Peripheral brain-derived neurotrophic factor (BDNF) as a biomarker in bipolar disorder: a meta-analysis of 52 studies.
Peripheral brain-derived neurotrophic factor (BDNF) as a biomarker in bipolar disorder: a meta-analysis of 52 studies.
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DOI：
10.1186/s12916-015-0529-7
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发表时间：
2015-11-30
期刊：
影响因子：
9.3
通讯作者：
Carvalho AF
中科院分区：
文献类型：
--
作者：
Fernandes BS;Molendijk ML;Köhler CA;Soares JC;Leite CM;Machado-Vieira R;Ribeiro TL;Silva JC;Sales PM;Quevedo J;Oertel-Knöchel V;Vieta E;González-Pinto A;Berk M;Carvalho AF
神经营养假说认为，心境障碍如双相情感障碍（BD）与脑源性神经营养因子（BDNF）的低表达有关。然而，其在外周血中作为疾病活动性和BD阶段的生物标志物的作用，超越病理生理学，仍然存在争议。在过去的几年中，越来越多的临床研究评估BDNF在血清和血浆中已被公布。因此，现在有可能分析BDNF水平与BD情感症状严重程度之间的关联，以及情绪发作的急性药物治疗对BDNF水平的影响。我们对所有关于双相情感障碍患者血清和血浆BDNF水平的研究进行了系统回顾和荟萃分析。通过一系列荟萃分析，包括总共52项研究，6，481名参与者，我们表明，与健康对照组相比，周围BDNF水平在躁狂（Hedges' g =-0.57，P = 0.010）和抑郁（Hedges' g =-0.93，P = 0.001）发作中降低到相同程度，而BDNF水平在正常心境中没有显著改变。在元回归分析中，BDNF水平与躁狂和抑郁症状的严重程度呈负相关。我们没有发现疾病持续时间对BDNF水平有显著影响的证据。此外，在血浆中，而不是血清中，外周BDNF水平增加后，成功治疗急性躁狂发作，但不是抑郁症。总之，我们的数据表明，外周BDNF水平，更清楚地在血浆中比在血清中，是一个潜在的生物标志物的疾病活动在BD，但不是一个生物标志物的阶段。我们认为，外周BDNF可能，在未来，被用来作为血液蛋白复合物的措施，以评估疾病活动在BD的一部分。本文的在线版本（doi：10.1186/s12916-015-0529-7）包含补充材料，可供授权用户使用。
The neurotrophic hypothesis postulates that mood disorders such as bipolar disorder (BD) are associated with a lower expression of brain-derived neurotrophic factor (BDNF). However, its role in peripheral blood as a biomarker of disease activity and of stage for BD, transcending pathophysiology, is still disputed. In the last few years an increasing number of clinical studies assessing BDNF in serum and plasma have been published. Therefore, it is now possible to analyse the association between BDNF levels and the severity of affective symptoms in BD as well as the effects of acute drug treatment of mood episodes on BDNF levels. We conducted a systematic review and meta-analysis of all studies on serum and plasma BDNF levels in bipolar disorder. Through a series of meta-analyses including a total of 52 studies with 6,481 participants, we show that, compared to healthy controls, peripheral BDNF levels are reduced to the same extent in manic (Hedges’ g = −0.57, P = 0.010) and depressive (Hedges’ g = −0.93, P = 0.001) episodes, while BDNF levels are not significantly altered in euthymia. In meta-regression analyses, BDNF levels additionally negatively correlate with the severity of both manic and depressive symptoms. We found no evidence for a significant impact of illness duration on BDNF levels. In addition, in plasma, but not serum, peripheral BDNF levels increase after the successful treatment of an acute mania episode, but not of a depressive one. In summary, our data suggest that peripheral BDNF levels, more clearly in plasma than in serum, is a potential biomarker of disease activity in BD, but not a biomarker of stage. We suggest that peripheral BDNF may, in future, be used as a part of a blood protein composite measure to assess disease activity in BD. The online version of this article (doi:10.1186/s12916-015-0529-7) contains supplementary material, which is available to authorized users.