Seroreactive marker for inflammatory bowel disease and associations with antibodies to dietary proteins in bipolar disorder

Emily G Severance, Kristin L. Gressitt, Shuojia Yang, Cassie R. Stallings, Andrea E. Origoni, Crystal Vaughan, Sunil Khushalani, Armin Alaedini, Faith B. Dickerson, Robert H Yolken

Research output: Contribution to journalArticle

Abstract

Objectives: Immune sensitivity to wheat glutens and bovine milk caseins may affect a subset of individuals with bipolar disorder. Digested byproducts of these foods are exorphins that have the potential to impact brain physiology through action at opioid receptors. Inflammation in the gastrointestinal (GI) tract might accelerate exposure of food antigens to systemic circulation and help explain elevated gluten and casein antibody levels in individuals with bipolar disorder. Methods: We measured a marker of GI inflammation, anti-Saccharomyces cerevisiae antibodies (ASCA), in non-psychiatric controls (n = 207), in patients with bipolar disorder without a recent onset of psychosis (n = 226), and in patients with bipolar disorder with a recent onset of psychosis (n = 38). We compared ASCA levels to antibodies against gluten, casein, Epstein-Barr virus (EBV), herpes simplex virus 1 (HSV-1), influenza A, influenza B, measles, and Toxoplasma gondii. Results: Elevated ASCA conferred a 3.5-4.4-fold increased odds ratio of disease association (age-, race-, and gender-corrected multinomial logistic regressions, p ≤ 0.00001) that was independent of type of medication received. ASCA correlated with food antibodies in both bipolar disorder groups (R2 = 0.29-0.59, p ≤ 0.0005), and with measles and T. gondii immunoglobulin G (IgG) in the recent onset psychosis bipolar disorder group (R2 = 0.31-0.36, p ≤ 0.004-0.01). Conclusions: Elevated seropositivity of a GI-related marker and its association with antibodies to food-derived proteins and self-reported GI symptoms suggest a GI comorbidity in at least a subgroup of individuals with bipolar disorder. Marker seroreactivity may also represent part of an overall heightened activated immune state inherent to this mood disorder.

Original languageEnglish (US)
Pages (from-to)230-240
Number of pages11
JournalBipolar Disorders
Volume16
Issue number3
DOIs
StatePublished - 2014

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Dietary Proteins
Bipolar Disorder
Inflammatory Bowel Diseases
Antibodies
Saccharomyces cerevisiae
Glutens
Caseins
Psychotic Disorders
Food
Toxoplasma
Measles
Human Influenza
Inflammation
Human Herpesvirus 1
Opioid Receptors
Human Herpesvirus 4
Mood Disorders
Triticum
Gastrointestinal Tract
Comorbidity

Keywords

  • Autoimmunity
  • Environment
  • Gastrointestinal
  • Immunology
  • Infection
  • Mood disorder

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry
  • Medicine(all)

Cite this

Seroreactive marker for inflammatory bowel disease and associations with antibodies to dietary proteins in bipolar disorder. / Severance, Emily G; Gressitt, Kristin L.; Yang, Shuojia; Stallings, Cassie R.; Origoni, Andrea E.; Vaughan, Crystal; Khushalani, Sunil; Alaedini, Armin; Dickerson, Faith B.; Yolken, Robert H.

In: Bipolar Disorders, Vol. 16, No. 3, 2014, p. 230-240.

Research output: Contribution to journalArticle

Severance, EG, Gressitt, KL, Yang, S, Stallings, CR, Origoni, AE, Vaughan, C, Khushalani, S, Alaedini, A, Dickerson, FB & Yolken, RH 2014, 'Seroreactive marker for inflammatory bowel disease and associations with antibodies to dietary proteins in bipolar disorder', Bipolar Disorders, vol. 16, no. 3, pp. 230-240. https://doi.org/10.1111/bdi.12159
Severance, Emily G ; Gressitt, Kristin L. ; Yang, Shuojia ; Stallings, Cassie R. ; Origoni, Andrea E. ; Vaughan, Crystal ; Khushalani, Sunil ; Alaedini, Armin ; Dickerson, Faith B. ; Yolken, Robert H. / Seroreactive marker for inflammatory bowel disease and associations with antibodies to dietary proteins in bipolar disorder. In: Bipolar Disorders. 2014 ; Vol. 16, No. 3. pp. 230-240.
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abstract = "Objectives: Immune sensitivity to wheat glutens and bovine milk caseins may affect a subset of individuals with bipolar disorder. Digested byproducts of these foods are exorphins that have the potential to impact brain physiology through action at opioid receptors. Inflammation in the gastrointestinal (GI) tract might accelerate exposure of food antigens to systemic circulation and help explain elevated gluten and casein antibody levels in individuals with bipolar disorder. Methods: We measured a marker of GI inflammation, anti-Saccharomyces cerevisiae antibodies (ASCA), in non-psychiatric controls (n = 207), in patients with bipolar disorder without a recent onset of psychosis (n = 226), and in patients with bipolar disorder with a recent onset of psychosis (n = 38). We compared ASCA levels to antibodies against gluten, casein, Epstein-Barr virus (EBV), herpes simplex virus 1 (HSV-1), influenza A, influenza B, measles, and Toxoplasma gondii. Results: Elevated ASCA conferred a 3.5-4.4-fold increased odds ratio of disease association (age-, race-, and gender-corrected multinomial logistic regressions, p ≤ 0.00001) that was independent of type of medication received. ASCA correlated with food antibodies in both bipolar disorder groups (R2 = 0.29-0.59, p ≤ 0.0005), and with measles and T. gondii immunoglobulin G (IgG) in the recent onset psychosis bipolar disorder group (R2 = 0.31-0.36, p ≤ 0.004-0.01). Conclusions: Elevated seropositivity of a GI-related marker and its association with antibodies to food-derived proteins and self-reported GI symptoms suggest a GI comorbidity in at least a subgroup of individuals with bipolar disorder. Marker seroreactivity may also represent part of an overall heightened activated immune state inherent to this mood disorder.",
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T1 - Seroreactive marker for inflammatory bowel disease and associations with antibodies to dietary proteins in bipolar disorder

