PMID- 22749155
OWN - NLM
STAT- MEDLINE
DCOM- 20130827
LR  - 20191210
IS  - 1573-2517 (Electronic)
IS  - 0165-0327 (Linking)
VI  - 143
IP  - 1-3
DP  - 2012 Dec 20
TI  - Evidence for an association between tumor necrosis factor-alpha levels and 
      lithium response.
PG  - 148-52
LID - S0165-0327(12)00404-1 [pii]
LID - 10.1016/j.jad.2012.04.044 [doi]
AB  - BACKGROUND: The role of inflammation in bipolar disorder has recently emerged as 
      a potential pathophysiological mechanism. Tumor necrosis factor-alpha (TNF-alpha) 
      modulation may represent a pathogenic molecular target and a biomarker for 
      staging bipolar disorder. In this context, the possible association between 
      lithium response and TNF-alpha level was examined. METHODS: Sixty euthymic bipolar 
      patients receiving lithium therapy were recruited for assessment of TNF-alpha level. 
      The ALDA lithium response scale (LRS) was used to evaluate longitudinal lithium 
      response in bipolar patients, using cut-offs of poor response, partial response 
      and good response. TNF-alpha level was assessed using enzyme-linked immunosorbent 
      assay. RESULTS: There was a significant increase in TNF-alpha level in patients with 
      poor lithium response compared to those with good response, also after 
      controlling for a range of potential confounders (adjusted effect size: 0.47, 
      p=0.011). Partial response showed a directionally similar, but attenuated and 
      statistically inconclusive association (adjusted effect size: 0.16, p=0.326). 
      LIMITATIONS: Assessment of response was retrospective and natural course cannot 
      be separated easily from treatment response in an observational design. Selection 
      of additional inflammatory markers could provide for a better understanding of 
      underlying immune changes. CONCLUSIONS: This study strengthens the hypothesis 
      that TNF-alpha level may mark or mediate lithium response, and that continuous immune 
      imbalance in poor lithium responders may occasion treatment resistance. Further 
      investigation of immune alterations in treatment-resistant bipolar patients may 
      be productive.
CI  - Copyright (c) 2012 Elsevier B.V. All rights reserved.
FAU - Guloksuz, Sinan
AU  - Guloksuz S
AD  - Department of Psychiatry and Psychology, Maastricht University Medical Centre, 
      EURON, Maastricht, The Netherlands. sguloksuz@yahoo.com
FAU - Altinbas, Kursat
AU  - Altinbas K
FAU - Aktas Cetin, Esin
AU  - Aktas Cetin E
FAU - Kenis, Gunter
AU  - Kenis G
FAU - Bilgic Gazioglu, Sema
AU  - Bilgic Gazioglu S
FAU - Deniz, Gunnur
AU  - Deniz G
FAU - Oral, E Timucin
AU  - Oral ET
FAU - van Os, Jim
AU  - van Os J
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120630
PL  - Netherlands
TA  - J Affect Disord
JT  - Journal of affective disorders
JID - 7906073
RN  - 0 (Biomarkers)
RN  - 0 (Lithium Compounds)
RN  - 0 (Tumor Necrosis Factor-alpha)
SB  - IM
MH  - Adult
MH  - Biomarkers/blood
MH  - Bipolar Disorder/*blood/*drug therapy/immunology
MH  - Confounding Factors, Epidemiologic
MH  - Enzyme-Linked Immunosorbent Assay
MH  - Female
MH  - Humans
MH  - Inflammation/blood/immunology
MH  - Lithium Compounds/*therapeutic use
MH  - Male
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Tumor Necrosis Factor-alpha/*blood
EDAT- 2012/07/04 06:00
MHDA- 2013/08/28 06:00
CRDT- 2012/07/04 06:00
PHST- 2012/03/15 00:00 [received]
PHST- 2012/04/10 00:00 [revised]
PHST- 2012/04/10 00:00 [accepted]
PHST- 2012/07/04 06:00 [entrez]
PHST- 2012/07/04 06:00 [pubmed]
PHST- 2013/08/28 06:00 [medline]
AID - S0165-0327(12)00404-1 [pii]
AID - 10.1016/j.jad.2012.04.044 [doi]
PST - ppublish
SO  - J Affect Disord. 2012 Dec 20;143(1-3):148-52. doi: 10.1016/j.jad.2012.04.044. 
      Epub 2012 Jun 30.