Bipolar I bozukluk tanılı hastaların tedavi öncesi ve sonrası sitokin düzeylerinin değerlendirilmesi
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Dosyalar
Tarih
2010
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızda bipolar I bozukluğunun manik döneminde proinflamatuvar, inflamatuvar, anitinflamatuvar sitokin, kortizol ve high sensitivity C-reactive protein düzeylerinin manik dönemin şiddeti ile ilişkisini ve tedavi yanıtı öngörmedeki etkilerini değerlendirmeyi amaçladık. Araştırmamızda, Trakya Üniversitesi Tıp Fakültesi Hastanesi Psikiyatri Servisinde Ruhsal bozuklukların tanısal ve sayımsal el kitabı, ikinci baskı, yeniden gözden geçirilmiş tam metin tanı ölçütlerine göre bipolar I bozukluk manik dönem tanısı ile yatırılarak klinik izlemi yapılan 30 hastanın tedavi öncesinde ve tedavi sonrasında bakılan proinflamatuvar (interlökin -6, tümör nekrotizan faktör- alfa), antiinflamatuvar ( interlökin-4, interlökin-10) ve inflamatuvar (interferon-gama) sitokin, high sensitivity C-reactive protein ve kortizol düzeyleri ile 30 sağlıklı gönüllünün verileri karşılaştırılmış ve manik döneminin şiddeti, Young Mani Derecelendirme Ölçeğiyle değerlendirilmiştir. Bipolar I bozukluğun manik döneminde tedavi öncesinde bakılan proinflamatuvar ve inflamatuvar sitokin düzeyleri sağlıklı kontrollerle karşılaştırıldığında; tümör nekrotizan faktör-alfa, interlökin-6, interferon-gama düzeyleri istatistiksel olarak anlamlı derecede yüksek, tedavi sonrası dönemde ise; tedavi öncesi döneme göre anlamlı derecede düşük saptandı. Hastaların tedavi öncesi ve sonrasında bakılan antiinflamatuvar sitokin ve kortizol düzeyleri sağlıklı kontrollerle karşılaştırıldığında anlamlı bir farklılık saptanmadı. Sağlıklı kontrollerle manik dönemdeki hastaların tedavi öncesi high sensitivity C-reaktif protein düzeyleri karşılaştırıldığında; high sensitivity C-reactive protein düzeyleri tedavi öncesi manik dönemde istatistiksel olarak anlamlı derecede yüksek, tedavi sonrası dönemde ise tedavi öncesi döneme göre anlamlı derecede düşük bulunmuştur. Araştırmamızda bakılan sitokinler ve high sensitivity C-reactive protein düzeylerinin klinik yanıt ile ilişkileri değerlendirildiğinde; yalnızca high sensitiv C-reactive protein düzeyleri klinik yanıtla ilişkili bulunmuştur. Araştırmamızda; bipolar I bozukluğunun manik dönemi ile proinflamatuvar sitokinler, inflamatuvar sitokin ve high sensitivity C-reactive protein düzeyleri arasında belirgin bir ilişki bulunduğunu, çalışmamızda değerlendirilen diğer parametrelere göre tedavi yanıtını öngörmede en uyumlu göstergenin high sensitivity C-reactive protein olabileceğini saptadık. Anahtar kelimeler: Bipolar bozukluk, manik dönem, sitokin, high sensitivity C-reactive protein, tedavi yanıtı.
