Costanza Alessandra, Amerio Andrea, Aguglia Andrea, Rossi Martina, Parise Alberto, Magnani Luca, Serafini Gianluca, Amore Mario, Martins Daniel, Nguyen Khoa D
Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), 24 Rue du Général-Dufour, 1211 Geneva, Switzerland.
Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland (USI), Via Giuseppe Buffi 13, 6900 Lugano, Switzerland.
Brain Sci. 2024 Sep 27;14(10):973. doi: 10.3390/brainsci14100973.
Long COVID-19 is an emerging chronic illness of significant public health concern due to a myriad of neuropsychiatric sequelae, including increased suicidal ideation (SI) and behavior (SB).
This review provides a concise synthesis of clinical evidence that points toward the dysfunction of astrocytes, the most abundant glial cell type in the central nervous system, as a potential shared pathology between SI/SB and COVID-19.
Depression, a suicide risk factor, and SI/SB were both associated with reduced frequencies of various astrocyte subsets and complex proteomic/transcriptional changes of astrocyte-related markers in a brain-region-specific manner. Astrocyte-related circulating markers were increased in depressed subjects and, to a less consistent extent, in COVID-19 patients. Furthermore, reactive astrocytosis was observed in subjects with SI/SB and those with COVID-19.
Astrocyte dysfunctions occurred in depression, SI/SB, and COVID-19. Reactive-astrocyte-mediated loss of the blood-brain barrier (BBB) integrity and subsequent neuroinflammation-a factor previously linked to SI/SB development-might contribute to increased suicide in individuals with long COVID-19. As such, the formulation of new therapeutic strategies to restore astrocyte homeostasis, enhance BBB integrity, and mitigate neuroinflammation may reduce SI/SB-associated neuropsychiatric manifestations among long COVID-19 patients.
长新冠是一种新出现的慢性疾病，因其众多神经精神后遗症，包括自杀意念（SI）和自杀行为（SB）增加，而成为重大公共卫生问题。
本综述简要综合了临床证据，这些证据表明星形胶质细胞（中枢神经系统中最丰富的神经胶质细胞类型）功能障碍是SI/SB与新冠之间潜在的共同病理特征。
抑郁症（一种自杀风险因素）以及SI/SB均与不同星形胶质细胞亚群的频率降低以及星形胶质细胞相关标志物在脑区特异性的复杂蛋白质组/转录变化有关。抑郁症患者以及新冠患者（程度不太一致）的星形胶质细胞相关循环标志物升高。此外，在有SI/SB的受试者以及新冠患者中观察到反应性星形胶质细胞增生。
抑郁症、SI/SB和新冠中均出现星形胶质细胞功能障碍。反应性星形胶质细胞介导的血脑屏障（BBB）完整性丧失以及随后的神经炎症（先前与SI/SB发展相关的一个因素）可能导致长新冠患者自杀率增加。因此，制定恢复星形胶质细胞稳态、增强血脑屏障完整性和减轻神经炎症的新治疗策略，可能会减少长新冠患者中与SI/SB相关的神经精神表现。
