON M5T 2S8, Canada
| | - Rüdiger Hardeland
- Johann Friedrich Blumenbach Institut für Zoologie und Anthropologie, Universität Göttingen, Buergerstrasse 50, D-37073 Göttingen, Germany.
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Teixeira AL, Gama CS, Rocha NP, Teixeira MM. Revisiting the Role of Eotaxin-1/CCL11 in Psychiatric Disorders. Front Psychiatry 2018; 9:241. [PMID: 29962972 PMCID: PMC6010544 DOI: 10.3389/fpsyt.2018.00241] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 05/17/2018] [Indexed: 12/16/2022] Open
Abstract
Eotaxin-1/CCL11 is a chemokine originally implicated in the selective recruitment of eosinophils into inflammatory sites during allergic reactions, being thoroughly investigated in asthma, allergic rhinitis, and other eosinophil-related conditions. Eotaxin-1/CCL11 is also involved with a skewed immune response toward a type-2 (Th2) profile. In addition to its role in immune response, recent studies have shown that eotaxin-1/CCL11 is associated with aging, neurogenesis and neurodegeneration, being able to influence neural progenitor cells, and microglia. Increased circulating levels of eotaxin-1/CCL11 have been described in major psychiatric disorders (schizophrenia, bipolar disorder, major depression), sometimes correlating with the severity of psychopathological and cognitive parameters. As similar findings have been reported in neurodegenerative conditions such as Alzheimer's disease, it has been hypothesized that mechanisms involving eotaxin-1/CCL11 signaling may underlie the "accelerated aging" profile commonly linked to psychiatric disorders. Future studies must determine whether eotaxin-1/CCL11 can be regarded as a prognostic biomarker and/or as therapeutic target for resistant/progressive cases.
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Affiliation(s)
- Antonio L Teixeira
- Neuropsychiatry Program & Immuno-Psychiatry Lab, Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.,Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Clarissa S Gama
- Molecular Psychiatry Laboratory, Hospital de Clínicas de Porto Alegre, Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Natalia P Rocha
- Neuropsychiatry Program & Immuno-Psychiatry Lab, Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States.,Laboratório Interdisciplinar de Investigação Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mauro M Teixeira
- Neuropsychiatry Program & Immuno-Psychiatry Lab, Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
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Brenhouse HC, Danese A, Grassi-Oliveira R. Neuroimmune Impacts of Early-Life Stress on Development and Psychopathology. Curr Top Behav Neurosci 2018; 43:423-447. [PMID: 30003509 DOI: 10.1007/7854_2018_53] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Maltreatment and trauma in childhood, termed early-life stress (ELS), has long-term effects on the immune system. ELS impacts immune signaling at the time of exposure but also disrupts the developmental trajectory of certain immunological processes, both in the periphery and in the brain. One consequence of these early alterations is a heightened immune response to stressors later in life. However, chronic and sustained inflammatory response can also lead to excitotoxicity and prevent typical brain development. In this chapter, we discuss current progress toward understanding the contribution of neuroimmune signaling to ELS-attributable dysfunction or maladaptation with a focus on postnatal experiences. To do so we first present an operational definition of ELS. Then, we offer a brief overview of the immune system and neuroimmune development, followed by a section discussing the interaction between immunity, childhood trauma, and mental disorders in humans. We present evidence from animal models about immune alterations after ELS and discuss the ways in which ELS-induced immune changes ultimately affect brain and behavior, as well as the importance of individual differences and future directions in this field. Taken together, we submit that when encountered with ELS, some core brain circuits could develop differently via various mechanisms involving dysfunctional immune reprograming. However, given the remarkable plasticity of both the brain and the immune system, many of the deleterious effects of ELS may be mitigated with interventions that account for sex and target neuroimmune interactions over the lifespan.
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Affiliation(s)
| | - Andrea Danese
- Social, Genetic, and Developmental Psychiatry Centre, Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Rodrigo Grassi-Oliveira
- Developmental Cognitive Neuroscience Lab (DCNL), Graduate Program in Psychology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
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Kozłowska E, Żelechowska P, Brzezińska-Błaszczyk E, Margulska A, Wysokiński A. Circulating cathelicidin LL-37 level is increased in euthymic patients with bipolar disorder. J Clin Neurosci 2017; 48:168-172. [PMID: 29239826 DOI: 10.1016/j.jocn.2017.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 11/01/2017] [Accepted: 11/15/2017] [Indexed: 12/23/2022]
Abstract
More and more data seems to imply that immune mechanisms are involved in the pathomechanism of bipolar disorder (BD). However, the primary role of cathelicidin LL-37 is defense against pathogens, more and more data indicated that this peptide strongly modulates immune system functioning and contributes to immune pathology of chronic and inflammatory diseases. No data is available on the level of LL-37 in bipolar patients. The aim of the study was to examine the circulating levels of cathelicidin LL-37 in euthymic patients with BD. Forty patients with BD and fifty-nine healthy volunteers were enrolled into the study. Concentration of LL-37 in serum was assessed using immunoenzymatic test ELISA. The mean LL-37 concentration in bipolar patients and in healthy subjects were 4.60 ± 7.65 ng/mL and 1.92 ± 2.89 ng/mL, respectively, and the difference was statistically significant (p = 0.035). Within the BD group LL-37 level was significantly higher in women than in men (p = 0.045). The evaluation of serum LL-37 concentration during stable 8 week treatment indicated that at baseline (T1) mean level of LL-37 was 5.82 ± 10.59 ng/mL; and after treatment (T2) was 4.33 ± 5.87 ng/mL; the difference between T1 and T2 was not significant. Elevated serum levels of LL-37 in bipolar patients may suggest the role of this peptide in the pathomechanism of BD.
