Infectious and immunogenetic factors in bipolar disorder

Oliveira, J.; Oliveira‐Maia, Albino J.; Tamouza, Ryad; Brown, Alan S.; Leboyer, Marion

doi:10.1111/acps.12791

Cited by 37 publications

(23 citation statements)

References 125 publications

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“…Regarding pre‐morbid environmental factors, OCD patients have been proposed to be exposed more frequently to stressors, such as perinatal events, psychological stressors, and other traumatic events, all thought to induce inflammation and oxidative stress, which may induce neurochemical modifications in several neurotransmitter pathways, including glutamate . Schiavone and collaborators hypothesized that oxidative stress could initially be adaptive, through enhancement of neurotransmission, but that chronic generation of ROS could lead to exaggerated neurophysiological responses, with disruption of physiological neurotransmission and increase of blood–brain barrier permeability, ultimately promoting neuroinflammation and neuronal death .…”

Section: Discussionmentioning

confidence: 99%

Oxidative and nitrosative stress markers in obsessive–compulsive disorder: a systematic review and meta‐analysis

Maia

Oliveira

Lajnef

et al. 2019

Acta Psychiatr Scand

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Oxidative and nitrosative stress markers in obsessive-compulsive disorder: a systematic review and meta-analysis Maia A, Oliveira J, Lajnef M, Mallet L, Tamouza R, Leboyer M, Oliveira-Maia AJ. Oxidative and nitrosative stress markers in obsessive-compulsive disorder: a systematic review and meta-analysis Objective: Obsessive-compulsive disorder (OCD) is a chronic, prevalent, and highly impairing psychiatric illness. Although the pathophysiology of OCD remains unknown, pathways involved in oxidative and nitrosative stress (O&NS) have been implicated. The present study aims to systematically review the literature for quantitative evidence that patients with OCD have altered measures of blood O&NS markers. Methods: Independent random-effects meta-analyses using standardized mean differences were conducted to assess each marker separately. Additionally, data from multiple markers were pooled together in a metaanalysis for measures of oxidant activity and another for measures of antioxidant activity. Results: Thirteen studies met inclusion criteria, involving 433 OCD patients and 459 controls. Eleven blood O&NS markers were eligible for independent quantitative analyses. We found that, in OCD patients, the oxidant markers 8-hydroxydeoxyguanosine and malondialdehyde, and the antioxidants glutathione peroxidase and superoxide dismutase, were significantly increased while total antioxidant status, vitamin C, and vitamin E were significantly decreased, when comparing with controls. Regarding pooled meta-analyses, we found a statistically significant increase in oxidant markers, but non-significant results regarding antioxidant markers. Conclusions: Our meta-analysis suggests that OCD patients have a systemic oxidative imbalance that is not adequately buffered by the antioxidant system. Additional studies are needed in order to support this association. Summations• Patients with obsessive-compulsive disorder have a dysregulated oxidative profile with increased blood oxidative markers.• No global changes in antioxidant defenses in obsessive-compulsive disorder are of remark thus suggesting that oxidative stress is not adequately buffered.• Our results underline the systemic impact of obsessive-compulsive disorder and should motivate the development of future studies in order to better understand this association. Considerations• Most studies did not provide measurements of oxidative and nitrosative stress markers according to pertinent demographic and clinical characteristics thus impairing relevant sensitivity analyses that would have allowed to assess the potential impact of these factors in the results.• The limited number of studies, their moderate quality and heterogeneity, and the evidence for publication bias prevent more robust conclusions.

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Section: Discussionmentioning

confidence: 99%

Oxidative and nitrosative stress markers in obsessive–compulsive disorder: a systematic review and meta‐analysis

Maia

Oliveira

Lajnef

et al. 2019

Acta Psychiatr Scand

Self Cite

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“…More broadly, because of immuno-genetic vulnerability, these patients often have a poorer ability to defend themselves against infections, as shown by the epidemiological associations between psychiatric disorders and a very large number of infections (toxoplasmosis, herpes, etc.) in the course of psychiatric pathologies (11). In addition, they are much more often affected by comorbidities than the general population, which are severe risk factors of SARS-Cov-19 infections (Table 1) (12).…”

Section: Individual Vulnerability Of Psychiatric Patients To Coronavirusmentioning

