C-Reactive Protein in Bipolar Disorder in an Indian Clinical Setting
Journal Title: Journal of Clinical and Diagnostic Research - Year 2018, Vol 12, Issue 9
Abstract
ABSTRACT Introduction: Serious psychiatric illnesses like bipolar disorder lack specific biomarkers of diagnosis or prognosis. However, association between Bipolar Disorder (BD) and various inflammatory markers has been consistently demonstrated by earlier studies pointing to underlying inflammation/dysimmunity. Often implicated in particular is the acute phase C-Reactive Protein (CRP) of hepatic origin, a generic marker of inflammation which is robust and very easy to test even in field settings without the need for a laboratory. Aim: To study the status of CRP, a generic marker of inflammation, in a well-characterised south Indian Tamil BD cohort, and investigate whether it can be a specifier of disease state. Materials and Methods: CRP was qualitatively estimated by latex agglutination method in the serum of 145 BD patients and 151 healthy controls. Statistical analyses were performed to test the association of CRP with the disease state. Results: It was found that, after controlling for age, gender, BMI and smoking status, CRP positivity (>0.6 mg/dL) was: (i) significantly higher among BD patients compared to healthy controls; (ii) significantly higher among patients having an acute mood episode (both mania (n=85), and depression (n=9) combined) compared to patients with residual symptoms or in remission, as well as compared to healthy subjects; (iii) not significantly different between patients in acute mania versus acute depression, but significantly higher in both acute mania and in acute depression compared to patients with residual symptoms or in remission. Conclusion: CRP, a robust generic inflammatory marker is significantly higher among BD patients as compared to normal controls, pointing to underlying inflammation operating in the disease. Also, it can differentiate between patients in acute phase and those in remission or having residual symptoms. If validated in longitudinal follow-up studies, these results could be helpful in Point Of Care (POC), as well as field settings especially in low income countries to identify patients whose symptoms are progressing towards relapse, at low costs, and without the need for a sophisticated laboratory.
Authors and Affiliations
Apaparna Sundaresh, Ravi Philip Rajkumar, Rajagopapal Krishnamoorthy, Marion Leboyer, Vir Singh Negi, Ryad Tamouza
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