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Affiliation(s)
- Elżbieta Kozłowska
- Department of Experimental Immunology, Medical University of Lodz, Poland
| | | | | | - Aleksandra Margulska
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Poland
| | - Adam Wysokiński
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Poland.
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Sayana P, Colpo GD, Simões LR, Giridharan VV, Teixeira AL, Quevedo J, Barichello T. A systematic review of evidence for the role of inflammatory biomarkers in bipolar patients. J Psychiatr Res 2017; 92:160-182. [PMID: 28458141 DOI: 10.1016/j.jpsychires.2017.03.018] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 03/23/2017] [Indexed: 02/02/2023]
Abstract
Bipolar disorder (BD) is a neuropsychiatric disorder that is characterized by a phasic course of affective episodes interspersed with a euthymic state. Epidemiological, clinical, genetic, post-mortem and preclinical studies have shown that inflammatory reactions and immune modulation play a pivotal role in the pathophysiology of BD. It is conceptualized that biomarkers of inflammation and immune responses should be employed to monitor the disease process in bipolar patients. The objective of this systematic review is to analyse the inflammatory markers involved in human studies and to explore each individual marker for its potential clinical application and summarize evidence regarding their role in BD. A systematic review of human studies to measure inflammatory markers was conducted, and the studies were identified by searching PubMed/MEDLINE, PsycINFO, EMBASE, and Web of Science databases for peer-reviewed journals that were published until September 2015. In this review, we included peripheral markers, genetic, post-mortem and cell studies with inflammatory biomarker analysis in BD. One hundred and two (102) papers met the inclusion criteria. The pro-inflammatory cytokines were elevated and the anti-inflammatory cytokines were reduced in BD patients, particularly during manic and depressive phases when compared to the controls. These changes tend to disappear in euthymia, indicating that inflammation may be associated with acute phases of BD. Even though there are promising findings in this field, further clinical studies using more established detection techniques are needed to clearly show the benefit of using inflammatory markers in the diagnosis, follow-up and prognosis of patients with BD.
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Affiliation(s)
- Pavani Sayana
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Gabriela Delevati Colpo
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Lutiana R Simões
- Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, UNESC, Criciúma, SC, Brazil
| | - Vijayasree Vayalanellore Giridharan
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Antonio Lucio Teixeira
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - João Quevedo
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA; Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA; Neuroscience Graduate Program, The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA; Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, UNESC, Criciúma, SC, Brazil
| | - Tatiana Barichello
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA; Neuroscience Graduate Program, The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA; Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, UNESC, Criciúma, SC, Brazil.
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Domingues RB, Duarte H, Senne C, Bruniera G, Brunale F, Rocha NP, Teixeira AL. Serum levels of adiponectin, CCL3/MIP-1α, and CCL5/RANTES discriminate migraine from tension-type headache patients. ARQUIVOS DE NEURO-PSIQUIATRIA 2017; 74:626-31. [PMID: 27556373 DOI: 10.1590/0004-282x20160096] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 05/25/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Inflammatory molecules and neurotrophic factors are implicated in pain modulation; however, their role in primary headaches is not yet clear. The aim of this study was to compare the levels of serum biomarkers in migraine and tension-type headache. METHODS This was a cross-sectional study. We measured serum levels of adiponectin, chemokines, and neurotrophic factors in patients with migraine and tension-type headache. Depression and anxiety symptoms, headache impact and frequency, and allodynia were recorded. RESULTS We included sixty-eight patients with migraine and forty-eight with tension-type headache. Cutaneous allodynia (p = 0.035), CCL3/MIP-1α (p = 0.041), CCL5/RANTES (p = 0.013), and ADP (p = 0.017) were significantly higher in migraine than in tension-type headache. The differences occurred independently of anxiety and depressive symptoms, frequency and impact of headache, and the presence of pain. CONCLUSIONS This study showed higher CCL3/MIP-1α, CCL5/RANTES, and ADP levels in migraine in comparison with tension-type headache. Our findings suggest distinctive roles of these molecules in the pathophysiology of these primary headaches.
