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Correlation between white blood cell count and mood-stabilising treatment response in two bipolar disorder trials

Published online by Cambridge University Press:  06 June 2019

Ole Köhler-Forsberg Open the ORCID record for Ole Köhler-Forsberg [Opens in a new window] ,
Louisa G. Sylvia ,
Charles L. Bowden ,
Joseph R. Calabrese ,
Michael E. Thase ,
Richard C. Shelton ,
Melvin McInnis ,
Mauricio Tohen ,
James H. Kocsis  and
Terence A. Ketter
...Show all authors
Ole Köhler-Forsberg*
Affiliation:
Department of Clinical Medicine, Aarhus University Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
Louisa G. Sylvia
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA
Charles L. Bowden
Affiliation:
Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA
Joseph R. Calabrese
Affiliation:
Department of Psychiatry, Case Western Reserve University, Cleveland, OH, USA
Michael E. Thase
Affiliation:
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
Richard C. Shelton
Affiliation:
Department of Psychiatry, University of Alabama at Birmingham, Birmingham, AL, USA
Melvin McInnis
Affiliation:
Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
Mauricio Tohen
Affiliation:
Department of Psychiatry, University of New Mexico Health Science Center, Albuquerque, NM, USA
James H. Kocsis
Affiliation:
Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
Terence A. Ketter
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
Edward S. Friedman
Affiliation:
Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
Thilo Deckersbach
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA
Michael J. Ostacher
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
Dan V. Iosifescu
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
Susan McElroy
Affiliation:
Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH and Lindner Center of HOPE, Mason, OH, USA
Andrew A. Nierenberg
Affiliation:
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA
*
Author for correspondence: Ole Köhler-Forsberg, Email: [email protected]
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Abstract

Background:

Immune system markers may predict affective disorder treatment response, but whether an overall immune system marker predicts bipolar disorder treatment effect is unclear.

Methods:

Bipolar CHOICE (N = 482) and LiTMUS (N = 283) were similar comparative effectiveness trials treating patients with bipolar disorder for 24 weeks with four different treatment arms (standard-dose lithium, quetiapine, moderate-dose lithium plus optimised personalised treatment (OPT) and OPT without lithium). We performed secondary mixed effects linear regression analyses adjusted for age, gender, smoking and body mass index to investigate relationships between pre-treatment white blood cell (WBC) levels and clinical global impression scale (CGI) response.

Results:

Compared to participants with WBC counts of 4.5–10 × 109/l, participants with WBC < 4.5 or WBC ≥ 10 showed similar improvement within each specific treatment arm and in gender-stratified analyses.

Conclusions:

An overall immune system marker did not predict differential treatment response to four different treatment approaches for bipolar disorder all lasting 24 weeks.

Keywords

bipolar disorderlithiumquetiapinetreatment responsewhite blood cell
Type
Short Communication
Information
Acta Neuropsychiatrica , Volume 31 , Issue 4 , August 2019 , pp. 230 - 234
Copyright
© Scandinavian College of Neuropsychopharmacology 2019 

