IL-23 and TGF-β1 levels as potential predictive biomarkers in treatment of bipolar I disorder with acute manic episode

J Affect Disord. 2015 Mar 15:174:361-6. doi: 10.1016/j.jad.2014.12.033. Epub 2014 Dec 18.

Abstract

Background: Growing evidence suggests that immune dysfunction may be involved in the physiopathology of bipolar disorders, with typical first-line treatment using lithium and quetiapine serving to restore pro-inflammation status. This study aimed to explore the relationship between inflammatory cytokines-especially regulatory factors and the effect of combination treatment-with quetiapine and lithium in manic patients.

Methods: 41 patients of bipolar I disorder with manic episode were enrolled and received combination treatment with quetiapine and lithium. Blood sampling and assessments were performed at baseline and after 8-week treatment. YMRS was used to evaluate the severity of manic symptoms at the same time of detecting plasma levels. A control group comprised of 36 age and gender matched healthy volunteers were enrolled, and their blood samples were assessed at the time of enrollment.

Results: TGF-β1 and IL-23 plasma levels in patients were significantly higher than healthy controls at baseline (P<0.05). When comparing remitted patients with non-remitted patients, initial plasma level TGF-β1 was higher (P=0.029) while IL-23 was lower (P=0.035). The plasma levels of TNF-α, TGF-β1, IL-23 and IL-17 significantly decreased after treatment among the patients who achieved response (P<0.05).

Limitations: The relatively small sample size in patients and control groups should be considered as a limitation of the study.

Conclusions: The high initial plasma level of TGF-β1 and low initial plasma level of IL-23 indicated better prognosis during combination treatment with quetiapine and lithium in manic patients. The trend of decreasing plasma levels of TNF-α, TGF-β1, IL-23 and IL-17 indicated therapeutic effect.

Keywords: Bipolar disorder; Interleukin; Mania; Transforming growth factor beta; Tumor necrosis factor alpha.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antipsychotic Agents / therapeutic use*
  • Biomarkers / blood
  • Bipolar Disorder / blood*
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / drug therapy*
  • Case-Control Studies
  • Dibenzothiazepines / therapeutic use
  • Female
  • Humans
  • Interleukin-17 / blood*
  • Interleukin-23 / blood*
  • Lithium Compounds / therapeutic use
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Quetiapine Fumarate
  • Severity of Illness Index
  • Transforming Growth Factor beta1 / blood*
  • Tumor Necrosis Factor-alpha / blood*

Substances

  • Antipsychotic Agents
  • Biomarkers
  • Dibenzothiazepines
  • Interleukin-17
  • Interleukin-23
  • Lithium Compounds
  • Transforming Growth Factor beta1
  • Tumor Necrosis Factor-alpha
  • Quetiapine Fumarate