The activation of monocyte and T cell networks in patients with bipolar disorder

Brain Behav Immun. 2011 Aug;25(6):1206-13. doi: 10.1016/j.bbi.2011.03.013. Epub 2011 Apr 8.


Objectives: We recently described a monocyte pro-inflammatory state in patients with bipolar disorder (BD). We hypothesized that the CD4(+)T cell system is also activated and determined percentages of Th1, Th2, Th17 and CD4(+)CD25(high)FoxP3(+) regulatory T cells.

Methods: We carried out a detailed FACS analysis to determine the various T cell subsets and used frozen stored peripheral blood mononuclear cells (PBMC) of 38 BD patients (of whom we previously had tested monocytes for pro-inflammatory gene expression (Drexhage et al., 2010b; Padmos et al., 2008)) and of 22 age/gender matched healthy controls (HC). In addition the cytokines CCL2, IL-1β, IL-6, TNF-α, PTX3, IL-10, IFN-γ, IL-17A, IL-4, IL-5 and IL-22 were measured in serum.

Results: (a) Serum sCD25 levels and percentages of anti-inflammatory CD4(+)CD25(high)FoxP3+ regulatory T cells were higher, the latter in BD patients <40 years of age. Percentages of Th1, Th2 and Th17 cells were normal. (b) Of the pro-inflammatory monocyte cytokines CCL2 and PTX3 were raised in serum. (c) The monocyte pro-inflammatory state and the raised percentages of CD4(+)CD25(high)FoxP3(+) regulatory T cells occurred independently from each other. (d) In BD patients positive for thyroid autoimmune disease a significantly reduced percentage of CD4(+)CD25(high)FoxP3(+) regulatory T cells was found as compared to BD patients without AITD.

Conclusion: Our data show an enhancement of pro-inflammatory monocyte and anti-inflammatory T cell forces in BD patients. A lack of anti-inflammatory T cell forces co-occurred with AITD in BD patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antigens, Differentiation, T-Lymphocyte / analysis
  • Bipolar Disorder / complications
  • Bipolar Disorder / genetics
  • Bipolar Disorder / immunology*
  • Cytokines / blood
  • Female
  • Flow Cytometry
  • Gene Expression Profiling
  • Humans
  • Immunophenotyping
  • Inflammation
  • Leukocytes, Mononuclear / immunology*
  • Lymphocyte Activation
  • Lymphocyte Count
  • Male
  • Middle Aged
  • RNA, Messenger / blood
  • T-Lymphocyte Subsets / immunology*
  • T-Lymphocytes, Regulatory / immunology
  • Thyroiditis, Autoimmune / complications
  • Thyroiditis, Autoimmune / immunology


  • Antigens, Differentiation, T-Lymphocyte
  • Cytokines
  • RNA, Messenger