title: Immune variations in bipolar disorder: phasic differences.
abstract: OBJECTIVE
  To characterize the immunological variations of patients with a bipolar disorder (BD) diagnosis in manic (BDm) and depressive (BDd) phases, by the quantification of the serum levels of interleukin (IL)-1beta, -2, -4, -6 and tumor necrosis factor alpha (TNF-alpha).
  
  
  METHODS
  Twenty physically healthy patients with a BD type I diagnosis and 33 matched controls were studied, after giving informed consent. The inclusion criteria included at least three weeks without any kind of psychopharmacological treatment, Young Mania Rating Scale score > or =20 for BDm (n = 10) and Hamilton Depression Rating Scale score > or =21 for BDd patients (n = 10). Exclusion criteria included any infectious diseases, allergies or any other kind of medical illness that required treatment with immunosuppressors, as well as any other diagnosis in Axis I. Physical and laboratory examinations were performed to rule out any clinical illness. Enzyme-linked immunosorbent assay (ELISA) was used to analyze the serum cytokines concentration.
  
  
  RESULTS
  BD patients, when compared to controls, showed significant differences (p < or = 0.05) in the serum levels of the measured cytokines. The sub-group of BDd patients showed an increase in IL-6 and TNF-alpha, as well as a decrease in IL-2 concentration. The BDm sub-group, on the other hand, showed an increase in TNF-alpha and IL-4 values, with a low concentration of IL-1 and IL-2. The comparison between both sub-groups suggests that there is a distinctive cytokine pattern for the specific phases of the disorder: for mania, we found a high IL-4 and low IL-1beta and IL-6 concentration, while in the depressive phase, the inverse pattern was found.
  
  
  CONCLUSIONS
  Our results show the existence of phasic differences in the serum levels of cytokines in BD.
authors.affiliation: Bipolar Disorder Clinic, National Institute of Psychiatry, Mexico City, Mexico.
authors.forename: Abigail
authors.initials: A
authors.lastname: Ortiz-Domínguez
authors.forename: María Eugenia
authors.initials: ME
authors.lastname: Hernández
authors.forename: Carlos
authors.initials: C
authors.lastname: Berlanga
authors.forename: Doris
authors.initials: D
authors.lastname: Gutiérrez-Mora
authors.forename: Julia
authors.initials: J
authors.lastname: Moreno
authors.forename: Gerhard
authors.initials: G
authors.lastname: Heinze
authors.forename: Lenin
authors.initials: L
authors.lastname: Pavón
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000097:blood / Q000276:immunology* / Q000503:physiopathology; D003863:Depression / Q000276:immunology; D015536:Down-Regulation; D005260:Female; D006801:Humans; D053583:Interleukin-1beta / Q000097:blood; D007376:Interleukin-2 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D015854:Up-Regulation
chemical_list: D053583:Interleukin-1beta; D007376:Interleukin-2; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D015847:Interleukin-4