Department of Laboratory Medicine, the Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, 410208, China.
Transl Psychiatry. 2023 May 8;13(1):153. doi: 10.1038/s41398-023-02445-y.
Bipolar disorder (BD) is a distinctly heterogeneous and multifactorial disorder with a high individual and social burden. Immune pathway dysregulation is an important pathophysiological feature of BD. Recent studies have suggested a potential role for T lymphocytes in the pathogenesis of BD. Therefore, greater insight into T lymphocytes' functioning in patients with BD is essential. In this narrative review, we describe the presence of an imbalance in the ratio and altered function of T lymphocyte subsets in BD patients, mainly in T helper (Th) 1, Th2, Th17 cells and regulatory T cells, and alterations in hormones, intracellular signaling, and microbiomes may be potential causes. Abnormal T cell presence explains the elevated rates of comorbid inflammatory illnesses in the BD population. We also update the findings on T cell-targeting drugs as potentially immunomodulatory therapeutic agents for BD disease in addition to classical mood stabilizers (lithium, valproic acid). In conclusion, an imbalance in T lymphocyte subpopulation ratios and altered function may be involved in the development of BD, and maintaining T cell immune homeostasis may provide an overall therapeutic benefit.
双相障碍（BD）是一种明显异质和多因素的疾病，具有较高的个体和社会负担。免疫途径失调是 BD 的一个重要病理生理特征。最近的研究表明，T 淋巴细胞在 BD 的发病机制中可能起作用。因此，深入了解 BD 患者 T 淋巴细胞的功能至关重要。在这篇叙述性综述中，我们描述了 BD 患者 T 淋巴细胞亚群比例失衡和功能改变的存在，主要表现在辅助性 T 细胞（Th）1、Th2、Th17 细胞和调节性 T 细胞，以及激素、细胞内信号和微生物组的改变可能是潜在的原因。异常的 T 细胞存在解释了 BD 人群中合并炎症性疾病的发生率升高。我们还更新了 T 细胞靶向药物的发现，这些药物除了经典的心境稳定剂（锂、丙戊酸）外，还可能作为 BD 疾病的免疫调节治疗药物。总之，T 淋巴细胞亚群比例失衡和功能改变可能与 BD 的发生有关，维持 T 细胞免疫平衡可能提供整体治疗益处。
