Low α-N-acetylgalactosaminidase plasma concentration correlates with the presence and severity of the bipolar affective disorder

World J Biol Psychiatry. 2023 Feb;24(2):187-194. doi: 10.1080/15622975.2022.2124451. Epub 2022 Sep 27.


Objectives: Believing that a neurodevelopmental pathology may cause bipolar affective disorder (BAD), we aimed to measure the concentrations of α-N-acetylgalactosaminidase (α-NAGAL), a lysosomal enzyme.

Methods: The study included 32 patients with BAD and 32 healthy controls. The Young Mania Rating Scale was used to measure the severity of the disease. Serum α-N-acetylgalactosaminidase concentrations were measured in all blood samples using the human α-N-acetylgalactosaminidase ELISA Kit.

Results: A statistically significant difference was found in the α-NAGAL values between the groups. The mean α-NAGAL values of BAD patients are lower than the mean α-NAGAL values of the control group. A strong negative and statistically significant relationship was found between the α-NAGAL values of patients with BAD and their Young Mania Rating Scale scores. And a positive strong correlation was found between the age of onset of the disease and α-NAGAL levels.

Conclusions: Low α-N-acetylgalactosaminidase concentrations may cause the accumulation of some glycoproteins in the lysosomes in the brain during the gestational period, producing the clinical symptoms of BAD. α-N-acetylgalactosaminidase deficiency may not be the only cause of BAD, but it may be an important factor in the aetiology of this disease.

Keywords: bipolar affective disorder; neurodevelopment; α-N-acetylgalactosaminidase.

MeSH terms

  • Bipolar Disorder*
  • Humans
  • Lysosomal Storage Diseases*
  • Mania
  • alpha-N-Acetylgalactosaminidase


  • alpha-N-Acetylgalactosaminidase