In this study, we aimed to assess the relations between proinflammatory, inflammatory and anti-inflammatory cytokines, cortisole and high sensitive C-reactive protein levels with the severity of the manic period in patients with bipolar I disorder as well as their predictive value of response to treatment. Thirty patients diagnosed and hospitalized as bipolar I disorder according to the diagnostic criteria published in the full text second and revised edition of Diagostic and Statistical Manual of Mental Disorders in the Department of Psychiatry of Faculty of Medicine Trakya University and 30 healthy volunteers were enrolled in the study. Proinflammatory(interleukin-6, tumor necrosis factor-alpha), anti-inflammatory (interleukin-4, interleukin-10) and inflammatory (interferon-gamma) cytokines, high sensitivity C-reactive protein and cortisole levels were determined in patients both before and after treatment and in healthy controls. The severity of the manic episodes were assessed according to the Young mania rating scale. Tumor necrosis factor-alpha, Interferon-gamma and Interleukin-6 levels were significantly increased before treatment in patients with manic episode of bipolar I disorder than controls, after treatment, the levels of interleukin-6, interferon-gamma, tumor necrosis factor-alpha were observed to be significantly decreased than the values before treatment. No difference was observed between the levels of anti-inflammatory cytokines and cortisole in patients before or after treatment and healthy controls. High sensitivity C-reactive protein levels were observed to be significantly high before treatment in patients with manic episode of bipolar I disorder. Levels of high sensitivity C-reactive protein were significantly decreased after treatment. Regarding the relations of cytokines, high sensitivity C-reactive protein levels and clinical response, high sensitivity C-reactive protein was observed to be the only parameter relevant with clinical response. In our study, we observed a remarkable relation between the proinflammatory cytokines, inflammatory cytokines and high sensitivity C-reactive protein levels with manic episode in bipolar I disorder patients; and demonstrated that high sensitivity C-reactive protein is the most consistent indicator according to the other parameters, in predicting the treatment outcomes. Key words; Bipolar disorder, manic episode, cytokine, high sensitivity C-reactive protein, clinical response.
In this study, we aimed to assess the relations between proinflammatory, inflammatory and anti-inflammatory cytokines, cortisole and high sensitive C-reactive protein levels with the severity of the manic period in patients with bipolar I disorder as well as their predictive value of response to treatment. Thirty patients diagnosed and hospitalized as bipolar I disorder according to the diagnostic criteria published in the full text second and revised edition of Diagostic and Statistical Manual of Mental Disorders in the Department of Psychiatry of Faculty of Medicine Trakya University and 30 healthy volunteers were enrolled in the study. Proinflammatory(interleukin-6, tumor necrosis factor-alpha), anti-inflammatory (interleukin-4, interleukin-10) and inflammatory (interferon-gamma) cytokines, high sensitivity C-reactive protein and cortisole levels were determined in patients both before and after treatment and in healthy controls. The severity of the manic episodes were assessed according to the Young mania rating scale. Tumor necrosis factor-alpha, Interferon-gamma and Interleukin-6 levels were significantly increased before treatment in patients with manic episode of bipolar I disorder than controls, after treatment, the levels of interleukin-6, interferon-gamma, tumor necrosis factor-alpha were observed to be significantly decreased than the values before treatment. No difference was observed between the levels of anti-inflammatory cytokines and cortisole in patients before or after treatment and healthy controls. High sensitivity C-reactive protein levels were observed to be significantly high before treatment in patients with manic episode of bipolar I disorder. Levels of high sensitivity C-reactive protein were significantly decreased after treatment. Regarding the relations of cytokines, high sensitivity C-reactive protein levels and clinical response, high sensitivity C-reactive protein was observed to be the only parameter relevant with clinical response. In our study, we observed a remarkable relation between the proinflammatory cytokines, inflammatory cytokines and high sensitivity C-reactive protein levels with manic episode in bipolar I disorder patients; and demonstrated that high sensitivity C-reactive protein is the most consistent indicator according to the other parameters, in predicting the treatment outcomes. Key words; Bipolar disorder, manic episode, cytokine, high sensitivity C-reactive protein, clinical response.
Açıklama
Anahtar Kelimeler
Psikiyatri, Psychiatry, Bipolar Bozukluk, Manik Dönem, Sitokin, High Sensitivity, Bipolar Disorder, Manic Episode, Cytokine, Clinical Response