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References

Amitai, M, Zivony, A, Kronenberg, S, Nagar, L, Saar, S, Sever, J, Apter, A, Shoval, G, Golubchik, P, Hermesh, H, Weizman, A, Zalsman, G. (2014) Short-term effects of lithium on white blood cell counts and on levels of serum thyroid-stimulating hormone and creatinine in adolescent inpatients: a retrospective naturalistic study. Journal of Child and Adolescent Psychopharmacology 24(9), 494–500.CrossRefGoogle ScholarPubMed
Bai, YM, Su, TP, Tsai, SJ, Wen-Fei, C, Li, CT, Pei-Chi, T, Mu-Hong, C. (2014) Comparison of inflammatory cytokine levels among type I/type II and manic/hypomanic/euthymic/depressive states of bipolar disorder. Journal of Affective Disorders 166, 187–192.CrossRefGoogle ScholarPubMed
Bowden, CL, Vieta, E, Ice, KS, Schwartz, JH, Wang, PP and Versavel, M (2010) Ziprasidone plus a mood stabilizer in subjects with bipolar I disorder: a 6-month, randomized, placebo-controlled, double-blind trial. The Journal of Clinical Psychiatry 71(2), 130–137.CrossRefGoogle Scholar
Brod, S, Rattazzi, L, Piras, G, D’Acquisto, F (2014) ‘As above, so below’ examining the interplay between emotion and the immune system. Immunology 143(3), 311–318.CrossRefGoogle ScholarPubMed
Cassidy, F, Wilson, WH and Carroll, BJ (2002) Leukocytosis and hypoalbuminemia in mixed bipolar states: evidence for immune activation. Acta Psychiatrica Scandinavica 105(1), 60–64.CrossRefGoogle ScholarPubMed
Dargel, AA, Godin, O, Kapczinski, F, Kupfer, DJ and Leboyer, M (2015) C-reactive protein alterations in bipolar disorder: a meta-analysis. The Journal of Clinical Psychiatry 76(2), 142–150.CrossRefGoogle ScholarPubMed
Dickerson, F, Katsafanas, E, Schweinfurth, LA, Savage, CL, Stallings, C, Origoni, A, Khushalani, S, Lillehoj, E, Yolken, R. (2015) Immune alterations in acute bipolar depression. Acta Psychiatrica Scandinavica 132(3), 204–210.CrossRefGoogle ScholarPubMed
Drexhage, RC, Knijff, EM, Padmos, RC, Heul-Nieuwenhuijzen, L, Beumer, W, Versnel, MA, Drexhage, HA. (2010) The mononuclear phagocyte system and its cytokine inflammatory networks in schizophrenia and bipolar disorder. Expert Review of Neurotherapeutics 10(1), 59–76.CrossRefGoogle ScholarPubMed
Hope, S, Dieset, I, Agartz, I, Steen, NE, Ueland, T, Melle, I, Aukrust, P, Andreassen, OA. (2011) Affective symptoms are associated with markers of inflammation and immune activation in bipolar disorders but not in schizophrenia. Journal of Psychiatric Research 45(12), 1608–1616.CrossRefGoogle ScholarPubMed
Hope, S, Hoseth, E, Dieset, I, Mørch, RH, Aas, M, Aukrust, P, Djurovic, S, Melle, I, Ueland, T, Agartz, I, Ueland, T, Westlye, LT, Andreassen, OA. (2015) Inflammatory markers are associated with general cognitive abilities in schizophrenia and bipolar disorder patients and healthy controls. Schizophrenia Research 165(2–3), 188–194.CrossRefGoogle ScholarPubMed
Hope, S, Ueland, T, Steen, NE, Dieset, I, Lorentzen, S, Berg, AO, Agartz, I, Aukrust, P, Andreassen, OA. (2013) Interleukin 1 receptor antagonist and soluble tumor necrosis factor receptor 1 are associated with general severity and psychotic symptoms in schizophrenia and bipolar disorder. Schizophrenia Research 145(1–3), 36–42.CrossRefGoogle ScholarPubMed
Köhler, O, Sylvia, LG, Bowden, CL, Calabrese, JR, Thase, M, Shelton, RC, McInnis, M, Tohen, M, Kocsis, JH, Ketter, TA, Friedman, ES, Deckersbach, T, Ostacher, MJ, Iosifescu, DV, McElroy, S, Nierenberg, AA. (2017) White blood cell count correlates with mood symptom severity and specific mood symptoms in bipolar disorder. Australian and New Zealand Journal of Psychiatry 51(4), 355–365.CrossRefGoogle ScholarPubMed
