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Bipolar bozukluğun manik ve remisyon dönemlerinde inflamatuvar yanıtın hastalık şiddeti ve cinsiyet ile ilişkisi

Yıl 2025, Cilt: 50 Sayı: 3, 908 - 918, 30.09.2025
https://doi.org/10.17826/cumj.1733754

Öz

Amaç: Bu çalışma, bipolar bozuklukta (BB) manik epizodlar ve erken remisyon döneminde inflamatuar belirteç düzeylerini karşılaştırmayı, ruhsal epizodların sistemik inflamasyonla ilişkili olduğuna dair artan kanıtlar doğrultusunda, inflamatuar belirteçler ile hastalık şiddeti arasındaki ilişkiyi ve bu yanıtlardaki olası cinsiyete bağlı farklılıkları değerlendirmeyi amaçlamıştır.
Gereç ve Yöntem: Bu retrospektif klinik çalışmaya, manik epizod tanısı konan ve tedavi edilen 61 BB hastası ile 64 sağlıklı kontrol dahil edildi. Hastaların hastaneye kabulünden sonraki 24 saat içinde ve taburculukta hemogram değerleri, C-reaktif protein (CRP), albümin seviyeleri ile birlikte Young Mani Derecelendirme Ölçeği (YMDÖ) skorları ölçüldü.
Bulgular: Manik epizoddaki BB hastalarında sağlıklı kontrollere kıyasla CRP (0,96 ± 2,02 mg/L), CRP/albümin oranı (CAR) (0,24±0,534) , nötrofil (5,81±3,42 10³/µ) ve ortalama trombosit hacmi (OTH) ( 8,11±1,302 fL) seviyeleri sağlıklı kontrollere göre daha yüksekti [kontrol grubu: CRP (0,21 ± 0,34 mg/L), CAR (0,046±0,075 ), nötrofil (4,22±1,26 10³/µ ), OTH (9,78±1,97 fL)]. Albümin düzeyleri hasta grubunda (4,19±0,43 g/dL) kontrollere kıyasla (4,65±0,23 g/dL) daha düşüktü. Monosit ve sistemik immün inflamasyon indeksi değerleri kadın hastalarda tedavi sonrası anlamlı şekilde artarken erkek hastalarda bu durum gözlenmedi. YMDÖ skorları ile inflamatuar belirteçler arasında kadınlarda albümin ve monositler için negatif korelasyon tespit edilirken, erkeklerde CRP ve CAR için negatif korelasyon belirlendi.
Sonuç: Bu bulgular, BB’de sistemik inflamasyonun rolünü vurgulamakta ve hastalık özellikleri ile tedavi yanıtlarında cinsiyete özgü farklılıklar olduğunu göstermekte olup, ileri araştırmaları gerektirmektedir.

Etik Beyan

Harran Üniversitesi Klinik Araştırmalar Etik Kurulu'ndan etik onay alınmıştır (27.04.2024 tarih, 07 sayılı oturum ve 12 sayılı karar).

