Title POVEZANOST ČIMBENIKA UPALE I KLINIČKE SLIKE U BOLESNIKA SA
SHIZOFRENIJOM, DEPRESIVNIM ILI BIPOLARNIM POREMEĆAJEM Title (english) RELATIONSHIP BETWEEN SERUM INFLAMMATORY FACTORS
AND CLINICAL PRESENTATION OF SCHIZOPHRENIA, DEPRESSIVE
DISORDER OR BIPOLAR DISORDER Author Ana Kovak Mufić Mentor Dalibor Karlović (mentor)Committee member Zlatko Trkanjec (predsjednik povjerenstva)Committee member Arijana Lovrenčić-Huzjan (član povjerenstva)Committee member Ana Matošić (član povjerenstva)Committee member Nada Vrkić (član povjerenstva) Committee member Ante Silić (član povjerenstva)Granter University of Zagreb Defense date and country 2016-04-13, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Universal decimal classificationUDC ) 61 - Medical sciences Abstract Uvod: Prema konceptu kontinuuma psihoze smatra se da shizofrenija, depresivni i bipolarni
poremećaj predstavljaju različite kliničke manifestacije zajedničkog patofiziološkog
mehanizma. Novija istraživanja su dokazala povišene serumske koncentracije upalnih
čimbenika u bolesnika sa shizofrenijom, depresivnim poremećajem i bipolarnim
poremećajem. Klinička slika navedenih poremećaja također ih povezuje s aktivacijom
imunoloških procesa. Koliko je poznato, do sada nije objavljena studija koja bi objedinila sve
navedene poremećaje u svjetlu citokine hipoteze i ispitala je li upala mogući zajednički
patofiziološki mehanizam kontinuuma psihoze. Cilj ovog istraživanja bio je ispitati serumske
koncentracije IL-6, TNF-α i CRP-a u bolesnika s depresivnim poremećajem, shizofrenijom i
bipolarnim poremećajem te usporediti dobivene koncentracije sa serumskim koncentracijama
IL-6, TNF-α i CRP-a u ispitanika iz kontrolne skupine. Sljedeći korak bio je ispitati
povezanost serumske koncentracije upalnih čimbenika s težinom kliničke slike u bolesnika s
depresivnim poremećajem, shizofrenijom i bipolarnim poremećajem.
Metode: U istraživanje je uključeno ukupno 245 ispitanika u dobi od 18 do 60 godina,
podijeljenih u četiri skupine: 51 zdravi dobrovoljac u kontrolnoj skupini, 76 ispitanika s
dijagnozom shizofrenije, 84 ispitanika s dijagnozom depresivnog poremećaja i 34 ispitanika s
dijagnozom bipolarnog poremećaja. Dijagnoze i težina simptoma su procijenjene pomoću
psihijatrijskih ocjenskih ljestvica MINI, PANSS, HAMD i YMRS. IL-6 je određivan
standardiziranom metodom ELISA, TNF-α je određivan imunoenzimskom metodom, a CRP
je određivan imunoturbidimetrijskom metodom.
Rezultati: Postoji statistički značajna razlika u serumskim koncentracijama IL-6 između
bolesnika s depresivnim poremećajem i bolesnika s bipolarnim poremećajem. Također je
dobivena statistički značajna razlika u serumskim koncentracijama TNF-α između sve tri
skupine bolesnika i kontrolne skupine. Nadalje, dobivena je statistički značajna razlika
između serumskih koncentracija CRP-a u skupini bolesnika s depresivnim poremećajem i u
kontrolnoj skupini.
Serumska koncentracija TNF-α je u korelaciji s težinom simptoma bipolarnog poremećaja,
dok u slučaju težine simptoma shizofrenije ili depresivnog poremećaja nismo naši povezanost.
Nadalje, nije nađena korelacija između serumskih koncentracija IL-6 i CRP-a i težine
simptoma shizofrenije, depresivnog ili bipolarnog poremećaja.
Zaključak: Prema našim rezultatima, povezanost serumske koncentracije IL-6, TNF-α i
CRP-a s težinom kliničke slike shizofrenije, depresivnog ili bipolarnog poremećaja nije
potvrdila hipotezu o kontinuumu psihoze. TNF-α bi potencijalno mogao biti biomarker za
ispitivane psihijatrijske poremećaje, što je predmet budućih istraživanja.
Abstract (english) Background: According to a concept of continuum of psychosis, it is postulated that
schizophrenia, depressive disorder and bipolar disorder represent different clinical
presentations of a common pathophysiological mechanism. Recent studies have proven
increased serum concentrations of inflammatory markers in patients with schizophrenia,
depressive disorder and bipolar disorder. Clinical presentation of given disorders links them to
an activation of immunological processes as well. Up to our best knowledge, comprehensive
study of all mentioned psychiatric conditions in light of cytokine hypothesis has not been
published yet in order to assess whether inflammation could have been a common
pathophysiological mechanism in terms of continuum of psychosis. The aim of this research
was to investigate serum concentrations of IL-6, TNF-α and CRP in patients with depressive
disorder, schizophrenia and bipolar disorder, and to compare given concentrations with serum
concentrations of IL-6, TNF-α and CRP in a control group. The next step was to investigate
the relationship of serum concentrations of inflammatory markers with severity of symptoms
in patients with depression, schizophrenia and bipolar disorder.
Methods: Study included a total of 245 subjects, aged 18 to 60, divided into four study
groups: 51 healthy subjects in control group, 76 subjects diagnosed with schizophrenia, 84
subjects diagnosed with depressive disorder, and 34 subjects diagnosed with bipolar disorder.
Diagnoses and severity of symptoms were assessed with psychiatric diagnostic rating scales
MINI, PANSS, HAMD and YMRS. IL-6 was determined by standardized ELISA procedure,
TNF-α was determined by immunoenzyme method, and CRP was determined by
immunoturbidimetric method.
Results: There is a statistically proven difference of serum concentrations of IL-6 between
patients with depressive disorder and patients with bipolar disorder. Difference of serum
concentrations of TNF-α between all three investigated groups of patients and control group is
statistically proven. Difference of serum concentration of CRP between patients with
depressive disorder and control group is statistically proven as well.
Serum concentration of TNF-α is in correlation with severity of symptoms of bipolar disorder,
while in case of severity of symptoms of schizophrenia and depressive disorder we found no
correlation. Moreover, we observed no correlation between serum concentrations of IL-6 and
CRP with severity of symptoms of schizophrenia, depressive disorder or bipolar disorder.
Conclusion: According to our results, the relationship between serum concentrations of IL-6,
TNF-α and CRP and clinical presentation of schizophrenia, depressive disorder and bipolar
disorder did not prove continuum hypothesis. TNF-α could be a potential marker for
investigated psychiatric disorders which is a subject for further investigation.
Keywords
šizofrenija
depresivni poremećaj
bipolarni poremećaj
čimbenici upale
Keywords (english)
schizophrenia
depressive disorder
bipolar disorder
inflammatory markers
Language croatian URN:NBN urn:nbn:hr:127:677791 Study programme Title: dental medicine Type of resource Text Extent 119 str. ; 29 cm File origin Born digital Access conditions Open access Terms of use Created on 2016-04-21 09:57:43