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Affiliation(s)
- Renan B Domingues
- Universidade Federal de Minas Gerais, Programa de Neurociências, Belo Horizonte MG, Brasil;,Senne Liquor Diagnóstico, São Paulo SP, Brasil
| | - Halina Duarte
- Universidade Federal de Minas Gerais, Programa de Neurociências, Belo Horizonte MG, Brasil
| | - Carlos Senne
- Senne Liquor Diagnóstico, São Paulo SP, Brasil;,Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte MG, Brasil
| | - Gustavo Bruniera
- Senne Liquor Diagnóstico, São Paulo SP, Brasil;,Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte MG, Brasil
| | - Fernando Brunale
- Senne Liquor Diagnóstico, São Paulo SP, Brasil;,Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório Interdisciplinar de Investigação Médica, Belo Horizonte MG, Brasil
| | - Natália P Rocha
- Hospital Israelita Albert Einstein, Laboratório de Patologia Clínica, São Paulo SP, Brasil
| | - Antonio L Teixeira
- Universidade Federal de Minas Gerais, Programa de Neurociências, Belo Horizonte MG, Brasil;,Hospital Israelita Albert Einstein, Laboratório de Patologia Clínica, São Paulo SP, Brasil
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Soczynska JK, Kennedy SH, Alsuwaidan M, Mansur RB, Li M, McAndrews MP, Brietzke E, Woldeyohannes HO, Taylor VH, McIntyre RS. A pilot, open-label, 8-week study evaluating the efficacy, safety and tolerability of adjunctive minocycline for the treatment of bipolar I/II depression. Bipolar Disord 2017; 19:198-213. [PMID: 28599348 DOI: 10.1111/bdi.12496] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 04/04/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The objectives of the study were to determine if adjunctive minocycline mitigates depressive symptom severity and improves cognitive function in individuals with bipolar I/II disorder (BD). The study also aimed to determine if changes in depressive and/or cognitive symptoms over the course of treatment were associated with changes in circulating inflammatory cytokine levels. METHODS A total of 29 (intention-to-treat: n=27) adults meeting DSM-IV-TR criteria for a major depressive episode as part of bipolar I or II disorder (i.e. Hamilton Depression Rating Scale 17-item [HAMD-17] ≥20) were enrolled in an 8-week, open-label study with adjunctive minocycline (100 mg bid). The primary outcome measure was the Montgomery-Åsberg Depression Rating Scale (MADRS). The HAMD-17, Clinical Global Impression-Severity (CGI-S), cognitive test composite scores and plasma cytokines were secondary outcome measures. Plasma cytokines were measured with the 30 V-Plex Immunoassay from Meso Scale Discovery. RESULTS Adjunctive minocycline was associated with a reduction in depressive symptom severity from baseline to week 8 on the MADRS (P<.001, d=0.835), HAMD-17 (P<.001, d=0.949) and CGI-S (P<.001, d=1.09). Improvement in psychomotor speed, but not verbal memory or executive function, was observed only amongst individuals exhibiting a reduction in depression severity (P=.007, d=0.826). Levels of interleukin (IL)-12/23p40 (P=.002) were increased, while levels of IL-12p70 (P=.001) and C-C motif chemokine ligand 26 (CCL26) (P<.001) were reduced from baseline to week 8. A reduction in CCL26 levels was associated with a less favourable treatment response (P<.001). CONCLUSIONS Results from the pilot study suggest that adjunctive minocycline may exert antidepressant effects in individuals with bipolar depression, possibly by targeting inflammatory cytokines.
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Affiliation(s)
- Joanna K Soczynska
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Sidney H Kennedy
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Mohammad Alsuwaidan
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Kuwait University, Kuwait City, Kuwait
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Madeline Li
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Psychosocial Oncology Clinic, University Health Network, Toronto, ON, Canada
| | - Mary Pat McAndrews
- Department of Psychology, University of Toronto, Toronto, ON, Canada.,Neuropsychology Clinic, University Health Network, Toronto, ON, Canada
| | - Elisa Brietzke
- Research Group in Molecular and Behavioral Neuroscience of Bipolar Disorder, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Hanna O Woldeyohannes
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Valerie H Taylor
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Women's College Hospital, Toronto, ON, Canada
| | - Roger S McIntyre
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Toxicology and Pharmacology, University of Toronto, Toronto, ON, Canada
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The opioid antagonist, β-funaltrexamine, inhibits lipopolysaccharide-induced neuroinflammation and reduces sickness behavior in mice. Physiol Behav 2017; 173:52-60. [DOI: 10.1016/j.physbeh.2017.01.037] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 01/20/2017] [Accepted: 01/20/2017] [Indexed: 11/20/2022]
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40
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Sigitova E, Fišar Z, Hroudová J, Cikánková T, Raboch J. Biological hypotheses and biomarkers of bipolar disorder. Psychiatry Clin Neurosci 2017; 71:77-103. [PMID: 27800654 DOI: 10.1111/pcn.12476] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 10/04/2016] [Accepted: 10/25/2016] [Indexed: 02/06/2023]
Abstract
The most common mood disorders are major depressive disorders and bipolar disorders (BD). The pathophysiology of BD is complex, multifactorial, and not fully understood. Creation of new hypotheses in the field gives impetus for studies and for finding new biomarkers for BD. Conversely, new biomarkers facilitate not only diagnosis of a disorder and monitoring of biological effects of treatment, but also formulation of new hypotheses about the causes and pathophysiology of the BD. BD is characterized by multiple associations between disturbed brain development, neuroplasticity, and chronobiology, caused by: genetic and environmental factors; defects in apoptotic, immune-inflammatory, neurotransmitter, neurotrophin, and calcium-signaling pathways; oxidative and nitrosative stress; cellular bioenergetics; and membrane or vesicular transport. Current biological hypotheses of BD are summarized, including related pathophysiological processes and key biomarkers, which have been associated with changes in genetics, systems of neurotransmitter and neurotrophic factors, neuroinflammation, autoimmunity, cytokines, stress axis activity, chronobiology, oxidative stress, and mitochondrial dysfunctions. Here we also discuss the therapeutic hypotheses and mechanisms of the switch between depressive and manic state.
