Study On The Correlation Between Different Emotional States And TCM Syndrome Types Of Bipolar Disorder And Cytokine Expression Level

Objective: Explore the correlation between the expression level of cytokines in peripheral blood of patients with bipolar disorder and different emotional states and different TCM syndrome types,in order to find an objective basis for the diagnosis of bipolar disorder in different emotional states and TCM syndrome differentiation and classification.Methods: 1.From September 2020 to March 2023,80 patients with bipolar disorder hospitalized in Hunan Provincial Brain Hospital were included in Experiment 1.According to the diagnostic and statistical manual of mental disorders(5th Edition),they were divided into a manic episodes group of 50 patients and a depressive episodes group of 30 patients,and 40 healthy control patients in the same period were collected.2.From September 2020 to March 2023,60 inpatients with bipolar disorder who met the diagnostic criteria of the diagnostic and statistical manual of mental disorders(5th Edition)and hospitalized in Hunan Provincial Brain Hospital were included in Experiment 2.According to the the Expert consensus on TCM syndrome differentiation criteria for bipolar disorder,they were divided into 30 patients in the syndrome of hyperactivity fire of heart and liver group and 30 patients in the syndrome of the liver depression and spleen deficiency group,and 40 healthy control patients in the same period were collected.3.Collect general demographic data for all subjects using a self-made case report form;The Chinese version of The Mini-International Neuropsychiatric Interview(MINI)was used to interview patients;Hamilton Depression Scale(HAMD)and Young’s Mania Rating Scale(YMRS)were used to assess the clinical symptoms of patients.In Experiment 2,the self-made information questionnaire for the four diagnoses of traditional Chinese medicine was used to collect patients’ TCM syndrome data for dialectical purposes.4.Using a fully automatic biochemical analyzer in the laboratory to measure general biochemical indicators such as liver function,renal function,blood sugar,blood lipids,etc.of patients;The serum levels of CD30,BAFF,s TNF-R1,and CXCL10 were measured by enzyme linked immunosorbent assay(ELISA).5.SPSS 26.0 statistical software was used for data analysis.Results: 1.The lymphocyte ratio(LY%)and albumin level in the manic episode group were lower than those in the depressive episode group and the healthy control group,while the neutrophil ratio(NEUT%)was higher than those in the depressive episode group and the healthy control group,with a significant difference(P<0.05).2.Compared with the healthy control group,the expression levels of CD30 and BAFF in the manic episode group were higher(P<0.001),while the expression levels of CXCL10 were lower(P<0.001),and the difference in the expression levels of s TNF-R1 was not significant(P>0.05).Compared with the healthy control group,the expression levels of CD30 and BAFF in the depressive episode group were higher(P<0.001),while the expression levels of s TNF-R1 and CXCL10 were not significantly different(P>0.05).Compared with the depressive episode group,the manic episode group had higher levels of BAFF and s TNF-R1 expression(P<0.01),lower levels of CXCL10 expression(P<0.001),and no significant difference in CD30 expression(P>0.05).3.Compared with the healthy control group,the levels of CD30 and BAFF in the syndrome of hyperactivity fire of heart and liver group were higher(P<0.01),while the levels of CXCL10 were lower(P<0.001),and there was no significant difference in the levels of s TNF-R1(P>0.05).Compared with the healthy control group,the levels of CD30 and BAFF in the syndrome of the liver depression and spleen deficiency group were higher(P<0.01),while the levels of s TNF-R1 and CXCL10 were not significantly different(P>0.05).Compared with the syndrome of the liver depression and spleen deficiency group,the levels of BAFF and s TNF-R1 in the syndrome of hyperactivity fire of heart and liver group were higher(P<0.01),and the levels of CXCL10 were lower(P<0.001),and the level of CD30 was not significantly different(P>0.05).4.The serum CD30 level in manic episode patients was positively correlated with albumin(r=0.346,P=0.014);The level of BAFF was positively correlated with albumin(r=0.389,P=0.005);CXCL10 levels were positively correlated with albumin(r=0.387,P=0.006).5.The CXCL10 of patients with depressive episodes is positively correlated with the total score of HAMD,anxiety/somatization factor scores,and cognitive impairment factor score,indicating that CXCL10 may be related to the levels of depression,anxiety,and cognitive impairment in patients with depressive episodes.6.The serum level of CXCL10 was positively correlated with the total score of HAMD(r=0.533,P=0.002),with anxiety/somatization factor scores(r=0.577,P=0.001),and with cognitive impairment factor scores(r=0.458,P=0.011).8.The ROC curve area(AUC)of serum CD30,BAFF,and CXCL10 in the diagnosis of manic episodes were 0.993,0.791,and 0,respectively,indicating that serum CD30,BAFF,and CXCL10 have clinical value in the diagnosis of bipolar disorder manic episodes(P<0.001).Conclusion: 1.As a comprehensive reflection of two different immune pathways,NLR is higher in bipolar disorder patients during manic episodes,and may be a predictive factor for bipolar disorder manic episodes.2.The lower serum albumin levels in bipolar disorder patients with manic episodes suggest that the antioxidant capacity of bipolar disorder patients during manic episodes is lower than during depressive episodes.3.The levels of CD30 and BAFF in manic and depressive patients with bipolar disorder are higher than those in healthy individuals,which may be a biological indicator for the diagnosis of bipolar disorder.CXCL10 in patients with bipolar disorder manic episodes was significantly lower than that in patients with depressive episodes and healthy controls,which may be a biological indicator for the diagnosis of bipolar disorder manic episodes.4.There are significant differences in the expression levels of BAFF,s TNF-R1,and CXCL10 between manic and depressive patients with bipolar disorder,which may be a status marker for diagnosing different emotional states in patients with bipolar disorder.5.CXCL10 in patients with depressive episodes was positively correlated with the total score of HAMD,anxiety/somatization factor scores,and cognitive impairment factor scores,suggesting that CXCL10 may be related to the level of depression,anxiety,and cognitive impairment in patients with depressive episodes.6.There are significant differences in BAFF,s TNF-R1,and CXCL10 between the patients with bipolar disorder with the syndrome of hyperactivity fire of heart and liver group and the patients with the syndrome of the liver depression and spleen deficiency group,suggesting that the above biomarkers may be related to the dialectical classification of bipolar disorder in traditional Chinese medicine.