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Are ICAM, VCAM and E-selectin levels different in first manic episode and subsequent remission?
Cetin Turan1, Sermin Kesebir1, Ozgür Süner1
1Erenköy Mental and Neurological Disease Training and Research Hospital, Sinan Ercan C. N: 29 Kadıköy, İstanbul, Turkey.
Insights
Bipolar patients show elevated levels of intercellular adhesion molecule (ICAM) and vascular cell adhesion molecule (VCAM) during their first manic episode. These levels decrease during remission, indicating a potential cardiovascular disease risk marker present at the onset of bipolar disorder.
Area of Science:
- Cardiovascular Health
- Psychiatric Disorders
- Biomarkers
Background:
- Bipolar disorder is associated with a two-fold higher mortality rate from cardiovascular diseases compared to other psychiatric conditions.
- Specific cellular adhesion molecules, including intercellular adhesion molecule (ICAM), vascular cell adhesion molecule (VCAM), and E-selectin, have been linked to cardiovascular disease risk.
Purpose of the Study:
- To compare plasma levels of ICAM, VCAM, and E-selectin in patients experiencing their first manic episode versus those in remission and healthy controls.
- To investigate the relationship between adhesion molecule levels and clinical and metabolic variables in bipolar patients.
Main Methods:
- The study included 50 patients with their first manic episode and 50 healthy controls, matched for age, gender, BMI, and smoking status.
- Plasma levels of ICAM, VCAM, E-selectin, fasting blood glucose, lipids (total cholesterol, LDL, HDL), and triglycerides were measured.
- Remission status was confirmed using the Young Mania Rating Scale and Hamilton Depression Rating Scale.
Main Results:
- ICAM and VCAM levels were significantly higher in patients during their first manic episode compared to those in remission and healthy individuals.
- Weak correlations were observed between ICAM levels and YMRS scores, total cholesterol, LDL cholesterol, and BMI in manic patients.
- ICAM, VCAM, and E-selectin levels showed a weak correlation with BMI in the manic episode group.
Conclusions:
- Elevated ICAM and VCAM levels indicate a proinflammatory and prothrombotic state, a risk factor for metabolic syndrome and cardiovascular disease, present at the onset of bipolar disorder.
- These adhesion molecule levels increase during manic episodes and return to normal during remission, suggesting they are dynamic markers.
- The findings highlight a probable cardiovascular disease risk already present at the disease's onset, independent of chronic psychotropic medication use.
Objective:
In bipolar patients, the rate of mortality from cardiovascular diseases is two-fold higher than that in other psychiatric disorders. The risk of cardiovascular diseases was found to be associated with some cellular adhesion molecules: Intracellular adhesion molecule (ICAM), vascular cell adhesion molecule (VCAM) and E-selectin. The aim of this study was to compare ICAM, VCAM and E-selectin levels at first manic episode and subsequent remission period, and to investigate the presence of a relationship between adhesion molecules levels and clinical and metabolic variables.
Methods:
In line with this purpose, 50 patients diagnosed with mania according to DSM IV-TR criteria, who had their first episode were evaluated consecutively. The control group consisted of 50 healthy individuals without any history of psychiatric admission and treatment, matched with the manic patients in terms of age, gender, BMI and smoking status. For the confirmation of subsequent remission period (n=40), Young Mania Rating Scale and Hamilton Depression Rating Scale were used. In three groups plasma ICAM, VCAM and E-selectin, fasting blood glucose, total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride levels were measured and compared.
Results:
ICAM and VCAM levels were found to be higher in first manic episode than those in subsequent remission and healthy individuals. A weak correlation was found between ICAM levels and YMRS scores in manic patients. In first manic episode, a weak correlation was found between ICAM and total cholesterol and LDL cholesterol levels and a weak correlation was found between ICAM, VCAM and E-selectin levels and BMI.
Conclusion:
In the present study, which is the first investigation of proinflammatory and prothrombotic state, which is defined as a risk for metabolic syndrome and cardiovascular disease, in bipolar disorder, ICAM and VCAM levels were found to be higher in first episode mania than those in subsequent remission and healthy individuals. As the study group included first episode mani cases, there was no effect of chronic psychotropic use. Probable risk of cardiovascular disease, reflected by increased ICAM and VCAM levels is already present in bipolar patients at the onset of the disease. In addition, ICAM and VCAM levels increasing in manic episode, return to normal in the subsequent remission period.
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