Purinergic system dysfunctions in subjects with bipolar disorder: A comparative cross-sectional study

Bartoli, Francesco; Crocamo, Cristina; Dakanalis, Antonios; Brosio, Enrico; Miotto, A.; Capuzzi, Enrico; Clerici, Massimo; Carrà, Giuseppe

doi:10.1016/j.comppsych.2016.09.011

Cited by 45 publications

(33 citation statements)

References 34 publications

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“…Moreover, UA levels were higher in BD manic/mixed phases as compared with depressive ones (SMD = 0.34), suggesting its role as a state biomarker. This finding was also confirmed by a recent observational study, 7 showing an association between bipolar mania and increased UA, after controlling for relevant confounders, such as metabolic profile and oxidative stress parameters. On the other hand, subjects with bipolar depression and those with major depressive disorder shared similar features on UA levels, thus not supporting the utility of UA in differentiating unipolar and bipolar depression.…”

supporting

confidence: 83%

Purinergic dysfunction in bipolar disorder: Any role for the antioxidant uric acid as a trait and state biomarker?

Bartoli

Carrà

Clerici

2017

Psychiatry Clin Neurosci

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supporting

confidence: 83%

Purinergic dysfunction in bipolar disorder: Any role for the antioxidant uric acid as a trait and state biomarker?

Bartoli

Carrà

Clerici

2017

Psychiatry Clin Neurosci

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“…In a cross‐sectional study, Bartoli et al recently compared UA levels between 128 subjects with BD and 118 with MDD, admitted as psychiatric inpatients. Patients with bipolar mania, but not those with bipolar depression, were found to have higher levels of serum UA ( P < 0.05), when compared with MDD . The differences in study design, diagnostic methodology, or sample characteristics are possible explanations for the apparent discrepant findings.…”

Section: Discussionmentioning

confidence: 86%

Serum uric acid as a predictor of bipolarity in individuals with a major depressive episode

et al. 2018

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| INTRODUC TI ONBipolar Disorder (BD) is one of the top 20 leading causes of disability worldwide. 1 It affects more than 1% of the population, with an estimated lifetime prevalence of 0.6% for type I BD, 0.4% for type II BD, and 1.4% for subthreshold manifestations of BD. 2 Despite the availability of effective treatments, the delay between the onset of BD and its diagnosis and management is often very long, with a pooled interval of almost 6 years. 3 Early diagnosis is difficult in clinical practice because the onset of BD is often characterized by a Objectives: There are no well-established biomarkers to predict the risk of conversion to bipolar disorder (BD) in patients with depression. Given the putative role of purinergic neurotransmission dysfunction in BD, the purpose of our study was to evaluate if higher serum uric acid (UA) levels could predict BD conversion in depressed inpatients. Methods:We reviewed retrospectively the records of subjects hospitalized between June 2007 and June 2010 with a diagnosis of major depressive disorder (MDD) who had undergone routine UA levels testing at admission. At an approximate 10-year follow-up we identified subjects with a subsequent diagnosis of BD. We compared UA levels between the BD-converter and non-BD converter groups, performed Receiver operating characteristic curve analysis to evaluate the prognostic accuracy of serum UA levels and calculated the clinical utility index (CUI) as a risk biomarker for conversion to BD. Results:The study included 250 subjects (55 "BD-converters" and 195 "No BD-converters"). "BD-converters" had significantly higher plasma UA levels compared to "No BD-converters" in their index hospitalization irrespective of gender (males:403.84 ± 91.76 vs 270.81 ± 53.58 µmol/L; U = 94.5, P < 0.001 and females 302.19 ± 52.64 vs 202.69 ± 48.93 µmol/L; t = 10.75, P < 0.001). Serum UA levels showed a very good to excellent accuracy for predicting conversion to BD in inpatients with MDD (area under the curve [AUC]: 0.90; 95% CI: 0.86, 0.94) and had a good to excellent CUI− and a moderate to good CUI+ grading for discriminating BDconverter cases from non-BD converters. Conclusions:Our study suggests that depressed patients with higher levels of serum UA are at greater risk of a subsequent manic or hypomanic episode. The purinergic system could prove a promising path for the search of biomarkers in BD. K E Y W O R D Sbipolar disorder, major depressive disorder, uric acid

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“…Another meta-analysis has shown that uric acid levels in individuals with depression were significantly lower than in those suffering from bipolar disorder [95]. Interestingly, subjects with bipolar disorder might have increased uric acid levels [96,97] and might benefit from drugs lowering uric acid [98]. Consistent with these findings, uric acid has been proposed as a diagnostic marker that may differentiate 'unipolar' and bipolar depression [99].…”

Section: Purinergic Metabolism and Biomarkersmentioning

confidence: 88%

Purinergic Signaling and Related Biomarkers in Depression

et al. 2020

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It is established that purinergic signaling can shape a wide range of physiological functions, including neurotransmission and neuromodulation. The purinergic system may play a role in the pathophysiology of mood disorders, influencing neurotransmitter systems and hormonal pathways of the hypothalamic-pituitary-adrenal axis. Treatment with mood stabilizers and antidepressants can lead to changes in purinergic signaling. In this overview, we describe the biological background on the possible link between the purinergic system and depression, possibly involving changes in adenosine- and ATP-mediated signaling at P1 and P2 receptors, respectively. Furthermore, evidence on the possible antidepressive effects of non-selective adenosine antagonist caffeine and other purinergic modulators is reviewed. In particular, A2A and P2X7 receptors have been identified as potential targets for depression treatment. Preclinical studies highlight that both selective A2A and P2X7 antagonists may have antidepressant effects and potentiate responses to antidepressant treatments. Consistently, recent studies feature the possible role of the purinergic system peripheral metabolites as possible biomarkers of depression. In particular, variations of serum uric acid, as the end product of purinergic metabolism, have been found in depression. Although several open questions remain, the purinergic system represents a promising research area for insights into the molecular basis of depression.

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Purinergic system dysfunctions in subjects with bipolar disorder: A comparative cross-sectional study

Cited by 45 publications

References 34 publications

Purinergic dysfunction in bipolar disorder: Any role for the antioxidant uric acid as a trait and state biomarker?

Purinergic dysfunction in bipolar disorder: Any role for the antioxidant uric acid as a trait and state biomarker?

Serum uric acid as a predictor of bipolarity in individuals with a major depressive episode

Purinergic Signaling and Related Biomarkers in Depression

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