title: Increased uric acid levels in drug-naïve subjects with bipolar disorder during a first manic episode.
abstract: Recent evidence suggests that purinergic system dysfunction may play a role in the pathophysiology and therapeutics of bipolar disorder (BPD). Uric acid is a key nitrogenous end product of purine metabolism. In addition to being a potential marker of treatment response, high levels of uric acid may represent a state marker during mania. In this study, we assessed the presence of purinergic dysfunction in 20 treatment-naïve first episode patients with BPD who were experiencing a manic episode. Patients were matched with 24 healthy controls. We found that acutely manic patients had significantly higher levels of plasma uric acid (4.85+/-1.60 mg/dL) compared to healthy controls (2.96+/-0.63 mg/dL, p<0.001; F=28.1). No association between uric acid levels with severity of manic symptoms was observed. These results support the role of purinergic system dysfunction in BPD early in the course of illness, and suggest that this phenomenon is not the result of chronicity or medication exposure. Overall, our findings suggest a novel mechanism in the pathophysiology of BPD.
authors.affiliation: Experimental Therapeutics, Mood and Anxiety Disorders Program, National Institute of Mental Health, National Institutes of Health, 10 Center Drive, CRC Unit 7 Southeast, Room 7-3445, Bethesda, Maryland, 20892-1285, USA.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Salvadore
authors.forename: Carlos I
authors.initials: CI
authors.lastname: Viale
authors.forename: David A
authors.initials: DA
authors.lastname: Luckenbaugh
authors.forename: Vanessa C
authors.initials: VC
authors.lastname: Zanatto
authors.forename: Luiz V
authors.initials: LV
authors.lastname: Portela
authors.forename: Diogo O
authors.initials: DO
authors.lastname: Souza
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Zarate
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Machado-Vieira
mesh_terms: D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000097:blood* / Q000175:diagnosis; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid