title: Seroreactive marker for inflammatory bowel disease and associations with antibodies to dietary proteins in bipolar disorder.
abstract: OBJECTIVE
  Immune sensitivity to wheat glutens and bovine milk caseins may affect a subset of individuals with bipolar disorder. Digested byproducts of these foods are exorphins that have the potential to impact brain physiology through action at opioid receptors. Inflammation in the gastrointestinal (GI) tract might accelerate exposure of food antigens to systemic circulation and help explain elevated gluten and casein antibody levels in individuals with bipolar disorder.
  
  
  METHODS
  We measured a marker of GI inflammation, anti-Saccharomyces cerevisiae antibodies (ASCA), in non-psychiatric controls (n = 207), in patients with bipolar disorder without a recent onset of psychosis (n = 226), and in patients with bipolar disorder with a recent onset of psychosis (n = 38). We compared ASCA levels to antibodies against gluten, casein, Epstein-Barr virus (EBV), herpes simplex virus 1 (HSV-1), influenza A, influenza B, measles, and Toxoplasma gondii.
  
  
  RESULTS
  Elevated ASCA conferred a 3.5-4.4-fold increased odds ratio of disease association (age-, race-, and gender-corrected multinomial logistic regressions, p ≤ 0.00001) that was independent of type of medication received. ASCA correlated with food antibodies in both bipolar disorder groups (R(2)  = 0.29-0.59, p ≤ 0.0005), and with measles and T. gondii immunoglobulin G (IgG) in the recent onset psychosis bipolar disorder group (R(2)  = 0.31-0.36, p ≤ 0.004-0.01).
  
  
  CONCLUSIONS
  Elevated seropositivity of a GI-related marker and its association with antibodies to food-derived proteins and self-reported GI symptoms suggest a GI comorbidity in at least a subgroup of individuals with bipolar disorder. Marker seroreactivity may also represent part of an overall heightened activated immune state inherent to this mood disorder.
authors: Stanley Division of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Emily G
authors: EG
authors: Severance
authors: Kristin L
authors: KL
authors: Gressitt
authors: Shuojia
authors: S
authors: Yang
authors: Cassie R
authors: CR
authors: Stallings
authors: Andrea E
authors: AE
authors: Origoni
authors: Crystal
authors: C
authors: Vaughan
authors: Sunil
authors: S
authors: Khushalani
authors: Armin
authors: A
authors: Alaedini
authors: Faith B
authors: FB
authors: Dickerson
authors: Robert H
authors: RH
authors: Yolken
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000150:complications* / Q000276:immunology; D004044:Dietary Proteins / Q000276:immunology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D015212:Inflammatory Bowel Diseases / Q000097:blood* / Q000150:complications*; D008297:Male; D012441:Saccharomyces cerevisiae / Q000276:immunology; D013223:Statistics as Topic
chemical_list: D004044:Dietary Proteins; D007074:Immunoglobulin G
keywords: autoimmunity; environment; gastrointestinal; immunology; infection; mood disorder