Cattane Nadia, Rossi Roberta, Lanfredi Mariangela, Cattaneo Annamaria
Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio - Fatebenefratelli, via Pilastroni 4, Brescia, Italy.
Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio - Fatebenefratelli, via Pilastroni 4, Brescia, Italy.
BMC Psychiatry. 2017 Jun 15;17(1):221. doi: 10.1186/s12888-017-1383-2.
According to several studies, the onset of the Borderline Personality Disorder (BPD) depends on the combination between genetic and environmental factors (GxE), in particular between biological vulnerabilities and the exposure to traumatic experiences during childhood. We have searched for studies reporting possible alterations in several biological processes and brain morphological features in relation to childhood trauma experiences and to BPD. We have also looked for epigenetic mechanisms as they could be mediators of the effects of childhood trauma in BPD vulnerability.
We prove the role of alterations in Hypothalamic-Pituitary-Adrenal (HPA) axis, in neurotrasmission, in the endogenous opioid system and in neuroplasticity in the childhood trauma-associated vulnerability to develop BPD; we also confirm the presence of morphological changes in several BPD brain areas and in particular in those involved in stress response. Not so many studies are available on epigenetic changes in BPD patients, although these mechanisms are widely investigated in relation to stress-related disorders. A better comprehension of the biological and epigenetic mechanisms, affected by childhood trauma and altered in BPD patients, could allow to identify "at high risk" subjects and to prevent or minimize the development of the disease later in life.
根据多项研究，边缘型人格障碍（BPD）的发病取决于遗传和环境因素（基因与环境相互作用，即GxE）的结合，特别是生物易感性与童年期遭受创伤经历之间的相互作用。我们检索了相关研究，这些研究报告了与童年创伤经历及BPD相关的几种生物过程和脑形态特征的可能改变。我们还寻找了表观遗传机制，因为它们可能是童年创伤对BPD易感性产生影响的介导因素。
我们证实了下丘脑-垂体-肾上腺（HPA）轴的改变、神经传递、内源性阿片系统及神经可塑性在童年创伤相关的BPD易感性中的作用；我们还证实了BPD患者多个脑区存在形态学变化，尤其是那些参与应激反应的脑区。关于BPD患者表观遗传变化的研究并不多，尽管这些机制在与应激相关的疾病中得到了广泛研究。更好地理解受童年创伤影响且在BPD患者中发生改变的生物和表观遗传机制，可能有助于识别“高危”个体，并在日后预防或尽量减少该疾病的发生。