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.
  • Fond G, Lançon C, Auquier P, Boyer L. C-reactive protein as a peripheral biomarker in schizophrenia. an updated systematic review. Front Psychiatry. 2018;9:392.
  • Balcioglu YH, Kirlioglu SS. C-reactive protein/albumin and neutrophil/albumin ratios as novel ınflammatory markers in patients with schizophrenia. Psychiatry Investig. 2020;17:902-910.
  • Ranzani OT, Zampieri FG, Forte DN, Azevedo LC, Park M. C-reactive protein/albumin ratio predicts 90-day mortality of septic patients. PloS One. 2013;8:e59321.
  • İmre O, Yılmaz İV. Neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio and platelet-lymphocyte ratio in manic episode patients with bipolar disorder. Eur J Ther. 2023;29:110–115
  • Ruan GT, Xie HL, Hu CL, Liu CA, Zhang HY, Zhang Q et al. Comprehensive prognostic effects of systemic inflammation and Insulin resistance in women with breast cancer with different BMI: A prospective multicenter cohort. Sci Rep. 2023;13:4303.
  • Kalelioğlu T, Genç A, Karamustafalıoğlu N. İki uçlu bozukluk ve inflamasyon. J Mood Disord. 2017;7:54-64.
  • Yuan N, Chen Y, Xia Y, Dai J, Liu C. Inflammation-related biomarkers in major psychiatric disorders: A cross-disorder assessment of reproducibility and specificity in 43 meta-analyses. Transl Psychiatry. 2019;9:233.
  • Liu J, Li S, Zhang S, Liu Y, Ma L, Zhu J et al. Systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio can predict clinical outcomes in patients with metastatic non-small-cell lung cancer treated with nivolumab. J Clin Lab Anal. 2019;33:e22964.
  • Xu H, Zheng L, Wang L, Gao H, Wei Y, Chen J. Albumin and associated biomarkers in severe neuropsychiatric disorders: Acute-phase schizophrenia and bipolar disorder. Neuropsychiatr Dis Treat. 2023;19:2027-2037.
  • Tohen M, Frank E, Bowden CL, Colom F, Ghaemi SN, Yatham LN et al. The International Society for Bipolar Disorders (ISBD) Task Force report on the nomenclature of course and outcome in bipolar disorders. Bipolar Disord. 2009;1:453-73.
  • Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: Reliability, validity and sensitivity. Br J Psychiatry.1978;133:429-35.
  • Karadağ F, Oral ET, Aran Yalçın F, Erten E. Young mani derecelendirme ölçeğinin Türkiye’de geçerlik ve güvenilirliği. Turk Psikiyatri Derg. 2001;13:107-4.
  • Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175-91.
  • Leboyer M, Soreca I, Scott J, Frye M, Henry C, Tamouza R, Kupfer DJ. Can bipolar disorder be viewed as a multi-system inflammatory disease? J Affect Disord. 2012;141:1-10.
  • Kupfer DJ, Frank E, Ritchey FC. Staging bipolar disorder: What data and what models are needed? Lancet Psychiatry. 2015;2:564-70.
  • Sırlıer Emir B, Yıldız S, Kazğan Kılıçaslan A, Kurt O, Uğur K, Tabara MF et al. Inflammation markers in patients with bipolar disorder who have committed offenses and their relationship with criminal behavior. Medicina (Kaunas). 2023;59:1725.
  • Harrison NA, Brydon L, Walker C, Gray MA, Steptoe A, Critchley HD. Inflammation causes mood changes through alterations in subgenual cingulate activity and mesolimbic connectivity. Biol Psychiatry. 2009;66:407-14.
  • Haroon E, Raison CL, Miller AH. Psychoneuroimmunology meets neuropsychopharmacology: Translational implications of the impact of inflammation on behavior. Neuropsychopharmacology. 2012;37:137-62.
  • Maes M. Activation of the inflammatory response system (irs) in major depression. Psychoneuroendocrinology. 2000;25:34.
  • Fernandes BS, Steiner J, Molendijk ML, Dodd S, Nardin P, Gonçalves CA et al. C-reactive protein concentrations across the mood spectrum in bipolar disorder: A systematic review and meta-analysis. Lancet Psychiatry. 2016;3:1147-56.
  • Belinskaia DA, Voronina PA, Goncharov NV. Integrative role of albumin: Evolutionary, biochemical and pathophysiological aspects. J Evol Biochem Physiol. 2021;57:1419-1448.
