The relationship between inflammatory response and disease severity and gender in the manic and remission phases of bipolar disorder
Abstract
Purpose: This study aimed to compare inflammatory marker levels during manic episodes and early remission in patients with bipolar disorder (BD), in light of increasing evidence linking mood episodes to alterations in systemic inflammation. Furthermore, it sought to examine the association between inflammatory markers and illness severity, as well as to explore potential gender-related differences in these inflammatory responses.
Materials and Methods: This retrospective clinical study included 61 patients diagnosed with BD manic episodes and treated and 64 healthy control subjects. Hemogram values, C-reactive protein (CRP), albumin levels and Young Mania Rating Scale (YMRS) scores were measured within 24 hours of admission and at discharge.
Results: In patients with BD experiencing a manic episode, CRP (0.96 ± 2.02 mg/L), CRP/albumin ratio (CAR) (0.24 ± 0.534), neutrophil count (5.81 ± 3.42 × 10³/µL), and mean platelet volume (MPV) (8.11 ± 1.302 fL) levels were higher compared to healthy controls [control group: CRP (0.21 ± 0.34 mg/L), CAR (0.046 ± 0.075), neutrophil count (4.22 ± 1.26 × 10³/µL), MPV (9.78 ± 1.97 fL)]. Albumin levels in the patient group (4.19 ± 0.43 g/dL) were lower than those in the controls (4.65 ± 0.23 g/dL). The monocyte level and systemic immune response index values significantly increased after treatment in female but not in male patients. A negative correlation was identified between the YMRS scores and inflammatory markers in females for albumin and monocytes, while in males, a negative correlation was identified for CRP and CAR.
Conclusion: These findings highlight the role of systemic inflammation in BD and suggest gender-specific differences in disorder characteristics and treatment responses, warranting further investigation.
Keywords
Albumin , Bipolar disorders , Affective disorders , Inflammation
Kaynakça
- Muneer A. Staging models in bipolar disorder: A systematic review of the literature. Clin Psychopharmacol Neurosci. 2016;31:117-30.
- Bonnín CD, Reinares M, Martínez-Arán A, Jiménez E, Sánchez-Moreno J, Solé B et al. Improving functioning, quality of life, and well-being in patients with bipolar disorder. Int J Neuropsychopharmacol. 2019;22:467-77.
- Dome P, Rihmer Z, Gonda X. Suicide risk in bipolar disorder: A brief review. Medicina (Kaunas). 2019;55:403.
- Machado-Vieira R, Courtes AC, Zarate CA Jr, Henter ID, Manji HK. Non-canonical pathways in the pathophysiology and therapeutics of bipolar disorder. Front Neurosci. 2023;17:1228455.
- Sayana P, Colpo GD, Simoes LR, Giridharan VV, Teixeira AL, Quevedo J et al. A systematic review of evidence for the role of inflammatory biomarkers in bipolar patients. J. Psychiatr Res. 2017;92:160-82.
- Arango Duque G, Descoteaux A. Macrophage cytokines: Involvement in immunity and infectious diseases. Front Immunol. 2014;5:491.
- Wu X, Chen Z, Liao Y, Yang Z, Liang X, Guan N et al. Are serum levels of inflammatory markers associated with the severity of symptoms of bipolar disorder? Front Psychiatry. 2023;13:1063479.
- Lu YR, Rao YB, Mou YJ, Chen Y, Lou HF, Zhang Y,et al. High concentrations of serum interleukin-6 and interleukin-8 in patients with bipolar disorder. Medicine (Baltimore). 2019;98:e14419
- Shrivastava AK, Singh HV, Raizada A, Singh SK. C-reactive protein, inflammation and coronary heart disease. Egypt Heart J. 2015;67:89-97.
- Demir N, Yıldırım O. A comparison of the relationship between c-reactive protein levels and cognitive functions in patients with schizophrenia, first-episode psychosis, and healthy controls. Psychiatry Clin Psychopharmacol. 2022;32:274.