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Affiliation(s)
- Ekaterina Sigitova
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Zdeněk Fišar
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jana Hroudová
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Tereza Cikánková
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jiří Raboch
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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Vasconcelos-Moreno MP, Fries GR, Gubert C, dos Santos BTMQ, Fijtman A, Sartori J, Ferrari P, Grun LK, Parisi MM, Guma FTCR, Barbé-Tuana FM, Kapczinski F, Rosa AR, Yatham LN, Kauer-Sant’Anna M. Telomere Length, Oxidative Stress, Inflammation and BDNF Levels in Siblings of Patients with Bipolar Disorder: Implications for Accelerated Cellular Aging. Int J Neuropsychopharmacol 2017; 20:445-454. [PMID: 28339618 PMCID: PMC5458375 DOI: 10.1093/ijnp/pyx001] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 01/19/2017] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Growing evidence supports the existence of neurobiological trait abnormalities in individuals at genetic risk for bipolar disorder. The aim of this study was to examine potential differences in brain-derived neurotrophic factor, cytokines, oxidative stress, and telomere length markers between patients with bipolar disorder, their siblings, and healthy controls. METHODS Thirty-six patients with bipolar disorder type I, 39 siblings, and 44 healthy controls were assessed. Serum levels of brain-derived neurotrophic factor, interleukin-6, interleukin-10, tumor necrosis factor-α, C-C motif chemokine 11, C-C motif chemokine 24, and 3-nitrotyrosine were measured, as were the activities of glutathione peroxidase, glutathione reductase, and glutathione S-transferase. Telomere length (T/S ratio) was measured using quantitative polymerase chain reaction. RESULTS Telomere length was different between the 3 groups (P = .041) with both patients and siblings showing a shorter T/S ratio compared with healthy controls. Patients showed increased levels of interleukin-6 (P = .005) and interleukin-10 (P = .002) compared with controls as well as increased levels of interleukin-6 (p = 0.014) and CCL24 (P = .016) compared with their siblings. C-C motif chemokine 11 levels were increased in siblings compared with controls (P = .015), and a similar tendency was found in patients compared with controls (P = .045). Glutathione peroxidase activity was decreased in patients compared with controls (P = .006) and siblings (P = .025). No differences were found for the other markers. CONCLUSIONS The present results suggest that unaffected siblings may present accelerated aging features. These neurobiological findings may be considered as endophenotypic traits. Further prospective studies are warranted.
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Affiliation(s)
- Mirela Paiva Vasconcelos-Moreno
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Gabriel Rodrigo Fries
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Carolina Gubert
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Bárbara Tietböhl Martins Quadros dos Santos
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Adam Fijtman
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Juliana Sartori
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Pamela Ferrari
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Lucas Kich Grun
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Mariana Migliorini Parisi
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Fátima Theresinha Costa Rodrigues Guma
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Florencia Maria Barbé-Tuana
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Flávio Kapczinski
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Adriane Ribeiro Rosa
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Lakshmi N. Yatham
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
| | - Marcia Kauer-Sant’Anna
- Laboratório de Psiquiatria Molecular, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Hospital deClínicas de Porto Alegre, Porto Alegre, RS, Brasil (Drs Vasconcelos-Moreno, Rodrigo Fries, Tietböhl Martins Quadros dos Santos, Fijtman, and Sartori, Ms Ferrari, and Drs Kapczinski, Ribeiro Rosa, Kauer-Sant’Anna); Programa de Pós Graduação em Ciências Médicas – Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Drs Paiva Vasconcelos-Moreno and Sartori, Ms Ferrari, Drs Kapczinski, Ribeiro Rosa, and Kauer-Sant’Anna); Programa de Pós-Graduação Ciências Biológicas - Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Dr Rodrigo Fries and Ms Gubert); Laboratório de Biologia Molecular e Bioinformática, Departamento de Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil (Mr Kich Grun, Ms Migliorini Parisi, and Drs Theresinha Costa Rodrigues Guma and Barbé-Tuana); Mood Disorders Center, University of British Columbia, Vancouver, BC, Canada (Dr Yatham)
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Tokac D, Tuzun E, Gulec H, Yılmaz V, Bireller ES, Cakmakoglu B, Kucukali CI. Chemokine and Chemokine Receptor Polymorphisms in Bipolar Disorder. Psychiatry Investig 2016; 13:541-548. [PMID: 27757133 PMCID: PMC5067349 DOI: 10.4306/pi.2016.13.5.541] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 01/26/2016] [Accepted: 02/12/2016] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE Bipolar disorder (BD) is a debilitating psychiatric disease with unknown etiology. Recent studies have shown inflammation as a potential contributing factor of BD pathogenesis. However, potential associations between chemokine and chemokine receptor polymorphisms and BD have been fundamentally understudied. To identify participation of chemokines in BD pathogenesis, we examined genetic variants of several chemokine and chemokine receptor genes. METHODS The study population comprised 200 patients with BD and 195 age- and sex-matched healthy controls. Genotyping of monocyte chemotactic protein 1 (MCP-1) A2518G, CCR2 V64I, CCR5 Δ32, CCR5 A55029G, stromal cell-derived factor 1 (SDF-1) 3'A, and CXCR4 C138T polymorphisms was performed using polymerase chain reaction and restriction enzyme digestion. RESULTS We found that CCR5-Δ32 II and CXCR4-C138T C+ genotype frequencies contributed to an increased risk for BD. However, no statistical significance could be obtained with these genotypes after Bonferroni correction. A significant asssociation was only found with MCP-1 GG and G+ genotypes, which were markedly more prevalent in patients with BD and these genotypes seemed to significantly increase the risk for BD even after Bonferroni correction. CONCLUSION Our findings indicate an association between genetic variants of certain chemokine and chemokine receptor (especially MCP-1) genes and BD. The exact mechanisms by which these variants contribute to BD pathogenesis and their clinical implications need to be further investigated.
