Oxidative stress biomarkers in bipolar disorder with suicidal behavior: A systematic review

Research output: Contribution to journalReview article

Abstract

Oxidative stress has been implicated in suicidal behavior and bipolar disorder (BD), respectively. However, the role of oxidative stress as a biomarker of suicidal behavior in BD remains inconclusive. This systematic review aims to determine the association between oxidative stress biomarkers and suicidal behavior among BD patients. All human studies from Scopus and Ovid Medline up until August 2017 on suicidal behavior, BD, and oxidative stress biomarkers were included according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of five studies met the eligibility criteria, of which 4 were case-control studies. Three studies identified at least one biomarker with significant association between suicidal acts and oxidative stress biomarkers (i.e., increased lipid peroxidation and NOS3 rs 1799983 TT genotype) in previous suicide attempt and increased deoxyribonucleic acid damage in suicide among sample populations with BD patients. No study reported conclusive associations between Ala-9 Val manganese superoxide dismutase or Pro 197 Leu glutathione peroxidase gene polymorphisms; or levels of nitric oxide metabolites, plasma total antioxidant potential, and malondialdehyde with suicidal acts among BD patients. Based on this systematic review, there is limited evidence of any association of the association between oxidative stress biomarkers and suicidal acts in BD patients. Definitive conclusions could not be ascertained due to lack of homogenous properly controlled and adequately powered studies. Future systematically well-designed and larger, prospective studies are warranted to clarify the role of oxidative stress pathways in the pathophysiology of suicidal behavior in BD.

Original languageEnglish
Pages (from-to)6-15
Number of pages10
JournalJournal of Pharmaceutical Negative Results
Volume10
Issue number1
DOIs
Publication statusPublished - 1 Jan 2019

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Bipolar Disorder
Oxidative Stress
Biomarkers
Suicide
Glutathione Peroxidase
Malondialdehyde
Mental Disorders
Lipid Peroxidation
Superoxide Dismutase
Meta-Analysis
Case-Control Studies
Nitric Oxide
Antioxidants
Genotype
Prospective Studies
Guidelines
DNA
Population
Genes

Keywords

  • Antioxidant
  • bipolar disorder
  • deoxyribonucleic acid damage
  • oxidative stress
  • suicidal behavior

ASJC Scopus subject areas

  • Pharmacology
  • Pharmaceutical Science
  • Drug Discovery

Cite this

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title = "Oxidative stress biomarkers in bipolar disorder with suicidal behavior: A systematic review",
abstract = "Oxidative stress has been implicated in suicidal behavior and bipolar disorder (BD), respectively. However, the role of oxidative stress as a biomarker of suicidal behavior in BD remains inconclusive. This systematic review aims to determine the association between oxidative stress biomarkers and suicidal behavior among BD patients. All human studies from Scopus and Ovid Medline up until August 2017 on suicidal behavior, BD, and oxidative stress biomarkers were included according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of five studies met the eligibility criteria, of which 4 were case-control studies. Three studies identified at least one biomarker with significant association between suicidal acts and oxidative stress biomarkers (i.e., increased lipid peroxidation and NOS3 rs 1799983 TT genotype) in previous suicide attempt and increased deoxyribonucleic acid damage in suicide among sample populations with BD patients. No study reported conclusive associations between Ala-9 Val manganese superoxide dismutase or Pro 197 Leu glutathione peroxidase gene polymorphisms; or levels of nitric oxide metabolites, plasma total antioxidant potential, and malondialdehyde with suicidal acts among BD patients. Based on this systematic review, there is limited evidence of any association of the association between oxidative stress biomarkers and suicidal acts in BD patients. Definitive conclusions could not be ascertained due to lack of homogenous properly controlled and adequately powered studies. Future systematically well-designed and larger, prospective studies are warranted to clarify the role of oxidative stress pathways in the pathophysiology of suicidal behavior in BD.",
keywords = "Antioxidant, bipolar disorder, deoxyribonucleic acid damage, oxidative stress, suicidal behavior",
author = "{Mohamad Kamal}, Nurul and Jiann Loo and {Jo Aan}, Goon and {Ahmad Damanhuri}, {Mohd Hanafi} and Shalisah Sharip and Suriati Saini and {Che Hamzah}, Jemaima and Chan, {Lai Fong}",
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AU - Mohamad Kamal, Nurul

AU - Loo, Jiann

AU - Jo Aan, Goon

AU - Ahmad Damanhuri, Mohd Hanafi

AU - Sharip, Shalisah

AU - Saini, Suriati

AU - Che Hamzah, Jemaima

AU - Chan, Lai Fong

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N2 - Oxidative stress has been implicated in suicidal behavior and bipolar disorder (BD), respectively. However, the role of oxidative stress as a biomarker of suicidal behavior in BD remains inconclusive. This systematic review aims to determine the association between oxidative stress biomarkers and suicidal behavior among BD patients. All human studies from Scopus and Ovid Medline up until August 2017 on suicidal behavior, BD, and oxidative stress biomarkers were included according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of five studies met the eligibility criteria, of which 4 were case-control studies. Three studies identified at least one biomarker with significant association between suicidal acts and oxidative stress biomarkers (i.e., increased lipid peroxidation and NOS3 rs 1799983 TT genotype) in previous suicide attempt and increased deoxyribonucleic acid damage in suicide among sample populations with BD patients. No study reported conclusive associations between Ala-9 Val manganese superoxide dismutase or Pro 197 Leu glutathione peroxidase gene polymorphisms; or levels of nitric oxide metabolites, plasma total antioxidant potential, and malondialdehyde with suicidal acts among BD patients. Based on this systematic review, there is limited evidence of any association of the association between oxidative stress biomarkers and suicidal acts in BD patients. Definitive conclusions could not be ascertained due to lack of homogenous properly controlled and adequately powered studies. Future systematically well-designed and larger, prospective studies are warranted to clarify the role of oxidative stress pathways in the pathophysiology of suicidal behavior in BD.

AB - Oxidative stress has been implicated in suicidal behavior and bipolar disorder (BD), respectively. However, the role of oxidative stress as a biomarker of suicidal behavior in BD remains inconclusive. This systematic review aims to determine the association between oxidative stress biomarkers and suicidal behavior among BD patients. All human studies from Scopus and Ovid Medline up until August 2017 on suicidal behavior, BD, and oxidative stress biomarkers were included according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of five studies met the eligibility criteria, of which 4 were case-control studies. Three studies identified at least one biomarker with significant association between suicidal acts and oxidative stress biomarkers (i.e., increased lipid peroxidation and NOS3 rs 1799983 TT genotype) in previous suicide attempt and increased deoxyribonucleic acid damage in suicide among sample populations with BD patients. No study reported conclusive associations between Ala-9 Val manganese superoxide dismutase or Pro 197 Leu glutathione peroxidase gene polymorphisms; or levels of nitric oxide metabolites, plasma total antioxidant potential, and malondialdehyde with suicidal acts among BD patients. Based on this systematic review, there is limited evidence of any association of the association between oxidative stress biomarkers and suicidal acts in BD patients. Definitive conclusions could not be ascertained due to lack of homogenous properly controlled and adequately powered studies. Future systematically well-designed and larger, prospective studies are warranted to clarify the role of oxidative stress pathways in the pathophysiology of suicidal behavior in BD.

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