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Review
. 2017 Oct;136(4):409-423.
doi: 10.1111/acps.12791. Epub 2017 Aug 20.

Infectious and immunogenetic factors in bipolar disorder

J Oliveira  1   2 , A J Oliveira-Maia  1   3   4   5 , R Tamouza  6   7 , A S Brown  8 , M Leboyer  7   9   10
Affiliations
Review

Infectious and immunogenetic factors in bipolar disorder

J Oliveira et al. Acta Psychiatr Scand. 2017 Oct.

Abstract

Objective: Despite the evidence supporting the association between infection and bipolar disorder (BD), the genetic vulnerability that mediates its effects has yet to be clarified. A genetic origin for the immune imbalance observed in BD, possibly involved in the mechanisms of pathogen escape, has, however, been suggested in recent studies.

Method: Here, we present a critical review based on a systematic literature search of articles published until December 2016 on the association between BD and infectious/immunogenetic factors.

Results: We provide evidence suggesting that infectious insults could act as triggers of maladaptive immune responses in BD and that immunogenetic vulnerability may amplify the effects of such environmental risk factors, increasing susceptibility to subsequent environmental encounters. Quality of evidence was generally impaired by scarce attempt of replication, small sample sizes and lack of high-quality environmental measures.

Conclusion: 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.

Keywords: bipolar disorder; immunogenetics; infection; inflammation.

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Figures

Figure 1
Figure 1
Article selection process of studies on the association between infection and bipolar disorder.
Figure 2
Figure 2
Article selection process of studies on the association between immunogenetic markers and bipolar disorder.
Figure 3
Figure 3
Increased vulnerability to infection in bipolar disorder: a multiple‐hit model.
See this image and copyright information in PMC

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