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Affiliation(s)
- Damla Tokac
- Department of Neurology, Istanbul Erenkoy Psychiatric and Neurological Disorders Hospital, Istanbul, Turkey
| | - Erdem Tuzun
- Department of Neuroscience, Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Huseyin Gulec
- Department of Neurology, Istanbul Erenkoy Psychiatric and Neurological Disorders Hospital, Istanbul, Turkey
| | - Vuslat Yılmaz
- Department of Neuroscience, Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Elif Sinem Bireller
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Istanbul Yeni Yuzyil University, Istanbul, Turkey
| | - Bedia Cakmakoglu
- Department of Molecular Medicine, Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Cem Ismail Kucukali
- Department of Neuroscience, Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
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Rosenblat JD, Gregory JM, McIntyre RS. Pharmacologic implications of inflammatory comorbidity in bipolar disorder. Curr Opin Pharmacol 2016; 29:63-9. [DOI: 10.1016/j.coph.2016.06.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 06/22/2016] [Indexed: 12/13/2022]
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Abstract
The pathophysiology of bipolar disorder (BD) remains poorly understood. Current psychopharmacologic treatments are often poorly tolerated and carry high rates of treatment resistance. Mounting evidence has suggested that innate immune system dysfunction may play a role in the pathophysiology of BD. Elevated proinflammatory cytokine levels have been identified. The innate immune system is a novel therapeutic target in BD. Lithium has been shown to have antiinflammatory properties. Further research is needed to establish the role of antiinflammatory agents in the treatment of BD; however, evidence from several clinical trials indicates that antiinflammatory agents may be incorporated into clinical practice soon.
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Affiliation(s)
- Joshua D Rosenblat
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, 399 Bathurst Street, MP 9-325, Toronto, Ontario M5T 2S8, Canada
| | - Roger S McIntyre
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, 399 Bathurst Street, MP 9-325, Toronto, Ontario M5T 2S8, Canada.
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Rosenblat JD, Kakar R, Berk M, Kessing LV, Vinberg M, Baune BT, Mansur RB, Brietzke E, Goldstein BI, McIntyre RS. Anti-inflammatory agents in the treatment of bipolar depression: a systematic review and meta-analysis. Bipolar Disord 2016; 18:89-101. [PMID: 26990051 DOI: 10.1111/bdi.12373] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 11/08/2015] [Accepted: 12/11/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Inflammation has been implicated in the risk, pathophysiology, and progression of mood disorders and, as such, has become a target of interest in the treatment of bipolar disorder (BD). Therefore, the objective of the current qualitative and quantitative review was to determine the overall antidepressant effect of adjunctive anti-inflammatory agents in the treatment of bipolar depression. METHODS Completed and ongoing clinical trials of anti-inflammatory agents for BD published prior to 15 May 15 2015 were identified through searching the PubMed, Embase, PsychINFO, and Clinicaltrials.gov databases. Data from randomized controlled trials (RCTs) assessing the antidepressant effect of adjunctive mechanistically diverse anti-inflammatory agents were pooled to determine standard mean differences (SMDs) compared with standard therapy alone. RESULTS Ten RCTs were identified for qualitative review. Eight RCTs (n = 312) assessing adjunctive nonsteroidal anti-inflammatory drugs (n = 53), omega-3 polyunsaturated fatty acids (n = 140), N-acetylcysteine (n = 76), and pioglitazone (n = 44) in the treatment of BD met the inclusion criteria for quantitative analysis. The overall effect size of adjunctive anti-inflammatory agents on depressive symptoms was -0.40 (95% confidence interval -0.14 to -0.65, p = 0.002), indicative of a moderate and statistically significant antidepressant effect. The heterogeneity of the pooled sample was low (I² = 14%, p = 0.32). No manic/hypomanic induction or significant treatment-emergent adverse events were reported. CONCLUSIONS Overall, a moderate antidepressant effect was observed for adjunctive anti-inflammatory agents compared with conventional therapy alone in the treatment of bipolar depression. The small number of studies, diversity of agents, and small sample sizes limited interpretation of the current analysis.