Köhler-Forsberg, O, Sylvia, L, Deckersbach, T, Ostacher, MJ, McInnis, M, Iosifescu, D, Bowden, C, McElroy, S, Calabrese, J, Thase, M, Shelton, RC, Tohen, M, Kocsis, J, Friedman, E, Ketter, T, Nierenberg, AA. (2018) Clinically relevant and simple immune system measure is related to symptom burden in bipolar disorder. Acta Neuropsychiatrica 30(5), 297–305.CrossRefGoogle ScholarPubMed
Li, H, Hong, W, Zhang, C, Wu, Z, Wang, Z, Yuan, C, Li, Z, Huang, J, Lin, Z, Fang, Y. (2015) IL-23 and TGF-beta1 levels as potential predictive biomarkers in treatment of bipolar I disorder with acute manic episode. Journal of Affective Disorders 174, 361–366.CrossRefGoogle ScholarPubMed
Liu, B and Taioli, E (2015) Seasonal variations of complete blood count and inflammatory biomarkers in the US population – analysis of NHANES data. PLoS One 10(11), e0142382.CrossRefGoogle ScholarPubMed
Lotrich, FE, Butters, MA, Aizenstein, H, Marron, MM, Reynolds, CF 3rd and Gildengers, AG. The relationship between interleukin-1 receptor antagonist and cognitive function in older adults with bipolar disorder. International Journal of Geriatric Psychiatry 2014; 29(6): 635–644.CrossRefGoogle ScholarPubMed
Nierenberg, AA, Sylvia, LG, Leon, AC, Reilly-Harrington, NA, Ketter, TA, Calabrese, JR, Thase, ME, Bowden, CL, Friedman, ES, Ostacher, MJ, Novak, L, Iosifescu, DV, Litmus Study Group. (2009) Lithium treatment – moderate dose use study (LiTMUS) for bipolar disorder: rationale and design. Clinical Trials 6(6), 637–648.CrossRefGoogle ScholarPubMed
Nierenberg, AA, Sylvia, LG, Leon, AC, Reilly-Harrington, NA, Shesler, LW, McElroy, SL, Friedman, ES, Thase, ME, Shelton, RC, Bowden, CL, Tohen, M, Singh, V, Deckersbach, T, Ketter, TA, Kocsis, JH, McInnis, MG, Schoenfeld, D, Bobo, WV, Calabrese, JR, Bipolar CHOICE Study Group. (2014) Clinical and Health Outcomes Initiative in Comparative Effectiveness for Bipolar Disorder (Bipolar CHOICE): a pragmatic trial of complex treatment for a complex disorder. Clinical Trials 11(1), 114–127.CrossRefGoogle ScholarPubMed
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R, Dunbar, GC. (1998) The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. The Journal of Clinical Psychiatry 59(Suppl 20), 22–33; quiz 34–57.Google ScholarPubMed
Spearing, MK, Post, RM, Leverich, GS, Brandt, D andNolen, W (1997) Modification of the Clinical Global Impressions (CGI) Scale for use in bipolar illness (BP): the CGI-BP. Psychiatry Research 73(3), 159–171.CrossRefGoogle ScholarPubMed
Uher, R, Tansey, KE, Dew, T, Maier, W, Mors, O, Hauser, J, Dernovsek, MZ, Henigsberg, N, Souery, D, Farmer, A, McGuffin, P. (2014) An inflammatory biomarker as a differential predictor of outcome of depression treatment with escitalopram and nortriptyline. The American Journal of Psychiatry 171(12), 1278–1286.CrossRefGoogle ScholarPubMed
Vieta, E, T’joen, C, McQuade, RD, Carson, WH Jr, Marcus, RN, Sanchez, R, Owen, R, Nameche, L. (2008) Efficacy of adjunctive aripiprazole to either valproate or lithium in bipolar mania patients partially nonresponsive to valproate/lithium monotherapy: a placebo-controlled study. The American Journal of Psychiatry 165(10), 1316–1325.CrossRefGoogle ScholarPubMed
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