Inflammatory Markers and Brain-Derived Neurotrophic Factor as Potential Bridges Linking Bipolar Disorder and Cardiovascular Risk Among Adolescents

Objectives Over the past two decades, there has been tremendous growth in research regarding bipolar disorder (BD) among children and adolescents (ie, pediatric BD [PBD]). The primary purpose of this article is to distill the extant literature, dispel myths or exaggerated assertions in the field, and disseminate clinically relevant findings. Methods An international group of experts completed a selective review of the literature, emphasizing areas of consensus, identifying limitations and gaps in the literature, and highlighting future directions to mitigate these gaps. Results Substantial, and increasingly international, research has accumulated regarding the phenomenology, differential diagnosis, course, treatment, and neurobiology of PBD. Prior division around the role of irritability and of screening tools in diagnosis has largely abated. Gold-standard pharmacologic trials inform treatment of manic/mixed episodes, whereas fewer data address bipolar depression and maintenance/continuation treatment. Adjunctive psychosocial treatment provides a forum for psychoeducation and targets primarily depressive symptoms. Numerous neurocognitive and neuroimaging studies, and increasing peripheral biomarker studies, largely converge with prior findings from adults with BD. Conclusions As data have accumulated and controversy has dissipated, the field has moved past existential questions about PBD toward defining and pursuing pressing clinical and scientific priorities that remain. The overall body of evidence supports the position that perceptions about marked international (US vs elsewhere) and developmental (pediatric vs adult) differences have been overstated, although additional research on these topics is warranted. Traction toward improved outcomes will be supported by continued emphasis on pathophysiology and novel therapeutics.

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“…241 The second study (40 BD patients and 20 HCs) found elevated IL-6 and TNF-α levels among adolescents with PBD. 242 …”

Section: | Peripheral Biomarkersmentioning

confidence: 99%

The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research

et al. 2017

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“…Similarly, Soeiro-de Souza and colleagues described that patients with recurrent episodes showed increased oxidative and inflammatory markers, which were related to the number of manic episodes ( 101 ). Further, increased inflammation, increased oxidative stress and reduced telomere length have been suggested as possible mechanistic links between psychiatric diseases like bipolar disorder and other systemic diseases, such as endocrine or cardiovascular diseases ( 102 – 105 ). Hence, the identification of a deregulation on those pathways related to both psychiatric and somatic diseases may have therapeutic implications ( 106 ).…”

Section: From Staging To Precision Staging Modelsmentioning

confidence: 99%

Toward Precision Psychiatry in Bipolar Disorder: Staging 2.0

et al. 2018

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Personalized treatment is defined as choosing the “right treatment for the right person at the right time.” Although psychiatry has not yet reached this level of precision, we are on the way thanks to recent technological developments that may aid to detect plausible molecular and genetic markers. At the moment there are some models that are contributing to precision psychiatry through the concept of staging. While staging was initially presented as a way to categorize patients according to clinical presentation, course, and illness severity, current staging models integrate multiple levels of information that can help to define each patient's characteristics, severity, and prognosis in a more precise and individualized way. Moreover, staging might serve as the foundation to create a clinical decision-making algorithm on the basis of the patient's stage. In this review we will summarize the evolution of the bipolar disorder staging model in relation to the new discoveries on the neurobiology of bipolar disorder. Furthermore, we will discuss how the latest and future progress in psychiatry might transform current staging models into precision staging models.

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“…BDNF is considered a biomarker for mental disorders such as bipolar disorder; as these patients have a high risk of developing cardiovascular disease, BDNF could be a link between the two diseases (176). Manni and colleagues demonstrated that serum BDNF was reduced in patients with acute coronary disease (ACD), hence, this neurotrophin may be implicated in the pathogenesis of cardiovascular disease (177); low serum BDNF were also found in patients with ACD during an oral glucose tolerance test (OGTT) (178).…”

Section: Brain- Neuron- Glial Cell Line-derived Neurotrophic Factormentioning

confidence: 99%

Measuring myokines with cardiovascular functions: pre-analytical variables affecting the analytical output

Lombardi¹,

Sansoni²,

Banfi³

2017

Ann. Transl. Med.

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Abstract:In the last few years, a growing number of molecules have been associated to an endocrine function of the skeletal muscle. Circulating myokine levels, in turn, have been associated with several pathophysiological conditions including the cardiovascular ones. However, data from different studies are often not completely comparable or even discordant. This would be due, at least in part, to the whole set of situations related to the preparation of the patient prior to blood sampling, blood sampling procedure, processing and/or store. This entire process constitutes the pre-analytical phase. The importance of the preanalytical phase is often not considered. However, in routine diagnostics, the 70% of the errors are in this phase. Moreover, errors during the pre-analytical phase are carried over in the analytical phase and affects the final output. In research, for example, when samples are collected over a long time and by different laboratories, a standardized procedure for sample collecting and the correct procedure for sample storage are acknowledged. In this review, we discuss the pre-analytical variables potentially affecting the measurement of myokines with cardiovascular functions.

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Inflammatory Markers and Brain-Derived Neurotrophic Factor as Potential Bridges Linking Bipolar Disorder and Cardiovascular Risk Among Adolescents

Cited by 36 publications

References 0 publications

The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research

The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research

Toward Precision Psychiatry in Bipolar Disorder: Staging 2.0

Measuring myokines with cardiovascular functions: pre-analytical variables affecting the analytical output

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