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 Mufić305705169 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
