title: Oxidative stress parameters in unmedicated and treated bipolar subjects during initial manic episode: a possible role for lithium antioxidant effects.
abstract: Studies have proposed the involvement of oxidative stress and neuronal energy dysfunctions in the pathophysiology of bipolar disorder (BD). This study evaluates plasma levels of the oxidative/energy metabolism markers, thiobarbituric acid reactive substances (TBARS), superoxide dismutase (SOD), catalase (CAT), and neuron-specific enolase (NSE) during initial episodes of mania compared to controls in 75 subjects. Two groups of manic subjects (unmedicated n=30, and lithium-treated n=15) were age/gender matched with healthy controls (n=30). TBARS and antioxidant enzymes activity (SOD and CAT) were increased in unmedicated manic patients compared to controls. Conversely, plasma NSE levels were lower during mania than in the controls. In contrast, acute treatment with lithium showed a significant reduction in both SOD/CAT ratio and TBARS levels. These results suggest that initial manic episodes are associated with both increased oxidative stress parameters and activated antioxidant defenses, which may be related to dysfunctions on energy metabolism and neuroplasticity pathways. Antioxidant effects using lithium in mania were shown, and further studies are necessary to evaluate the potential role of these effects in the pathophysiology and therapeutics of BD.
authors.affiliation: Mood Disorders Program, HMIPV, Fundacao Faculdade Federal Ciencias Medicas de Porto Alegre and Bipolar Disorder Research Program, Espirita Hospital of Porto Alegre, Porto Alegre, Brazil. machadovieirar@terra.com.br
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Machado-Vieira
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Andreazza
authors.forename: Carlos Ivan
authors.initials: CI
authors.lastname: Viale
authors.forename: Vanessa
authors.initials: V
authors.lastname: Zanatto
authors.forename: Victor
authors.initials: V
authors.lastname: Cereser
authors.forename: Rafael
authors.initials: R
authors.lastname: da Silva Vargas
authors.forename: Flávio
authors.initials: F
authors.lastname: Kapczinski
authors.forename: Luiz V
authors.initials: LV
authors.lastname: Portela
authors.forename: Diogo O
authors.initials: DO
authors.lastname: Souza
authors.forename: Mirian
authors.initials: M
authors.lastname: Salvador
authors.forename: Valentim
authors.initials: V
authors.lastname: Gentil
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000097:blood / Q000188:drug therapy*; D016022:Case-Control Studies; D002374:Catalase / Q000097:blood; D005260:Female; D006801:Humans; D018021:Lithium Chloride / Q000627:therapeutic use*; D008297:Male; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D018384:Oxidative Stress / Q000187:drug effects*; D010751:Phosphopyruvate Hydratase / Q000097:blood; D013482:Superoxide Dismutase / Q000097:blood; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism
chemical_list: D018696:Neuroprotective Agents; D017392:Thiobarbituric Acid Reactive Substances; D002374:Catalase; D013482:Superoxide Dismutase; D010751:Phosphopyruvate Hydratase; D018021:Lithium Chloride