A new study reveals that the gastrointestinal (GI) tract may be the starting point for the inflammation problems found in bipolar disorder, suggesting the importance of a diet change and anti-inflammatory treatment for certain patients.
Bipolar disorder is characterized by cyclical changes in mood, energy and activity levels that range from deep depression, to mania or hypomania.
During the study, researchers found that elevated levels of a GI inflammation marker called anti-Saccharomyces cerevisiae antibodies (ASCA) were linked with approximately a 4-fold increased risk for bipolar disorder, regardless of the medications being taken.
It is already known that ASCA are consistently higher in Crohn’s disease as well.
The study involved 264 bipolar disorder patients, 38 of whom had recently suffered from a bout of psychosis. ASCA levels in patients correlated strongly with immunoglobulin G — an antibody against wheat gluten and cow milk caseins. These links were especially strong in patients with bipolar disorder who also reported GI symptoms, such as gastroesophageal reflux disease.
These findings support previous theories that exorphins — the byproducts of gluten and casein digestion — may affect brain functioning through action at the opioid receptors, said the researchers, led by Emily Severance, Ph.D. from the Johns Hopkins University School of Medicine.
To investigate this further, they looked at correlations between ASCA levels and non-food-related antigens, including measles and Toxoplasma gondii, and found significant correlations in patients with bipolar disorder — but only those with recent onset psychosis.
“Although our findings require further scrutiny and larger sample sizes, the possibility of a more generalized inflammatory nature inherent to earlier stages of disease cannot be discounted,” wrote the researchers in the journal Bipolar Disorders.
The investigators believe that these findings could help identify patients with bipolar disorder who may be at risk for GI- and food-based sensitivities.
“Treatment strategies that involve dietary modifications, anti-inflammatory agents and/or microbiota modulations should be evaluated for effects on symptom improvement in carefully controlled clinical trials,” said the researchers.
Source: Bipolar Disorders