Hamdani Nora, Tamouza Ryad, Leboyer Marion
Universite Paris Est, Faculte de medecine, Creteil, 94000, France. norahamdani@achaphpfr
Front Biosci (Elite Ed). 2012 Jan 1;4(6):2170-82. doi: 10.2741/e534.
Bipolar is a severe psychiatric disorder which ethiopathogenesis remains unclear. Despite a clearly established heritability, genetic studies have failed to elucidate the underlying mechanism of bipolar disorder, most likely due to the contributing role of environmental factors in the genesis of the disease.. Environmental factors have been consistently described to induce immuno-inflammation dysfunction, which are also known to play a role in the pathogenesis of bipolar disorders as due to the combined actions of small effects in many different genes interacting with environmental factors). Several mechanisms might explain the pro-inflammatory processes observed in bipolar disorder. Emerging evidence support the pathophysiological role of Human Endogenous Retroviruses, which reactivation (normally silenced), can be induced by infectious agents during pregnancy, early childhood and/or adolescence. ,Neurotoxic effects and inflammatory state are induced, which might in turn and after a prodromal phase, trigger acute mood episodes,. The present paper reviews the role of the immuno-inflammatory processes as key contributors to the bipolar disorders pathophysiology , the evidence supporting immuno-genetic predisposition,background, and the the possible implications of retroviruses reactivation in the pathogenesis of bipolar disorder.
双相情感障碍是一种严重的精神疾病,其病因发病机制尚不清楚。尽管遗传因素已明确确立,但基因研究仍未能阐明双相情感障碍的潜在机制,这很可能是由于环境因素在该疾病发生过程中所起的作用。一直以来,环境因素被认为会诱发免疫炎症功能障碍,而免疫炎症功能障碍在双相情感障碍的发病机制中也发挥着作用(这是由于许多不同基因与环境因素相互作用产生的微小效应共同作用的结果)。有几种机制可以解释在双相情感障碍中观察到的促炎过程。新出现的证据支持人类内源性逆转录病毒的病理生理作用,其重新激活(通常处于沉默状态)可在孕期、幼儿期和/或青春期由感染因子诱导产生。由此会诱发神经毒性作用和炎症状态,这反过来可能在经过一个前驱期后引发急性情绪发作。本文综述了免疫炎症过程作为双相情感障碍病理生理学关键因素的作用、支持免疫遗传易感性的证据、背景情况,以及逆转录病毒重新激活在双相情感障碍发病机制中的可能影响。