Prevalence of intrathecal antibody synthesis against neurotropic agents in patients with bipolar disorders

Abstract

Objective: A potential influence of infections and immunological aspects on etiology and pathogenesis of bipolar disorders has been discussed. Our aim was to detect an intrathecal specific antibody synthesis against neurotropic agents that have been linked to bipolar disorders. Methods: We evaluated the concentration of antibodies against 4 neurotropic agents (Herpes simplex virus type 1/2, Epstein-Barr virus, Cytomegalovirus, Toxoplasma gondii) in paired cerebrospinal fluid and serum samples from 40 patients with bipolar disorders using an enzyme-linked immunosorbent assay. The specific antibody index (AI) was calculated and an AI> 1.4 was considered as evidence of intrathecal specific antibody synthesis. 26 patients with Pseudotumor cerebri served as controls. Results: 8 of the 40 patients with bipolar disorders had a specific intrathecal antibody synthesis against at least one of the 4 neurotropic agents compared to 1 patient in the control group. Concerning these 8 patients, there was no significant preponderance of a single neurotropic agent. Conclusions: Our results disagree with theories that discuss a direct role of HSV, CMV, EBV and T. gondii in etiology of bipolar disorders. However, the trend for polyspecifc intrathecal antibody synthesis may indicate an activation of the intrathecal humoral immune system in patients with bipolar disorders as it is known for, e.g. multiple sclerosis.