title: Targeting mitochondrially mediated plasticity to develop improved therapeutics for bipolar disorder.
abstract: BACKGROUND
  Bipolar disorder (BPD) is a severe illness with few treatments available. Understanding BPD pathophysiology and identifying potential relevant targets could prove useful for developing new treatments. Remarkably, subtle impairments of mitochondrial function may play an important role in BPD pathophysiology.
  
  
  METHODS
  This article focuses on human studies and reviews evidence of mitochondrial dysfunction in BPD as a promising target for the development of new, improved treatments. Mitochondria are crucial for energy production, generated mainly through the electron transport chain (ETC) and play an important role in regulating apoptosis and calcium (Ca²⁺) signaling as well as synaptic plasticity. Mitochondria move throughout the neurons to provide energy for intracellular signaling. Studies showed polymorphisms of mitochondria-related genes as risk factors for BPD. Postmortem studies in BPD also show decreased ETC activity/expression and increased nitrosative and oxidative stress (OxS) in patient brains. BPD has been also associated with increased OxS, Ca²⁺ dysregulation and increased proapoptotic signaling in peripheral blood. Neuroimaging studies consistently show decreased energy levels and pH in brains of BPD patients.
  
  
  CONCLUSIONS
  Targeting mitochondrial function, and their role in energy metabolism, synaptic plasticity and cell survival, may be an important avenue for development of new mood-stabilizing agents.
authors: University of Sao Paulo, Institute and Department of Psychiatry, Laboratory of Neuroscience, LIM-27, Faculty of Medicine , Paulo Rua Ovidio Pires de Campos 785, São Paulo, SP , Brazil.
authors: Rafael T
authors: RT
authors: de Sousa
authors: Rodrigo
authors: R
authors: Machado-Vieira
authors: Carlos A
authors: CA
authors: Zarate
authors: Husseini K
authors: HK
authors: Manji
mesh_terms: D018692:Antimanic Agents / Q000494:pharmacology*; D017209:Apoptosis / Q000187:drug effects; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology; D002118:Calcium / Q000378:metabolism; D002470:Cell Survival / Q000187:drug effects; D015195:Drug Design; D004734:Energy Metabolism / Q000187:drug effects; D006801:Humans; D008928:Mitochondria / Q000187:drug effects / Q000473:pathology; D058990:Molecular Targeted Therapy; D009473:Neuronal Plasticity / Q000187:drug effects; D011110:Polymorphism, Genetic; D012307:Risk Factors
chemical_list: D018692:Antimanic Agents; D002118:Calcium
keywords: apoptosis; bipolar disorder; calcium; mitochondria; mood stabilizer; oxidative stress