confidence: 99%

Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review

et al. 2020

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Objective: The lack of resources and coordination to face the coronavirus epidemic raises concerns for the health of patients with mental disorders in a country where we still have memories of the dramatic experience of famine in psychiatric hospitals during the Second World War. This article aims to propose guidance to ensure mental health care during the SARS-CoV epidemic in France. Methods: The authors performed a narrative review identifying relevant results in the scientific and medical literature and in local initiatives in France. Results : We identified four types of major vulnerabilities among patients with mental disorders during this pandemic: 1) medical comorbidities that are more frequently found among patients with mental disorders (cardiovascular and pulmonary pathologies, diabetes, obesity, etc.) which are risk factors for severe covid-19 infection; 2) age (the elderly form the population most vulnerable to the coronavirus); 3) cognitive and behavioural disorders, which can hamper compliance with confinement and hygiene measures and finally and 4) psychosocial vulnerability as a result of stigmatization and/or socio-economic difficulties. Furthermore, the mental health healthcare system is more vulnerable than other healthcare systems. Current government plans are poorly suited to psychiatric establishments in a context of major shortages of organizational, material and human resources. In addition, a certain number of structural aspects make the psychiatric institution particularly vulnerable: many beds have been closed, wards have high densities of patients, mental health community facilities are closed, and medical teams are understaffed and poorly trained to face infectious diseases. There are also major issues when referring patients with acute mental disorders to intensive care units. To maintain the continuity of psychiatric care in this pandemic situation, several directions can be considered, in particular with the creation of "COVID+ units". These units are under the dual supervision of a psychiatrist and an internist / infectious disease specialist; all new entrants are placed in quarantine for 14 days; the nursing staff receives specific training, daily medical checkups and close psychological support. Family visits are prohibited and replaced by videoconference. At the end of hospitalization, in particular for the population of patients in compulsory ambulatory care situations, specific case-management are organized with the possibility of home visits, in order to support patients when they get back home and to help them cope with the experience of confinement, which is liable to induce recurrences of mental disorders. The total or partial closure of community mental health facilities is particularly disturbing for patients, but a regular follow-up is possible with telemedicine and should include the monitoring of suicide risk and psycho-education strategies;developing support platforms could also be very helpful in this context. Private practice psychiatrists also have a crucial role...

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“…We first consider the parallels between the findings in epidemiologic and animal studies for schizophrenia, bipolar disorder, and autism spectrum disorders. Since a full review of the findings of MIA and neuropsychiatric outcomes is beyond the scope of this article, we highlight some key results and refer the reader to several comprehensive reviews(1, 2, 6, 14-17, 22). Below, we focus on the potential areas of concordance between epidemiologic and basic science studies for each of these disorders.…”

Section: Review Of the Findings Of Mia Studies Of Neuropsychiatric Oumentioning

confidence: 99%

“…Such studies have been supplanted in more recent years with birth cohort studies that utilize prospectively acquired serologic biomarkers of infection and/or inflammation in individual pregnancies. As discussed in the next section, an increasing number of publications suggest associations between maternal infectious or inflammatory biomarkers and schizophrenia, autism spectrum disorders, and bipolar disorder(1, 2, 6, 14-16, 22). Other studies, which have utilized prospective data on maternal infection acquired from records on clinically diagnosed infections, have also yielded evidence in support of these exposures as risk factors(1, 6).…”

Section: Introductionmentioning

confidence: 98%

Maternal Immune Activation and Neuropsychiatric Illness: A Translational Research Perspective

Brown

Meyer

2018

AJP

206

186

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Epidemiologic studies, including prospective birth cohort investigations, have implicated maternal immune activation in the etiology of neuropsychiatric disorders. Maternal infectious pathogens and inflammation are plausible risk factors for these outcomes and have been associated with schizophrenia, autism spectrum disorder, and bipolar disorder. Concurrent with epidemiologic research are animal models of prenatal immune activation, which have documented behavioral, neurochemical, neuroanatomic, and neurophysiologic disruptions that mirror phenotypes observed in these neuropsychiatric disorders. Epidemiologic studies of maternal immune activation offer the advantage of directly evaluating human populations but are limited in their ability to uncover pathogenic mechanisms. Animal models, on the other hand, are limited in their generalizability to psychiatric disorders but have made significant strides toward discovering causal relationships and biological pathways between maternal immune activation and neuropsychiatric phenotypes. Incorporating these risk factors in reverse translational animal models of maternal immune activation has yielded a wealth of data supporting the predictive potential of epidemiologic studies. To further enhance the translatability between epidemiology and basic science, the authors propose a complementary approach that includes deconstructing neuropsychiatric outcomes of maternal immune activation into key pathophysiologically defined phenotypes that are identifiable in humans and animals and that evaluate the interspecies concordance regarding interactions between maternal immune activation and genetic and epigenetic factors, including processes involving intergenerational disease transmission. [AJP AT 175: Remembering Our Past As We Envision Our Future October 1857: The Pathology of Insanity J.C. Bucknill: "In the brain the state of inflammation itself either very quickly ceases or very soon causes death; but when it does cease it leaves behind it consequences which are frequently the causes of insanity, and the conditions of cerebral atrophy."(Am J Psychiatry 1857; 14:172-193 )].

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Infectious and immunogenetic factors in bipolar disorder

Abstract: Infection has emerged as a potential preventable cause of morbidity in BD, urging the need to better investigate components of the host-pathogen interaction in patients and at-risk subjects, and thus opening the way to novel therapeutic opportunities.

Cited by 37 publications

References 125 publications

Oxidative and nitrosative stress markers in obsessive–compulsive disorder: a systematic review and meta‐analysis

Oxidative and nitrosative stress markers in obsessive–compulsive disorder: a systematic review and meta‐analysis

Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review

Maternal Immune Activation and Neuropsychiatric Illness: A Translational Research Perspective

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