Zhao Ning O, Topolski Natasha, Tusconi Massimo, Salarda Erika M, Busby Christopher W, Lima Camila N N C, Pillai Anilkumar, Quevedo Joao, Barichello Tatiana, Fries Gabriel R
Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA.
Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX. 6767 Bertner Ave, 77030, Houston, TX, USA.
Brain Behav Immun Health. 2022 Mar 5;21:100441. doi: 10.1016/j.bbih.2022.100441. eCollection 2022 May.
Bipolar disorder (BD) is a severe psychiatric disorder affecting approximately 1-3% of the population and characterized by a chronic and recurrent course of debilitating symptoms. An increasing focus has been directed to discover and explain the function of Blood-Brain Barrier (BBB) integrity and its association with a number of psychiatric disorders; however, there has been limited research in the role of BBB integrity in BD. Multiple pathways may play crucial roles in modulating BBB integrity in BD, such as inflammation, insulin resistance, and alterations of neuronal plasticity. In turn, BBB impairment is hypothesized to have a significant clinical impact in BD patients. Based on the high prevalence of medical and psychiatric comorbidities in BD and a growing body of evidence linking inflammatory and neuroinflammatory mechanisms to the disorder, recent studies have suggested that BBB dysfunction may play a key role in BD's pathophysiology. In this comprehensive narrative review, we aim to discuss studies investigating biological markers of BBB in patients with BD, mechanisms that modulate BBB integrity, their clinical implications on patients, and key targets for future development of novel therapies.
双相情感障碍（BD）是一种严重的精神疾病，影响着约1%-3%的人口，其特征是症状反复发作且使人衰弱。人们越来越关注发现和解释血脑屏障（BBB）完整性的功能及其与多种精神疾病的关联；然而，关于BBB完整性在双相情感障碍中的作用的研究有限。多种途径可能在调节双相情感障碍中的BBB完整性方面发挥关键作用，如炎症、胰岛素抵抗和神经元可塑性改变。反过来，据推测BBB损伤对双相情感障碍患者有重大临床影响。基于双相情感障碍中医学和精神共病的高患病率以及越来越多将炎症和神经炎症机制与该疾病联系起来的证据，最近的研究表明BBB功能障碍可能在双相情感障碍的病理生理学中起关键作用。在这篇全面的叙述性综述中，我们旨在讨论调查双相情感障碍患者BBB生物学标志物的研究、调节BBB完整性的机制、它们对患者的临床意义以及新型疗法未来开发的关键靶点。
