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Role of the IL-6-Receptor expression in CD14+ monocytes in modulating sleep in patients with bipolar disorder
Philipp Ritter1, Moritz Brandt2, Wiebke Schrempf3
1Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Objective:
Bipolar disorder is a severe mental disorder associated with persistent sleep disturbances and elevated levels of mRNA coding for pro-inflammatory cytokines within peripheral monocytes. The mechanisms causing and sustaining a reduced sleep quality remain elusive. The pro-inflammatory cytokine receptor IL-6R is known to negatively affect sleep quality and architecture. Since elevations in IL-6R have repeatedly been demonstrated in bipolar disorder the association of sleep quality and architecture with levels of mRNA coding for IL-6R in monocytes was to be tested.
Methods:
Euthymic patients with bipolar disorder (n = 24) and healthy control subjects (n = 25) were assessed using all night polysomnography (PSG) and six day actigraphy. CD14+ monocytes were isolated on the evening of PSG assessment and levels of mRNA coding for IL-6R and other cytokines were determined using hybridization based assays. Interactions between IL-6R and sleep measures were calculated using linear regression models, adjusting for potential confounders.
Results:
Patients with bipolar disorder were found to have a reduced subjective sleep quality as assessed by the Pittsburgh Sleep Quality Index (PSQI) and more frequent arousals and short changes to wake during sleep. Both PSQI and the frequency of arousals were significantly predicted by levels of IL-6R. Contrary to previous publications, elevated levels of mRNA coding for pro-inflammatory cytokines in peripheral CD14+ monocytes of patients with bipolar disorder could not be replicated.
Limitations:
Participants were only investigated with one night of PSG which may have given rise to first night effects.
Conclusions:
Reduced sleep quality in euthymic patients with bipolar disorder may be related to an increased expression of IL-6R by peripheral monocytes.
Insights
Bipolar disorder patients show poorer sleep quality, linked to higher Interleukin-6 receptor (IL-6R) levels in monocytes. This suggests IL-6R may contribute to sleep disturbances in bipolar disorder.
Area of Science:
- Neuroscience
- Psychiatry
- Immunology
Background:
- Bipolar disorder is frequently linked to persistent sleep disturbances.
- Pro-inflammatory cytokines and their receptors, like Interleukin-6 receptor (IL-6R), are implicated in mental health conditions.
- Elevated IL-6R levels have been observed in bipolar disorder patients, but its direct association with sleep quality remains unclear.
Purpose of the Study:
- To investigate the relationship between sleep quality and architecture and the levels of mRNA coding for IL-6R in peripheral monocytes of euthymic bipolar disorder patients.
- To explore the potential role of IL-6R in mediating sleep disturbances associated with bipolar disorder.
Main Methods:
- Assessed sleep quality and architecture in euthymic bipolar disorder patients (n=24) and healthy controls (n=25) using polysomnography (PSG) and actigraphy.
- Isolated CD14+ monocytes and quantified mRNA levels for IL-6R using hybridization assays.
- Analyzed the association between IL-6R levels and sleep measures using linear regression, controlling for confounders.
Main Results:
- Bipolar disorder patients reported reduced subjective sleep quality (Pittsburgh Sleep Quality Index) and exhibited more frequent arousals and brief awakenings.
- IL-6R levels significantly predicted both subjective sleep quality and the frequency of arousals.
- The study did not replicate previous findings of elevated pro-inflammatory cytokine mRNA in monocytes of bipolar disorder patients.
Conclusions:
- Reduced sleep quality in euthymic bipolar disorder patients may be associated with increased IL-6R expression in peripheral monocytes.
- IL-6R emerges as a potential biomarker and therapeutic target for sleep disturbances in bipolar disorder.
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