title: Plasma concentrations of soluble cytokine receptors in euthymic bipolar patients with and without subsyndromal symptoms.
abstract: BACKGROUND
  Current evidence suggests that high concentrations of pro-inflammatory markers are associated with bipolar disorder characterized by severe impairment during inter-episodic periods, reduced treatment response and persistent subsyndromal symptoms. We tested whether persistent subsyndromal symptoms in euthymic bipolar patients were associated with markers of an ongoing chronic pro-inflammatory process.
  
  
  METHODS
  Forty-five euthymic bipolar patients (22 with subsyndromal symptoms (BD+) and 23 without subsyndromal symptoms (BD-) and 23 well controls (WC) were recruited for assessment of soluble tumor necrosis factor receptor-1 (sTNF-R1), soluble interleukin-6 receptor (sIL-6R) and soluble interleukin-2 receptor (sIL-2R) concentrations. Soluble cytokine receptor concentrations were assessed using enzyme-linked immunosorbent assay.
  
  
  RESULTS
  In comparison to WC, sTNF-R1 concentration was higher in both BD- and BD+ (age and sex adjusted standardized β, respectively: β = 0.34, p = 0.012 and β = 0.41, p = 0.003). Similarly, compared to WC, sIL-6R concentration was higher in both BD- and BD+ (age and sex adjusted standardized β, respectively: β = 0.44, p = 0.001 and β = 0.37, p = 0.008). There was no difference between BD- and BD+ in the concentration of either sTNF-R1 or sIL-6R; plasma concentration of sIL-2R was not analyzed as 75% percent of the samples were non-detectable.
  
  
  CONCLUSIONS
  Although bipolar patients present with a pro-inflammatory shift compared to well controls, subsyndromal symptoms are not associated with additive increasing effects. Longitudinal studies with larger samples are required to clarify the relationship between illness course and inflammatory markers in bipolar disorder.
authors.affiliation: Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey.
authors.forename: Turan
authors.initials: T
authors.lastname: Cetin
authors.forename: Sinan
authors.initials: S
authors.lastname: Guloksuz
authors.forename: Esin Aktas
authors.initials: EA
authors.lastname: Cetin
authors.forename: Sema Bilgic
authors.initials: SB
authors.lastname: Gazioglu
authors.forename: Gunnur
authors.initials: G
authors.lastname: Deniz
authors.forename: E Timucin
authors.initials: ET
authors.lastname: Oral
authors.forename: Jim
authors.initials: J
authors.lastname: van Os
mesh_terms: D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D001714:Bipolar Disorder / Q000097:blood* / Q000175:diagnosis / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D018121:Receptors, Cytokine / Q000097:blood*; D015375:Receptors, Interleukin-2 / Q000097:blood; D019947:Receptors, Interleukin-6 / Q000097:blood; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood; D012995:Solubility; D013577:Syndrome
chemical_list: D015415:Biomarkers; D018121:Receptors, Cytokine; D015375:Receptors, Interleukin-2; D019947:Receptors, Interleukin-6; D018124:Receptors, Tumor Necrosis Factor