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Affiliation(s)
- Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, Department of Psychiatry and Pharmacology, University of Toronto, Toronto, Canada
| | - Ron Kakar
- Mood Disorders Psychopharmacology Unit, University Health Network, Department of Psychiatry and Pharmacology, University of Toronto, Toronto, Canada.,Department of Psychiatry, Western University, London and Windsor, ON, Canada
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Vic., Australia.,Department of Psychiatry, The Florey Institute of Neuroscience and Mental Health, and Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, University of Melbourne, Parkville, Vic., Australia
| | - Lars V Kessing
- Psychiatric Center Copenhagen, Faculty of Health and Medical Sciences and Department O, University of Copenhagen, Copenhagen, Denmark
| | - Maj Vinberg
- Psychiatric Center Copenhagen, Faculty of Health and Medical Sciences and Department O, University of Copenhagen, Copenhagen, Denmark
| | - Bernhard T Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, University Health Network, Department of Psychiatry and Pharmacology, University of Toronto, Toronto, Canada.,Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of Sao Paulo, São Paulo, Brazil.,Program of Recognition and Intervention in Individuals in AT-Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Elisa Brietzke
- Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of Sao Paulo, São Paulo, Brazil.,Program of Recognition and Intervention in Individuals in AT-Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Benjamin I Goldstein
- Departments of Psychiatry, Pharmacology, and Psychological Clinical Science, Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Department of Psychiatry and Pharmacology, University of Toronto, Toronto, Canada
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García-Marchena N, Araos PF, Barrios V, Sánchez-Marín L, Chowen JA, Pedraz M, Castilla-Ortega E, Romero-Sanchiz P, Ponce G, Gavito AL, Decara J, Silva D, Torrens M, Argente J, Rubio G, Serrano A, de Fonseca FR, Pavón FJ. Plasma Chemokines in Patients with Alcohol Use Disorders: Association of CCL11 (Eotaxin-1) with Psychiatric Comorbidity. Front Psychiatry 2016; 7:214. [PMID: 28149283 PMCID: PMC5242327 DOI: 10.3389/fpsyt.2016.00214] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 12/26/2016] [Indexed: 12/16/2022] Open
Abstract
Recent studies have linked changes in peripheral chemokine concentrations to the presence of both addictive behaviors and psychiatric disorders. The present study further explore this link by analyzing the potential association of psychiatry comorbidity with alterations in the concentrations of circulating plasma chemokine in patients of both sexes diagnosed with alcohol use disorders (AUD). To this end, 85 abstinent subjects with AUD from an outpatient setting and 55 healthy subjects were evaluated for substance and mental disorders. Plasma samples were obtained to quantify chemokine concentrations [C-C motif (CC), C-X-C motif (CXC), and C-X3-C motif (CX3C) chemokines]. Abstinent AUD patients displayed a high prevalence of comorbid mental disorders (72%) and other substance use disorders (45%). Plasma concentrations of chemokines CXCL12/stromal cell-derived factor-1 (p < 0.001) and CX3CL1/fractalkine (p < 0.05) were lower in AUD patients compared to controls, whereas CCL11/eotaxin-1 concentrations were strongly decreased in female AUD patients (p < 0.001). In the alcohol group, CXCL8 concentrations were increased in patients with liver and pancreas diseases and there was a significant correlation to aspartate transaminase (r = +0.456, p < 0.001) and gamma-glutamyltransferase (r = +0.647, p < 0.001). Focusing on comorbid psychiatric disorders, we distinguish between patients with additional mental disorders (N = 61) and other substance use disorders (N = 38). Only CCL11 concentrations were found to be altered in AUD patients diagnosed with mental disorders (p < 0.01) with a strong main effect of sex. Thus, patients with mood disorders (N = 42) and/or anxiety (N = 16) had lower CCL11 concentrations than non-comorbid patients being more evident in women. The alcohol-induced alterations in circulating chemokines were also explored in preclinical models of alcohol use with male Wistar rats. Rats exposed to repeated ethanol (3 g/kg, gavage) had lower CXCL12 (p < 0.01) concentrations and higher CCL11 concentrations (p < 0.001) relative to vehicle-treated rats. Additionally, the increased CCL11 concentrations in rats exposed to ethanol were enhanced by the prior exposure to restraint stress (p < 0.01). Concordantly, acute ethanol exposure induced changes in CXCL12, CX3CL1, and CCL11 in the same direction to repeated exposure. These results clearly indicate a contribution of specific chemokines to the phenotype of AUD and a strong effect of sex, revealing a link of CCL11 to alcohol and anxiety/stress.
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Affiliation(s)
- Nuria García-Marchena
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Málaga, Spain; Facultad de Psicología, Universidad Complutense de Madrid, Madrid, Spain
| | - Pedro Fernando Araos
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga , Málaga , Spain
| | - Vicente Barrios
- Department of Endocrinology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Department of Pediatrics, Universidad Autónoma de Madrid, Madrid, Spain; CIBER Fisiopatología de la obesidad y nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Sánchez-Marín
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga , Málaga , Spain
| | - Julie A Chowen
- Department of Endocrinology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Department of Pediatrics, Universidad Autónoma de Madrid, Madrid, Spain; CIBER Fisiopatología de la obesidad y nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - María Pedraz
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga , Málaga , Spain
| | - Estela Castilla-Ortega
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga , Málaga , Spain
| | - Pablo Romero-Sanchiz
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga , Málaga , Spain
| | - Guillermo Ponce
- Servicio de Psiquiatría, Hospital Universitario 12 de Octubre , Madrid , Spain
| | - Ana L Gavito
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga , Málaga , Spain
| | - Juan Decara
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga , Málaga , Spain
| | - Daniel Silva
- Facultad de Psicología, Universidad Complutense de Madrid , Madrid , Spain
| | - Marta Torrens
- Institut de Neuropsiquiatria i Addiccions (INAD), Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; Department of Psychiatry, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Jesús Argente
- Department of Endocrinology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain; Department of Pediatrics, Universidad Autónoma de Madrid, Madrid, Spain; CIBER Fisiopatología de la obesidad y nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Gabriel Rubio
- Servicio de Psiquiatría, Hospital Universitario 12 de Octubre , Madrid , Spain
| | - Antonia Serrano
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga , Málaga , Spain
| | - Fernando Rodríguez de Fonseca
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Málaga, Spain; Facultad de Psicología, Universidad Complutense de Madrid, Madrid, Spain
| | - Francisco Javier Pavón
- Unidad Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga , Málaga , Spain
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Ślusarczyk J, Trojan E, Chwastek J, Głombik K, Basta-Kaim A. A Potential Contribution of Chemokine Network Dysfunction to the Depressive Disorders. Curr Neuropharmacol 2016; 14:705-20. [PMID: 26893168 PMCID: PMC5050392 DOI: 10.2174/1570159x14666160219131357] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 10/19/2015] [Accepted: 11/03/2015] [Indexed: 02/08/2023] Open
Abstract
In spite of many years of research, the pathomechanism of depression has not yet been elucidated. Among many hypotheses, the immune theory has generated a substantial interest. Up till now, it has been thought that depression is accompanied by the activation of inflammatory response and increase in pro-inflammatory cytokine levels. However, recently this view has become controversial, mainly due to the family of small proteins called chemokines. They play a key role in the modulation of peripheral function of the immune system by controlling immune reactions, mediating immune cell communication, and regulating chemotaxis and cell adhesion. Last studies underline significance of chemokines in the central nervous system, not only in the neuromodulation but also in the regulation of neurodevelopmental processes, neuroendocrine functions and in mediating the action of classical neurotransmitters. Moreover, it was demonstrated that these proteins are responsible for maintaining interactions between neuronal and glial cells both in the developing and adult brain also in the course of diseases. This review outlines the role of chemokine in the central nervous system under physiological and pathological conditions and their involvement in processes underlying depressive disorder. It summarizes the most important data from experimental and clinical studies.
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Affiliation(s)
| | | | | | | | - Agnieszka Basta-Kaim
- Department of Experimental Neuroendocrinology, Polish Academy of Sciences, 12 Smętna St. 31-343 Kraków, Poland.
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Rosenblat JD, Brietzke E, Mansur RB, Maruschak NA, Lee Y, McIntyre RS. Inflammation as a neurobiological substrate of cognitive impairment in bipolar disorder: Evidence, pathophysiology and treatment implications. J Affect Disord 2015; 188:149-59. [PMID: 26363613 DOI: 10.1016/j.jad.2015.08.058] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 08/05/2015] [Accepted: 08/26/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Bipolar disorder (BD) has been associated with cognitive impairment during depressed, manic and euthymic periods. Inflammation has been shown to be involved in the pathophysiology of BD and cognitive impairment. METHODS For this systematic review, the MEDLINE/PubMed, Embase, Google Scholar and ClinicalTrials.gov databases were searched for relevant articles assessing the association between cognitive function and inflammatory markers in BD subjects. A discussion of potential mechanisms and therapeutic implications is also included to provide further context to the subject matter. RESULTS Eight studies, including a total of 555 BD subjects, assessing the association between cognitive function and inflammatory markers were identified. Cognitive dysfunction was associated with elevated levels of pro-inflammatory markers YKL40, IL-6, sCD40L, IL-1Ra, hsCRP and TNF-α. Mechanistically, elevation in inflammatory cytokines alters monoamine levels leading to cognitive and affective dysfunction. Neuro-inflammation, manifesting as microglial activation, leads to increased oxidative stress, pathologic synaptic pruning and impaired neuroplasticity in key brain regions sub-serving mood and cognition. Immune dysfunction also activates the hypothalamic-pituitary-adrenal (HPA) axis leading to hypercortisolemia and metabolic dysfunction, further promoting neuronal dysfunction. Anti-inflammatory agents are therefore currently being investigated in the treatment of BD and appear to exert an antidepressant effect; however, cognitive outcomes have yet to be reported. CONCLUSION Several studies suggest that immune dysfunction is associated with cognitive impairment in BD. Several neurobiological pathways have been identified whereby immune dysfunction may promote cognitive impairment in BD. Future investigations of anti-inflammatory agents targeting cognitive function as a treatment outcome are merited.
