Made available in DSpace on 2015-04-14T14:51:20Z (GMT). No. of bitstreams: 1 439544.pdf: 1258585 bytes, checksum: 19aa18ec90c3c36b13cb69c6788c4a18 (MD5) Previous issue date: 2012-03-30 / Bipolar Disorder (BD) is a complex, multifactorial and chronic psychiatic illness. It is characterized by alternating cycles of mania and depression, with periods of remission or euthymia. Several studies have suggested a direct interaction between nervous, endocrine and immune systems in the pathophysiology of BD. An immune activation, as evidenced by increased plasma levels of proinflammatory cytokines, has been frequently reported in BD. However, the majority of the studies have mainly investigated mania and depression phases, and very few studies have been developed with euthymic patients. In this study, we investigated cellular and molecular mechanisms potentially involved in the inflammatory process in BD, including various lymphocytes subtypes and intracelular pathways of lymphocyte activation. Twentyseven euthymic female subjects with BD type I and 24 age- and sex-matched controls were recruited in this study. Lymphocytes were isolated and stimulated in vitro to assess Th1/Th17/Th2 cytokines (IL-2, IL-4, IL-5, IL-10, IL-17, IFN-ע and TNF-?) and expression of mitogen-activated protein kinases (MAPKs). The expression of MAPKs (p-oERK and p38), lymphocyte subtypes and cytokines were assessed by flow cytometry. All cytokines assessed were found elevated in bipolar disorder compared with healthy controls. In particu-lar, it was evidenced a bias to a Th1 inflammatory profile in BD. Interestingly, we observed a significant reduction (-56%) of regulatory T cells (CD4+CD25+Foxp3+) and expansion (43%) of CD8+ regulatory T cells (CD8+CD28-) in BD. The lymphocytes of BD patients showed an significant increase in p-ERK in relation to p-p38, indicating lymphocyte activation. Our data suggest that multiple molecular and cellular mechanisms contribute to the immunological imbalance observed in BD / O Transtorno Bipolar (TB) ? uma doen?a psiqui?trica cr?nica, complexa e multifatorial, caracterizada por ciclos alternados de mania e depress?o, intercalados com per?odos de remiss?o ou eutimia. Diversos estudos v?m demonstrando associa??es entre sistema nervoso, end?crino e imunol?gico na patofisiologia do TB. Uma ativa??o imune, evidenciada por n?veis plasm?ticos aumentados de citocinas pr?-inflamat?rias, tem sido freq?entemente relatada no TB. No entanto, a maioria dos estudos refere-se principalmente ?s fases de mania e depress?o, e poucos estudos foram desenvolvidos na fase de eutim?a. Neste estudo, investigamos mecanismos celulares e moleculares potencialmente envolvidos no fen?meno inflamat?rio no TB, incluindo diversos subtipos linfocit?rios e vias intracelulares de ativa??o linfocit?ria. Vinte e sete pacientes mulheres com TB I eut?micos e 24 controles saud?veis pareados por sexo e idade foram recrutadas neste estudo. Os linf?citos foram isolados e estimulados in vitro para avaliar as citocinas Th1/Th17/Th2 (IL-2, IL-4, IL-5, IL-10, IL-17, IFN-ע e TNF-?) e express?o de prote?nas cinases ativadas por mit?geno (MAPKs). A express?o das MAPKs (p-ERK e p-p38), subtipos linfocit?rios e citocinas foram avaliados por citometria de fluxo. Todas as citocinas avaliadas encontraram-se elevadas nos bipolares em compara??o com controles sau-d?veis. Em particular, foi evidenciado um vi?s para um perfil Th1 (inflamat?rio) no TB I. Interessantemente, observamos uma redu??o significativa (-56%) de c?lulas T regulat?rias (CD4+CD25+Foxp3+) e expans?o (43%) de c?lulas T CD8+ regulat?rias (CD8+CD28-) no TB. Os linf?citos dos pacientes bipolares apresentaram um aumento significativo de p-ERK em rela??o a p-p38, indicando uma ativa??o linfocit?ria. Concluindo, nossos dados sugerem que m?ltiplos mecanismos celulares e moleculares contribuem para um desequil?brio imune observado no TB