title: A relative resistance of T cells to dexamethasone in bipolar disorder.
abstract: OBJECTIVE
  A relative resistance of immune cells to steroids has been established in patients with major depression (MD). In this study, we investigated the in vitro responsiveness of T cells to dexamethasone (DEX) of patients with bipolar disorder (BD).
  
  
  METHODS
  T cells of outpatients with DSM-IV BD (n = 54) and of healthy control subjects (HC; n = 29) were isolated, cultured and stimulated with phytohemagglutinin (PHA) for 72 h. The suppressive effect of graded concentrations of DEX (5 x 10(-9)-10(-5) M) on PHA-induced CD25 (IL-2R) expression was measured by fluorescence-activated cell sorting (FACS) analysis. Data were correlated to the T-cell activation status in the peripheral blood of the same patients and to their diagnosis, current mood state, ultradian cycling pattern and current use of medication, including lithium.
  
  
  RESULTS
  T cells of patients with BD were less sensitive to DEX-induced suppressive effects as compared with T cells of HC. These data were particularly evident at 10(-7) M DEX (mean % suppression +/- SEM BD: 18.9% +/- 3.5 versus HC: 35.8% +/- 4.7, p = 0.001). We found no correlations of this relative in vitro DEX resistance of T cells neither with the previously mentioned clinical characteristics nor with the actual activation status of the T cells in the BD patients.
  
  
  CONCLUSIONS
  A relative T-cell resistance to steroids, as has been observed in MD previously, may be a trait phenomenon of BD, independent of mood state.
authors.affiliation: Department of Immunology, Erasmus MC, 3000 DR Rotterdam, the Netherlands. e.knijff@erasmusmc.nl
authors.forename: Esther M
authors.initials: EM
authors.lastname: Knijff
authors.forename: M Nadine
authors.initials: MN
authors.lastname: Breunis
authors.forename: Marielle C
authors.initials: MC
authors.lastname: van Geest
authors.forename: Ralph W
authors.initials: RW
authors.lastname: Kupka
authors.forename: Cindy
authors.initials: C
authors.lastname: Ruwhof
authors.forename: Harm J
authors.initials: HJ
authors.lastname: de Wit
authors.forename: Willem A
authors.initials: WA
authors.lastname: Nolen
authors.forename: Hemmo A
authors.initials: HA
authors.lastname: Drexhage
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000276:immunology* / Q000503:physiopathology; D017252:CD3 Complex; D002478:Cells, Cultured; D003907:Dexamethasone / Q000494:pharmacology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005938:Glucocorticoids / Q000494:pharmacology*; D006801:Humans; D053645:Interleukin-2 Receptor alpha Subunit; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013601:T-Lymphocytes / Q000187:drug effects*
chemical_list: D017252:CD3 Complex; D005938:Glucocorticoids; D053645:Interleukin-2 Receptor alpha Subunit; D003907:Dexamethasone