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Affiliation(s)
- Joshua D Rosenblat
- Mood Disorder Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Elisa Brietzke
- Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of Sao Paulo, Sao Paulo, Brazil; Program of Recognition and Intervention in Individuals in AT-Risk Mental States (PRISMA), Department of Psychiatry, Universidade FeInterdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of Sao Pauloderal de São Paulo, São Paulo, Brazil
| | - Rodrigo B Mansur
- Mood Disorder Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of Sao Paulo, Sao Paulo, Brazil; Program of Recognition and Intervention in Individuals in AT-Risk Mental States (PRISMA), Department of Psychiatry, Universidade FeInterdisciplinary Laboratory of Clinical Neurosciences (LINC), Federal University of Sao Pauloderal de São Paulo, São Paulo, Brazil
| | - Nadia A Maruschak
- Mood Disorder Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Yena Lee
- Mood Disorder Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorder Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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49
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Fiedorowicz JG, Prossin AR, Johnson CP, Christensen GE, Magnotta VA, Wemmie JA. Peripheral inflammation during abnormal mood states in bipolar I disorder. J Affect Disord 2015; 187:172-8. [PMID: 26339927 PMCID: PMC4587340 DOI: 10.1016/j.jad.2015.08.036] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Revised: 08/01/2015] [Accepted: 08/12/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Bipolar disorder carries a substantive morbidity and mortality burden, particularly related to cardiovascular disease. Abnormalities in peripheral inflammatory markers, which have been commonly reported in case-control studies, potentially link these co-morbidities. However, it is not clear whether inflammatory markers change episodically in response to mood states or are indicative of chronic pro-inflammatory activity, regardless of mood, in bipolar disorder. METHODS Investigations focused on comparing concentrations of specific inflammatory cytokines associated with immune activation status (primary outcome=tumor necrosis factor alpha (TNF-α)) in 37 participants with bipolar disorder across 3 mood states (mania N=15, depression N=9, normal mood N=13) and 29 controls without a psychiatric disorder (total N=66). Cytokine levels were also compared to T1ρ, a potential neuroimaging marker for inflammation, in select brain regions in a subsample (N=39). RESULTS Participants with bipolar disorder and healthy controls did not differ significantly in inflammatory cytokine concentrations. However, compared to cases with normal mood, cases with abnormal mood states (mania and depression) had significantly elevated levels of TNF-α, its soluble receptors (sTNFR1/sTNFR2), other macrophage-derived cytokines (interleukin 1β (IL-1β), IL-6, IL-10, and IL-18) in addition to IL-4, interferon-γ, monocyte chemotactic protein-1, fibroblast growth factor β, and vascular endothelial growth factor. Cytokine levels were not correlated with signals from T1ρ imaging in selected structures (amygdalae, hippocampi, hypothalamus, anterior cingulate gyrus, and middle frontal gyrus). LIMITATIONS Participants were not followed prospectively across mood states. CONCLUSION Activation of inflammatory markers was found in abnormal mood states of bipolar disorder. Longitudinal study of individuals with mood disorders is needed to confirm these findings and to elucidate the time course of any such changes.
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Affiliation(s)
- Jess G. Fiedorowicz
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, 52242, Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, 52242, Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, 52242, Corresponding author. Address: 200 Hawkins Drive W278GH, Iowa City, IA 52242-1057, Phone: (319) 384-9267, Fax (319) 353-8656,
| | - Alan R. Prossin
- Department of Psychiatry, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Casey P. Johnson
- Department of Radiology, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, 52242
| | - Gary E. Christensen
- Department of Radiation Oncology, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, 52242, Department of Electrical and Computer Engineering, College of Engineering, The University of Iowa, Iowa City, Iowa, 52242
| | - Vincent A. Magnotta
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, 52242, Department of Radiology, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, 52242
| | - John A. Wemmie
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, 52242, Veterans Affairs Hospital Center, Iowa City, IA
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50
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Stertz L, Fries GR, Rosa AR, Kauer-Sant'anna M, Ferrari P, Paz AVC, Green C, Cunha ÂBM, Dal-Pizzol F, Gottfried C, Kapczinski F. Damage-associated molecular patterns and immune activation in bipolar disorder. Acta Psychiatr Scand 2015; 132:211-7. [PMID: 25891376 DOI: 10.1111/acps.12417] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/09/2015] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Immune activation in bipolar disorder (BD) has been frequently reported. Damage-associated molecular patterns (DAMPs) are key players in the immune activation reaction. The aim of this study was to assess DAMP levels in drug-free patients with BD during acute episodes. METHOD Serum levels of a predetermined set of DAMPs were assessed in drug-free patients with BD (n = 20) during an acute mood episode. We also included two control groups: healthy subjects, used as a negative control (n = 20); and patients with sepsis, used as a positive control for severe immune activation (n = 20). RESULTS Multivariate analysis using generalized linear mixed model indicated that all DAMPs differed as a function of group membership after controlling for age and addressing multiplicity (P < 0.0006 for all comparisons). Follow-up analyses showed higher levels in BD subjects of circulating cell-free (ccf) nuclear (n)DNA (P = 0.02), HSP70 (P = 0.03) and HSP90α (P = 0.02) as compared to healthy subjects. Also, patients with BD showed lower levels of ccf nDNA (P = 0.04), HSP60 (P = 0.03), HSP70 (P = 0.01), and HSP90α (P = 0.002) as compared to patients with sepsis and higher levels of ccf mitochondrial DNA (P < 0.0001). CONCLUSION The present findings may be linked to the inflammatory activity previously described among patients with BD and may help in the development of more targeted and personalized treatments for patients under acute episodes of BD.
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Affiliation(s)
- L Stertz
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, BRA.,Bipolar Disorder Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Psychiatry and Behavioral Sciences, Center for Molecular Psychiatry, University of Texas Health Science Center, Houston, TX, USA
| | - G R Fries
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, BRA.,Bipolar Disorder Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - A R Rosa
- Bipolar Disorder Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Pharmacology, Basic Science Institute, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - M Kauer-Sant'anna
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, BRA.,Bipolar Disorder Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - P Ferrari
- Bipolar Disorder Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - A V C Paz
- Bipolar Disorder Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - C Green
- Department of Pediatrics, Center for Clinical Research and Evidence-Based Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Â B M Cunha
- Department of Pharmacology, Basic Science Institute, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Neuropsychiatry, Centro de Ciências da Saude, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | - F Dal-Pizzol
- Laboratorio de FisiopatologiaExperimental, Unidade Academica de Ciencias da Saude, Universidade do Extremo Sul Catarinense, Criciuma, SC, USA
| | - C Gottfried
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, BRA
| | - F Kapczinski
- Bipolar Disorder Program & INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Psychiatry and Behavioral Sciences, Center for Molecular Psychiatry, University of Texas Health Science Center, Houston, TX, USA
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