Levels Of Peripheral Blood Cytokines In Patients With Bipolar Depressive Episode And Depression

Background: Bipolar disorder(BD)and Major Depressive Disorder(MDD)are the two most common mood disorders.BD patients experienced a higher duration of depression than mania or hypomania during the whole course of the disease.And BD most the first onset of depressive symptoms,that is bipolar depressive episode(Bipolar Disorder Depressive episode,BDD).The clinical manifestations of BDD at the first onset are almost identical with MDD,so BDD is easily misdiagnosed as MDD.Clinical studies have shown that the disorder of immune system is closely related to the pathophysiological mechanism of BD and MDD.Cytokine regulation disorders in the immune system generally exist in patients with BD and MDD.However,it is not clear how the two diseases differ in the pattern of inflammation during depressive episodes.The purpose of this study is to observe the differences in the levels of cytokines between BDD and MDD patients admitted to hospital in the acute stage and healthy control group,and on this basis,to explore whether cytokines can be used as biomarkers to assist the diagnosis of BDD and MDD,so as to help early identification of BD.Methods: A total of 65 MDD patients and 47 BDD patients were included in the study as the observation group.All the patients in the observation group were newly admitted to the bipolar disorder ward of the designated Hospital during the period from December 2020 to December 2022.A total of 62 patients in the same period were selected as the health control group.The blood samples of all patients in the observation group were collected in the morning of the second day of admission(7:00-8:30),and the peripheral venous blood samples of patients under fasting condition were required,,the blood samples were centrifuged in time,and the serum was extracted,and the serum was retained at-80 ℃ for standby.Young Mania Rating Scale(YMRS)and Hamilton Depression Scale(HAMD)were used to assess their condition,and the scores of Mood Disorder Questionnaire(MDQ)and 32 items of hypomania symptom list(HCL-32)were collected.Blood samples were collected and stored in the same way on the day of admission of the healthy control group.After collecting the required samples,use the enzyme-linked immune adsorbed assay(Elisa)to determined IL-1、IL-1β、IL-6、TNF-α(Tumor necrosis factor-α)and CRP(C-reactive protein)expression level.This study uses IBM SPSS 25.0 for statistical analysis of the data obtained.Results: The results showed that compared with the healthy control group,both BDD patients and MDD patients had immune inflammatory disorder when they were in the stage of acute depression.Compared with the healthy control group,CRP and TNF in BDD group-α and IL-6 and IL-1 β both were significantly higher.MDD group CRP,TNF-α、IL-6 and IL-1βboth were significantly higher than the healthy control group.There are different cytokines between BDD group and MDD group: The overall level of IL-1β in BDD group is higher than that of MDD group,the overall level of IL-6,CRP and TNF-α has no significant difference between them.Conclusion: MDD and BDD patients show different inflammatory characteristics,especially IL-1β,even in the same depression state。Relative to MDD,high level of IL-1βhas moderate diagnostic significance for the diagnosis and prediction of BDD(AUC = 0.627,P < 0.05).The secondary conclusions are as follows: The overall levels of IL-6 and CRP、IL-1β、TNF-α of BDD and MDD group were significantly higher than those of the healthy control group;IL-1β of BDD group is higher than that of MDD group;The CRP level of BDD group has significant statistical difference among different sex groups,and the IL-1β of MDD group is significant statistical difference in the level between different sexes;IL-1 β has a low positive correlation between the concentration and BMI,the number of onset,and the CRP concentration and age,the age of onset.