  • Li J, Hu R, Luo H, Guo Y, Zhang Z, Luo Q et al. Associations between dietary habits and bipolar disorder: A diet-wide mendelian randomization study. Front Psychiatry. 2024;15:1388316
  • Liao CK, Yu YL, Lin YC, Hsu YJ, Chern YJ, Chiang JM et al. Prognostic value of the C-reactive protein to albumin ratio in colorectal cancer: An updated systematic review and meta-analysis. World J Surg Oncol. 2021;19:139.
  • Tanrıkulu AB, Kaya H, Çatak Z. Elevated C-reactive protein/albumin ratio in patients with methamphetamine use disorder. Int J Psychiatry Clin Pract. 2023;27:351-358
  • Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean platelet volume (MPV): New perspectives for an old marker in the course and prognosis of ınflammatory conditions. Mediators Inflamm. 2019;2019:9213074.
  • Almış BH, Eğilmez OB. Platelet parameters in first-episode patients with schizophrenia and bipolar disorder. Psychiatry Clin Psychopharmacol. 2021;31:339.
  • Wei Y, Feng J, Ma J, Chen D, Xu H, Yin L et al. Characteristics of platelet-associated parameters and their predictive values in Chinese patients with affective disorders. BMC Psychiatry. 2022;22:150.
  • Chen Z, Wang J, Carru C, Sedda S, Nivoli AM, Li Z. Meta‐analysis of peripheral mean platelet volume in patients with mental disorders: Comparisons in depression, anxiety, bipolar disorder, and schizophrenia. Brain Behav. 2023;13:e3240.
  • Fusar-Poli L, Natale A, Amerio A, Cimpoesu P, Grimaldi Filioli P, Aguglia E et al. Neutrophil-to-lymphocyte, platelet-to-lymphocyte and monocyte-to-lymphocyte ratio in bipolar disorder. Brain Sci. 2021;11:58.
  • Nayak R, Rosh I, Kustanovich I, Stern S. Mood stabilizers in psychiatric disorders and mechanisms learnt from ın vitro model systems. Int J Mol Sci. 2021;22:9315.
  • Zhao S, Dong S, Qin Y, Wang Y, Zhang B, Liu A. Inflammation index SIRI is associated with increased all-cause and cardiovascular mortality among patients with hypertension. Front Cardiovasc Med. 2023;9:1066219.
  • Wei Y, Wang T, Li G, Feng J, Deng L, Xu H et al. Investigation of systemic immune-inflammation index, neutrophil/high-density lipoprotein ratio, lymphocyte/high-density lipoprotein ratio, and monocyte/high-density lipoprotein ratio as indicators of inflammation in patients with schizophrenia and bipolar disorder. Front Psychiatry. 2022;13:941728.
  • Korkmaz ŞA, Kızgın S, Oğuz EF, Neşelioğlu S, Erel Ö. Thiol-disulphide homeostasis, ischemia-modified albumin, complete blood count-derived inflammatory markers and C-reactive protein from acute mania to early remission in bipolar disorder. J Affect Disord. 2023;339:426-34.
  • Parial S. Bipolar disorder in women. Indian J Psychiatry. 2015;57(Suppl 2):252-63.
  • Kundakovic M, Rocks D. Sex hormone fluctuation and increased female risk for depression and anxiety disorders: From clinical evidence to molecular mechanisms. Front Neuroendocrinol. 2022;66:101010.
  • Frey BN, Dias RS. Sex hormones and biomarkers of neuroprotection and neurodegeneration: Implications for female reproductive events in bipolar disorder. Bipolar Disord. 2016;16:48-57
  • Krolick KN, Zhu Q, Shi H. Effects of estrogens on central nervous system neurotransmission: Implications for sex differences in mental disorders. Prog Mol Biol Transl Sci. 2018;160:105-171.
  • Huang MH, Chan YE, Chen MH, Hsu JW, Huang KL, Li CT et al. A longitudinal study of the association between pro-inflammatory cytokines and mood symptoms in bipolar disorder. Acta Psychiatr Scand. 2023;147:81-91.
  • Becking K, Boschloo L, Vogelzangs N, Haarman BC, Riemersma-Van Der Lek R et al. The association between immune activation and manic symptoms in patients with a depressive disorder. Transl Psychiatry. 2013;3:e314.
  • Zhao NO, Topolski N, Tusconi M, Salarda EM, Busby CW, Lima CNNC et al. Blood-brain barrier dysfunction in bipolar disorder: Molecular mechanisms and clinical implications. Brain Behav Immun Health. 2022;21:100441.

