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Review
. 2022 Jun 9;10(6):1368.
doi: 10.3390/biomedicines10061368.

Clinical Value of Inflammatory and Neurotrophic Biomarkers in Bipolar Disorder: A Systematic Review and Meta-Analysis

Amanda Vega-Núñez  1   2   3 , Carlos Gómez-Sánchez-Lafuente  1   2   3 , Fermín Mayoral-Cleries  1   3 , Antonio Bordallo  1   3 , Fernando Rodríguez de Fonseca  1   3 , Juan Suárez  1   4 , José Guzmán-Parra  1   3
Affiliations
Review

Clinical Value of Inflammatory and Neurotrophic Biomarkers in Bipolar Disorder: A Systematic Review and Meta-Analysis

Amanda Vega-Núñez et al. Biomedicines. .

Abstract

Bipolar disorder (BD) is a multifactorial chronic psychiatric disease highly defined by genetic, clinical, environmental and social risk factors. The present systematic review and meta-analysis aimed to examine the relationship between inflammatory and neurotrophic factors and clinical, social and environmental factors involved in the development and the characterization of BD. Web of Science, PubMed, PsycINFO, Scopus and Science Direct were searched by two independent reviewers. The systematic review was registered in PROSPERO (CRD42020180626). A total of 51 studies with 4547 patients with a diagnosis of BD were selected for systematic review. Among them, 18 articles were included for meta-analysis. The study found some evidence of associations between BDNF and/or inflammatory factors and different stressors and functional and cognitive impairment, but limitations prevented firm conclusions. The main finding of the meta-analysis was a negative correlation between circulating levels of BDNF and depression severity score (standardized mean difference = -0.22, Confidence Interval 95% = -0.38, -0.05, p = 0.01). Evidence indicates that BDNF has a role in the depressive component of BD. However, the poor consistency found for other inflammatory mediators clearly indicates that highly controlled studies are needed to identity precise biomarkers of this disorder.

Keywords: BDNF; biomarker; bipolar disorder; clinical factors; cytokines; depression; mania; meta-analysis; neurotrophins; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) diagram. Following exclusion criteria, a total of 51 studies were selected for systematic review. Among them, 18 articles were included for meta-analysis.
Figure 2
Figure 2
Forest plot of the meta-analysis of BDNF in patients with BD1 subtype compared to those with BD2 subtype in three selected studies (21, 40, 45 in Table 1).
Figure 3
Figure 3
Forest plot of the meta-analysis of BDNF in (a) depression compared to euthymia from the data of three selected studies (18, 33a, 42 in Table 1), (b) mania compared to euthymia (b) from the data of five selected studies (2, 18, 32, 33a, 42 in Table 1), and (c) TNF-α in depression compared to mania from the data of three selected studies (18, 34, 44a in Table 1).
Figure 4
Figure 4
Forest plot of correlations between inflammatory factors (BDNF, IL-6 and TNF-α) and (a) depression severity score (HDRS or MADRS) from the data of selected studies (11, 12, 13, 21, 30b, 35, 40, 42, 44a in Table 1) and (b) mania severity score (YMRS) from the data of selected studies (11, 13, 22, 26, 35, 40, 42, 43, 44a in Table 1).
See this image and copyright information in PMC

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