title: Immunologic variables in acute mania of bipolar disorder.
abstract: Macrophages, lymphocytes and their products, may be involved in the pathophysiology of psychiatric disorders. The cell-mediated immune activation response of manic patients during pre-medication and medication stages remains unclear. The purpose of this case-control study was to investigate the plasma levels of immunologic variables, including interleukin (IL)-1 receptor antagonist (IL-1RA), soluble CD 4 (sCD4) and sCD8, and TH1 (interferon [IFN]-gamma and IL-2) and TH2 (IL-4 and IL-10) cytokines in patients with pre-medicated, medicated bipolar mania. The study subjects, aged 16-44 years, were physically healthy patients with Young Mania Rating Scale (YMRS) scores > or =26, and normal controls, aged 19-40 years, were matched for sex. The immune variables were measured in acute mania and in consequent remission (YMRS scores < or =12) among bipolar patients. The plasma levels of IL-1RA, sCD4, and sCD8 were found significantly increased in pre-medicated acute manic patients as compared to normal controls. But only IL-1RA and sCD8 were found different in remitted bipolar patients as compared to normal controls. For TH1 cytokines, culture supernatant level of IFN-gamma was found significantly lower in manic patients of both acute and remission stages as compared to normal controls. No significant difference was found in IL-2 level in pre-medicated acute manic patients compared to controls. For TH2 cytokines, no significant differences in IL-4 and IL-10 levels were observed. We showed that cell-mediated immune response was activated in patients with bipolar disorder during the pre-medication, medication, and the remission stages. Our study findings suggest that the immune-modulation in patients with bipolar disorder may be abnormal.
authors.affiliation: Graduate Institute of Cell and Molecular Biology, Taipei Medical University, Taipei, Taiwan.
authors.forename: Hsing-Cheng
authors.initials: HC
authors.lastname: Liu
authors.forename: Yi-Yuan
authors.initials: YY
authors.lastname: Yang
authors.forename: Yech-Mei
authors.initials: YM
authors.lastname: Chou
authors.forename: Kun-Po
authors.initials: KP
authors.lastname: Chen
authors.forename: Winston W
authors.initials: WW
authors.lastname: Shen
authors.forename: Sy-Jye
authors.initials: SJ
authors.lastname: Leu
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000097:blood / Q000494:pharmacology; D001714:Bipolar Disorder / Q000188:drug therapy / Q000276:immunology*; D015704:CD4 Antigens / Q000097:blood; D016827:CD8 Antigens / Q000097:blood; D002474:Cell-Free System / Q000276:immunology; D016207:Cytokines / Q000097:blood; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D053703:Interleukin-11 Receptor alpha Subunit; D008094:Lithium / Q000097:blood / Q000627:therapeutic use; D008213:Lymphocyte Activation / Q000187:drug effects; D008262:Macrophage Activation / Q000187:drug effects / Q000276:immunology; D008875:Middle Aged; D018123:Receptors, Interleukin / Q000097:blood; D053702:Receptors, Interleukin-11; D012074:Remission Induction; D018417:Th1 Cells / Q000187:drug effects / Q000276:immunology / Q000378:metabolism; D018418:Th2 Cells / Q000187:drug effects / Q000276:immunology / Q000378:metabolism
chemical_list: D014150:Antipsychotic Agents; D015704:CD4 Antigens; D016827:CD8 Antigens; D016207:Cytokines; C508428:IL11RA protein, human; D018836:Inflammation Mediators; D053703:Interleukin-11 Receptor alpha Subunit; D018123:Receptors, Interleukin; D053702:Receptors, Interleukin-11; D008094:Lithium