The relationship between inflammatory response and disease severity and gender in the manic and remission phases of bipolar disorder

Yıl 2025, Cilt: 50 Sayı: 3, 908 - 918, 30.09.2025
https://doi.org/10.17826/cumj.1733754

Öz

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.

Etik Beyan

Ethical approval was obtained from the Harran University Clinical Research Ethics Committee (27.04.2024 dated, 07 numbered session and 12 numbered decision).

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.
  • Fond G, Lançon C, Auquier P, Boyer L. C-reactive protein as a peripheral biomarker in schizophrenia. an updated systematic review. Front Psychiatry. 2018;9:392.
  • Balcioglu YH, Kirlioglu SS. C-reactive protein/albumin and neutrophil/albumin ratios as novel ınflammatory markers in patients with schizophrenia. Psychiatry Investig. 2020;17:902-910.
  • Ranzani OT, Zampieri FG, Forte DN, Azevedo LC, Park M. C-reactive protein/albumin ratio predicts 90-day mortality of septic patients. PloS One. 2013;8:e59321.
  • İmre O, Yılmaz İV. Neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio and platelet-lymphocyte ratio in manic episode patients with bipolar disorder. Eur J Ther. 2023;29:110–115
  • Ruan GT, Xie HL, Hu CL, Liu CA, Zhang HY, Zhang Q et al. Comprehensive prognostic effects of systemic inflammation and Insulin resistance in women with breast cancer with different BMI: A prospective multicenter cohort. Sci Rep. 2023;13:4303.
  • Kalelioğlu T, Genç A, Karamustafalıoğlu N. İki uçlu bozukluk ve inflamasyon. J Mood Disord. 2017;7:54-64.
  • Yuan N, Chen Y, Xia Y, Dai J, Liu C. Inflammation-related biomarkers in major psychiatric disorders: A cross-disorder assessment of reproducibility and specificity in 43 meta-analyses. Transl Psychiatry. 2019;9:233.
  • Liu J, Li S, Zhang S, Liu Y, Ma L, Zhu J et al. Systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio can predict clinical outcomes in patients with metastatic non-small-cell lung cancer treated with nivolumab. J Clin Lab Anal. 2019;33:e22964.
  • Xu H, Zheng L, Wang L, Gao H, Wei Y, Chen J. Albumin and associated biomarkers in severe neuropsychiatric disorders: Acute-phase schizophrenia and bipolar disorder. Neuropsychiatr Dis Treat. 2023;19:2027-2037.
  • Tohen M, Frank E, Bowden CL, Colom F, Ghaemi SN, Yatham LN et al. The International Society for Bipolar Disorders (ISBD) Task Force report on the nomenclature of course and outcome in bipolar disorders. Bipolar Disord. 2009;1:453-73.
  • Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: Reliability, validity and sensitivity. Br J Psychiatry.1978;133:429-35.
  • Karadağ F, Oral ET, Aran Yalçın F, Erten E. Young mani derecelendirme ölçeğinin Türkiye’de geçerlik ve güvenilirliği. Turk Psikiyatri Derg. 2001;13:107-4.
  • Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175-91.
  • Leboyer M, Soreca I, Scott J, Frye M, Henry C, Tamouza R, Kupfer DJ. Can bipolar disorder be viewed as a multi-system inflammatory disease? J Affect Disord. 2012;141:1-10.
  • Kupfer DJ, Frank E, Ritchey FC. Staging bipolar disorder: What data and what models are needed? Lancet Psychiatry. 2015;2:564-70.
  • Sırlıer Emir B, Yıldız S, Kazğan Kılıçaslan A, Kurt O, Uğur K, Tabara MF et al. Inflammation markers in patients with bipolar disorder who have committed offenses and their relationship with criminal behavior. Medicina (Kaunas). 2023;59:1725.
  • Harrison NA, Brydon L, Walker C, Gray MA, Steptoe A, Critchley HD. Inflammation causes mood changes through alterations in subgenual cingulate activity and mesolimbic connectivity. Biol Psychiatry. 2009;66:407-14.
  • Haroon E, Raison CL, Miller AH. Psychoneuroimmunology meets neuropsychopharmacology: Translational implications of the impact of inflammation on behavior. Neuropsychopharmacology. 2012;37:137-62.
  • Maes M. Activation of the inflammatory response system (irs) in major depression. Psychoneuroendocrinology. 2000;25:34.
  • Fernandes BS, Steiner J, Molendijk ML, Dodd S, Nardin P, Gonçalves CA et al. C-reactive protein concentrations across the mood spectrum in bipolar disorder: A systematic review and meta-analysis. Lancet Psychiatry. 2016;3:1147-56.
  • Belinskaia DA, Voronina PA, Goncharov NV. Integrative role of albumin: Evolutionary, biochemical and pathophysiological aspects. J Evol Biochem Physiol. 2021;57:1419-1448.
  • Li J, Hu R, Luo H, Guo Y, Zhang Z, Luo Q et al. Associations between dietary habits and bipolar disorder: A diet-wide mendelian randomization study. Front Psychiatry. 2024;15:1388316
