title: The role of inflammatory cytokines in suicidal behavior: a systematic review.
abstract: There is growing evidence that inflammatory mediators play a critical role in the pathophysiology of both major depression and suicidal behavior. Immunological differences have been reported in both major affective disorders and suicidal behavior. Specifically, increased levels of pro-inflammatory cytokines have been shown to correlate with the severity of depression and various cytokines have been identified as potentially important in understanding the pathophysiology of major affective disorders/suicidality. We aimed to conduct a systematic review of the current literature to investigate the association between inflammatory cytokines and suicidal behavior. Only articles from peer-reviewed journals were selected for inclusion in the present review. Most studies documented the association between suicidality and IL2, IL-6, IL-8, TNF-α and VEGF levels that have been found altered in suicidal behavior. The presence of major depressive disorder (MDD) with suicidal ideation/attempts was associated with differences in inflammatory cytokine profile when compared to that without suicidal ideation/attempts. Most suicide attempters or subjects with suicidal ideation showed an imbalance of the immune system but this does not imply the existence of a causal link. Also, not all studies demonstrated a positive correlation between inflammatory cytokines and suicidal behavior. Further additional studies should elucidate the molecular mechanisms of the immune activation pathways underlying suicidality.
authors.affiliation: Department of Neurosciences, Mental Health and Sensory Organs-Suicide Prevention Center, Sapienza University of Rome, Sant'Andrea Hospital, 1035-1039 Via di Grottarossa, Rome 00189, Italy. Electronic address: gianluca.serafini@uniroma1.it.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Serafini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
authors.forename: Maria
authors.initials: M
authors.lastname: Elena Seretti
authors.forename: Henry
authors.initials: H
authors.lastname: Stefani
authors.forename: Mario
authors.initials: M
authors.lastname: Palermo
authors.forename: William
authors.initials: W
authors.lastname: Coryell
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
mesh_terms: D016207:Cytokines / Q000378:metabolism*; D003865:Major Depressive Disorder / Q000378:metabolism* / Q000523:psychology*; D006801:Humans; D013405:Suicide / Q000523:psychology
chemical_list: D016207:Cytokines
keywords: Cytokines; Inflammation; Inflammatory mediators; Suicidal behavior