AU - Severance, Emily G

AU - Gressitt, Kristin L.

AU - Yang, Shuojia

AU - Stallings, Cassie R.

AU - Origoni, Andrea E.

AU - Vaughan, Crystal

AU - Khushalani, Sunil

AU - Alaedini, Armin

AU - Dickerson, Faith B.

AU - Yolken, Robert H

PY - 2014

Y1 - 2014

N2 - Objectives: Immune sensitivity to wheat glutens and bovine milk caseins may affect a subset of individuals with bipolar disorder. Digested byproducts of these foods are exorphins that have the potential to impact brain physiology through action at opioid receptors. Inflammation in the gastrointestinal (GI) tract might accelerate exposure of food antigens to systemic circulation and help explain elevated gluten and casein antibody levels in individuals with bipolar disorder. Methods: We measured a marker of GI inflammation, anti-Saccharomyces cerevisiae antibodies (ASCA), in non-psychiatric controls (n = 207), in patients with bipolar disorder without a recent onset of psychosis (n = 226), and in patients with bipolar disorder with a recent onset of psychosis (n = 38). We compared ASCA levels to antibodies against gluten, casein, Epstein-Barr virus (EBV), herpes simplex virus 1 (HSV-1), influenza A, influenza B, measles, and Toxoplasma gondii. Results: Elevated ASCA conferred a 3.5-4.4-fold increased odds ratio of disease association (age-, race-, and gender-corrected multinomial logistic regressions, p ≤ 0.00001) that was independent of type of medication received. ASCA correlated with food antibodies in both bipolar disorder groups (R2 = 0.29-0.59, p ≤ 0.0005), and with measles and T. gondii immunoglobulin G (IgG) in the recent onset psychosis bipolar disorder group (R2 = 0.31-0.36, p ≤ 0.004-0.01). Conclusions: Elevated seropositivity of a GI-related marker and its association with antibodies to food-derived proteins and self-reported GI symptoms suggest a GI comorbidity in at least a subgroup of individuals with bipolar disorder. Marker seroreactivity may also represent part of an overall heightened activated immune state inherent to this mood disorder.

AB - Objectives: Immune sensitivity to wheat glutens and bovine milk caseins may affect a subset of individuals with bipolar disorder. Digested byproducts of these foods are exorphins that have the potential to impact brain physiology through action at opioid receptors. Inflammation in the gastrointestinal (GI) tract might accelerate exposure of food antigens to systemic circulation and help explain elevated gluten and casein antibody levels in individuals with bipolar disorder. Methods: We measured a marker of GI inflammation, anti-Saccharomyces cerevisiae antibodies (ASCA), in non-psychiatric controls (n = 207), in patients with bipolar disorder without a recent onset of psychosis (n = 226), and in patients with bipolar disorder with a recent onset of psychosis (n = 38). We compared ASCA levels to antibodies against gluten, casein, Epstein-Barr virus (EBV), herpes simplex virus 1 (HSV-1), influenza A, influenza B, measles, and Toxoplasma gondii. Results: Elevated ASCA conferred a 3.5-4.4-fold increased odds ratio of disease association (age-, race-, and gender-corrected multinomial logistic regressions, p ≤ 0.00001) that was independent of type of medication received. ASCA correlated with food antibodies in both bipolar disorder groups (R2 = 0.29-0.59, p ≤ 0.0005), and with measles and T. gondii immunoglobulin G (IgG) in the recent onset psychosis bipolar disorder group (R2 = 0.31-0.36, p ≤ 0.004-0.01). Conclusions: Elevated seropositivity of a GI-related marker and its association with antibodies to food-derived proteins and self-reported GI symptoms suggest a GI comorbidity in at least a subgroup of individuals with bipolar disorder. Marker seroreactivity may also represent part of an overall heightened activated immune state inherent to this mood disorder.

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KW - Environment

KW - Gastrointestinal

KW - Immunology

KW - Infection

KW - Mood disorder

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