  • Liao CK, Yu YL, Lin YC, Hsu YJ, Chern YJ, Chiang JM et al. Prognostic value of the C-reactive protein to albumin ratio in colorectal cancer: An updated systematic review and meta-analysis. World J Surg Oncol. 2021;19:139.
  • Tanrıkulu AB, Kaya H, Çatak Z. Elevated C-reactive protein/albumin ratio in patients with methamphetamine use disorder. Int J Psychiatry Clin Pract. 2023;27:351-358
  • Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean platelet volume (MPV): New perspectives for an old marker in the course and prognosis of ınflammatory conditions. Mediators Inflamm. 2019;2019:9213074.
  • Almış BH, Eğilmez OB. Platelet parameters in first-episode patients with schizophrenia and bipolar disorder. Psychiatry Clin Psychopharmacol. 2021;31:339.
  • Wei Y, Feng J, Ma J, Chen D, Xu H, Yin L et al. Characteristics of platelet-associated parameters and their predictive values in Chinese patients with affective disorders. BMC Psychiatry. 2022;22:150.
  • Chen Z, Wang J, Carru C, Sedda S, Nivoli AM, Li Z. Meta‐analysis of peripheral mean platelet volume in patients with mental disorders: Comparisons in depression, anxiety, bipolar disorder, and schizophrenia. Brain Behav. 2023;13:e3240.
  • Fusar-Poli L, Natale A, Amerio A, Cimpoesu P, Grimaldi Filioli P, Aguglia E et al. Neutrophil-to-lymphocyte, platelet-to-lymphocyte and monocyte-to-lymphocyte ratio in bipolar disorder. Brain Sci. 2021;11:58.
  • Nayak R, Rosh I, Kustanovich I, Stern S. Mood stabilizers in psychiatric disorders and mechanisms learnt from ın vitro model systems. Int J Mol Sci. 2021;22:9315.
  • Zhao S, Dong S, Qin Y, Wang Y, Zhang B, Liu A. Inflammation index SIRI is associated with increased all-cause and cardiovascular mortality among patients with hypertension. Front Cardiovasc Med. 2023;9:1066219.
  • Wei Y, Wang T, Li G, Feng J, Deng L, Xu H et al. Investigation of systemic immune-inflammation index, neutrophil/high-density lipoprotein ratio, lymphocyte/high-density lipoprotein ratio, and monocyte/high-density lipoprotein ratio as indicators of inflammation in patients with schizophrenia and bipolar disorder. Front Psychiatry. 2022;13:941728.
  • Korkmaz ŞA, Kızgın S, Oğuz EF, Neşelioğlu S, Erel Ö. Thiol-disulphide homeostasis, ischemia-modified albumin, complete blood count-derived inflammatory markers and C-reactive protein from acute mania to early remission in bipolar disorder. J Affect Disord. 2023;339:426-34.
  • Parial S. Bipolar disorder in women. Indian J Psychiatry. 2015;57(Suppl 2):252-63.
  • Kundakovic M, Rocks D. Sex hormone fluctuation and increased female risk for depression and anxiety disorders: From clinical evidence to molecular mechanisms. Front Neuroendocrinol. 2022;66:101010.
  • Frey BN, Dias RS. Sex hormones and biomarkers of neuroprotection and neurodegeneration: Implications for female reproductive events in bipolar disorder. Bipolar Disord. 2016;16:48-57
  • Krolick KN, Zhu Q, Shi H. Effects of estrogens on central nervous system neurotransmission: Implications for sex differences in mental disorders. Prog Mol Biol Transl Sci. 2018;160:105-171.
  • Huang MH, Chan YE, Chen MH, Hsu JW, Huang KL, Li CT et al. A longitudinal study of the association between pro-inflammatory cytokines and mood symptoms in bipolar disorder. Acta Psychiatr Scand. 2023;147:81-91.
  • Becking K, Boschloo L, Vogelzangs N, Haarman BC, Riemersma-Van Der Lek R et al. The association between immune activation and manic symptoms in patients with a depressive disorder. Transl Psychiatry. 2013;3:e314.
  • Zhao NO, Topolski N, Tusconi M, Salarda EM, Busby CW, Lima CNNC et al. Blood-brain barrier dysfunction in bipolar disorder: Molecular mechanisms and clinical implications. Brain Behav Immun Health. 2022;21:100441.
Toplam 50 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Psikiyatri
Bölüm Araştırma
Yazarlar

Ülker Atılan Fedai 0000-0001-5428-3868

Sıdıka Baziki Çetin 0000-0002-4686-8214

Yayımlanma Tarihi 30 Eylül 2025
Gönderilme Tarihi 3 Temmuz 2025
Kabul Tarihi 12 Ağustos 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 50 Sayı: 3

Kaynak Göster

MLA Atılan Fedai, Ülker ve Sıdıka Baziki Çetin. “The relationship between inflammatory response and disease severity and gender in the manic and remission phases of bipolar disorder”. Cukurova Medical Journal, c. 50, sy. 3, 2025, ss. 908-1, doi:10.17826/cumj.1733754.