الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: There is strong evidence in literature on the involvement of immune dysregulation in bipolar disorder (BD) pathophysiology. Interleukin-6 (IL-6) plays a dual role in inflammation, acting as pro and anti-inflammatory cytokine. Moreover, its serum levels were found higher in bipolar patients than in healthy control. This study aims to assess the phasic difference of serum IL-6 levels BP-I during euthymia, depression, and mania and identify the relationship between serum IL-6 levels and mood, cognitive abnormalities as well as clinical characteristics of BP-I patients. Methods: Serum IL-6 levels (pg/ml) were measured with a sandwich enzyme-linked immunosorbent assay (ELISA). Depression and mania symptoms were assessed using the Hamilton Depression Rating Scale (HDRS) and the Young Mania Rating Scale (YMRS), respectively. Clinical characteristics were evaluated through a semi-structured clinical psychiatric interview, and cognitive status was tested using the Montreal Cognitive Assessment (MoCA). Results: Serum IL-6 levels were statistically significantly higher in all three phases when compared to healthy controls. In the mania group, IL-6 levels were lower than in depression and euthymia groups and inversely correlated with the YMRS score. Moreover, in the same group, IL-6 was lower in mania with psychotic features and higher in patients with previous suicide attempts. Conclusions: Inflammation underlies the pathophysiology of BP-I. IL-6 may have an anti-inflammatory role in the pathogenesis of manic episodes. Moreover, increased IL-6 in mania patients may be associated with increased suicidality.