Diazepam Binding Inhibitor and Dehydroepiandrosterone Sulphate Plasma Levels in Borderline Personality Disorder Adolescents

Abstract

Background: Borderline personality disorder (BPD) patients display a complex and heterogeneous clinical phenotype that plausibly implies variable underlying pathogenic mechanisms. A dysregulation of peripheral benzodiazepine receptors has previously been shown in BPD peripheral tissues, implying possible alterations of its ligand, the diazepam binding inhibitor (DBI) or of the downstream products of its activation, i.e. neuroactive steroids. Methods: The aim of this work consisted in assessing, by ELISA, fasting plasma levels of DBI and dehydroepiandrosterone sulphate (DHEA-S), including cortisol and the cortisol-to-DHEA-S molar ratio (CDR), in 17 BPD adolescents versus 13 healthy controls, testing the possibility that clinical scales related to depressive or anxious traits (CDI, STAI-Y) or to disease severity (BPDCL) might be associated with a selective dysregulation of these parameters. Results: DBI plasma levels were unchanged, while DHEA-S ones were significantly increased (approx. 70%) and the CDR decreased in BPD patients. No meaningful correlations with clinical variables emerged. Conclusion: Our results indicate that a dysfunction of the neurosteroid system might be operative in BPD in spite of unchanged DBI plasma levels and that DHEA-S might represent a generalized trait marker for the altered stress response that is associated with this disorder.

A systematic review of the neurobiological underpinnings of borderline personality disorder (BPD) in childhood and adolescence

“…Of the 209 full text articles reviewed, we identified 25 studies providing information on the neurobiological correlates of BPD. We identified a further three relevant studies via hand search (Coolidge, Thede, & Jang, 2001;Houston, Ceballos, Hesselbrock, & Bauer, 2005;Jovev et al, 2008 articles from the updated search Conti et al, 2013;Kaess, Parzer, Koenig, Resch, & Brunner, 2016;Kalpakci, Vanwoerden, Elhai, & Sharp, 2016;Zhang et al, 2015). Therefore, a total of 34 studies are included in the review.…”

“…We identified one study examining dysfunction of the neurosteroid system in adolescents with BPD (Conti et al, 2013). The authors compared BPD patients (M age =15.5; SD=1.2) to healthy controls on diazepam binding inhibitor (DBI) and dehydroepiandrosterone sulphate (DHEA-S) plasma levels, and also cortisol to DHEA-S molar ratio (CDR).…”

“…For example, findings from neurocognitive studies may directly inform social-cognitive therapies, i.e., adolescents may be taught to replace emotionally driven interpretations , while neurochemical studies could underpin pharmacological regimens (Conti et al, 2013). We would like to thank the editor for inviting us to revise our manuscript.…”

“…We conducted an updated search on June 4 th 2016. This yielded an additional 6 studies Conti et al, 2013;Kaess, Parzer, Koenig, Resch, & Brunner, 2016;Kalpakci, Vanwoerden, Elhai, & Sharp, 2016;Zhang et al, 2015).…”

“…Please see page 6, 2 nd paragraph: Conti et al, 2013;Kaess et al, 2016;Kalpakci et al, 2016;Zhang et al, 2015). Therefore, a total of 34 studies are included in the review.…”