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Topic: Neurovascular and neuroinflammation mechanisms

associated with bipolar disorder

The role of neuroinflammation in juvenile

bipolar disorder

Giulia Serra 1,2,3,4 , Lavinia De Chiara , Ciro Marangoni , Gianni L. Faedda 3,6,7
1
4,5
1 Department of Neurosciences, Mental Health, and Sensory Organs, Sant’Andrea Hospital, Sapienza University of Rome, 00192
Rome, Italy.
2 Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA.
3 International Consortium for Bipolar and Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont,
MA 02478, USA.
4 Lucio Bini Mood Disorder Center, 00193 Rome, Italy.
5 Department of Biomedical and Specialty Surgical Sciences, Section of Neurological, Psychiatric and Psychological Sciences,
University of Ferrara, 44121 Ferrara, Italy.
6 Lucio Bini Mood Disorders Center, New York 10022, USA.
7 New York University Medical Center and Child Study Center, New York 10016, USA.

ABSTRA CT

A pathophysiological relationship has been reported between inflammatory processes, decreased levels of neurotrophins,
increased oxidative stress and psychiatric disorders in both juvenile and adult ages. Moreover, this relationship remains unclear
in juvenile bipolar disorder (BD). We performed a systematic literature review of studies reporting measurements of inflammatory
markers, oxidative stress markers or neurotrophins in juvenile and young adult subjects with BD. Concordant findings showed
that inflammatory markers are increased since the earlier stages of BD. A positive correlation between decreased levels of a
peripheral brain‑derived neurotrophic factor and juvenile BD is controversial suggesting that those changes might occur only
during the late stage of BD. No changes in central glutathione levels were reported in young adult age BD indicating that oxidative
stress may be an outcome of long illness duration and repeated affective episodes. In conclusion, preliminary findings indicate
that a certain relationship exists between inflammatory process and juvenile BD but evidence are insufficient to support a causal
relationship. Adequately powered and prospective studies are warranted to clarify the role of inflammation, neurotrophins and
oxidative stress in juvenile BD.

Key words: Adolescent, bipolar disorder, brain‑derived neurotrophic factor, children, inflammation, oxidative stress, pediatric

INTRODUCTION Multiple studies analyzing peripheral biomarkers of
mood disorders have provided important information on
During the last 20 years, a growing body of evidences has the pathophysiologic process underlying adult bipolar
supported a pathophysiological relationship between disorder (BD). [1,3] Concordant and consistent evidences
inflammatory processes, decreased neurotrophins have shown that brain‑derived neurotrophic factor (BDNF)
levels, increased oxidative stress and psychiatric decreases during both manic and depressive phases
disorders in both juvenile and adult ages. [1,2] of bipolar illness, [4‑6] increases after the treatment with
antidepressant and antimanics [7‑9] and correlate with the
Corresponding Author: Dr. Giulia Serra, illness stage with decreased levels in the late stage of BD. [10]
Department of Neurosciences, Mental Health, and Sensory
Organs, Sant’Andrea Hospital, Sapienza University of Several independent laboratories have found that
Rome, Via di Grottarossa 1035‑1039, Rome 00192, Italy. depressive and manic states are associated with an
E‑mail: giuliaserra@gmail.com

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Cite this article as: Serra G, De Chiara L, Marangoni C, Faedda GL.
The role of neuroinflammation in juvenile bipolar disorder. Neuroimmunol
DOI:
10.4103/2347-8659.167303 Neuroinflammation 2015;2:244-51.
Received: 22-03-2015; Accepted: 20-04-2015

244 © 2015 Neuroimmunology and Neuroinflammation | Published by Hongkong Partner Publishing Co. Limited