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Bipolar disorder patients display reduced serum complement levels and elevated peripheral blood complement expression levels

Published online by Cambridge University Press:  12 April 2017

Uğur Akcan ,
Sercan Karabulut ,
Cem İsmail Küçükali ,
Sibel Çakır  and
Erdem Tüzün
Uğur Akcan
Affiliation:
Department of Neuroscience, Aziz Sancar Institute of Experimental Medical Research, Istanbul University, Istanbul, Turkey
Sercan Karabulut
Affiliation:
Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
Cem İsmail Küçükali
Affiliation:
Department of Neuroscience, Aziz Sancar Institute of Experimental Medical Research, Istanbul University, Istanbul, Turkey
Sibel Çakır
Affiliation:
Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
Erdem Tüzün*
Affiliation:
Department of Neuroscience, Aziz Sancar Institute of Experimental Medical Research, Istanbul University, Istanbul, Turkey
*
*Erdem Tüzün, Department of Neuroscience, Aziz Sancar Institute for Experimental Medicine, Istanbul University, Istanbul 34390, Turkey. Tel: +90-2124142000; Fax: +90-2124142001; E-mail: drerdem@yahoo.com
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Abstract

Objective

Bipolar disorder (BD) patients have recently been shown to exhibit increased proinflammatory cytokine levels indicating the role of inflammation in this disease. As inflammatory responses often include complement level alterations and complement production is influenced by cytokines, we aimed to find out whether complement system is activated in BD in a time-dependent manner and complement factors are involved in BD pathogenesis.

Methods

Serum C4, factor B, sC5b-9 and neuron-specific enolase levels were measured by enzyme-linked immunosorbent assay, whereas peripheral blood mononuclear cell messenger RNA (mRNA) expression levels of C1q, C4, factor B and CD55 were measured by real-time polymerase chain reaction in chronic BD patients (n=22), first episode BD patients (n=24) and healthy controls (n=19).

Results

Serum complement levels were significantly reduced in chronic BD patients as compared with first episode BD patients and healthy controls. Serum levels of complement factors showed significant inverse correlation with disease duration, severity of manic symptoms and serum neuron-specific enolase levels. In chronic BD patients, peripheral blood mononuclear cell mRNA expression levels of C1q, C4 and factor B were significantly elevated, whereas the mRNA expression level of the complement inhibitor CD55 was significantly reduced.

Conclusions

Our results suggest that complement factor levels are reduced in BD presumably due to overconsumption of the complement system and complement production is increased at mRNA level possibly as a compensation measure. Complement factors might potentially be used as indicators of disease severity, neuronal loss and cognitive dysfunction.

Keywords

bipolar disorderC4CD55complementfactor B
Type
Original Article
Information
Acta Neuropsychiatrica , Volume 30 , Issue 2 , April 2018 , pp. 70 - 78
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Copyright
© Scandinavian College of Neuropsychopharmacology 2017 

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