title: Neuroinflammation in suicide: Toward a comprehensive model.
abstract: Suicidal behaviour (SB) entered the DSM-5, underlying a specific biological vulnerability. Then, recent findings suggested a possible role of the immune system in SB pathogenesis. The objective of this review is to present these main immune factors involved in SB pathogenesis.
  
  
  
  We conducted a review using Preferred Reporting Items for Systematic reviews and Meta-Analysis criteria, and combined ("Inflammation") AND ("Suicidal ideation" OR "Suicidal attempt" OR "suicide").
  
  
  
  Post mortem studies demonstrated associations between suicide and inflammatory cytokines in the orbitofrontal cortex, a brain region involved in suicidal vulnerability. Also, microgliosis and monocyte-macrophage system activation may be a useful marker of suicide neurobiology. Kynurenine may influence inflammatory processes, and related molecular pathways may be involved in SB pathophysiology. Few recent studies associated inflammatory markers with suicidal vulnerability: serotonin dysfunction, impulsivity and childhood trauma. Interestingly, the perception of threat that leads suicidal individuals to contemplate suicide may activate biological stress responses, including inflammatory responses.
  
  
  
  Translational projects would be crucial to identify a specific marker in SB disorders, to investigate its clinical correlations, and the interaction between inflammatory cytokines and monoamine systems in SB. These researches might lead to new biomarkers and novel directions for therapeutic strategies.
authors.affiliation: a Department of Emergency Psychiatry , Hôpital Lapeyronie, CHU Montpellier and Post Acute Care , CHU Montpellier , France.|b Inserm, University of Montpellier , Montpellier , France.|c FondaMental Foundation , France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Courtet
authors.affiliation: d University of Seville , Spain.
authors.forename: Lucas
authors.initials: L
authors.lastname: Giner
authors.affiliation: a Department of Emergency Psychiatry , Hôpital Lapeyronie, CHU Montpellier and Post Acute Care , CHU Montpellier , France.|b Inserm, University of Montpellier , Montpellier , France.|c FondaMental Foundation , France.
authors.forename: Maude
authors.initials: M
authors.lastname: Seneque
authors.affiliation: a Department of Emergency Psychiatry , Hôpital Lapeyronie, CHU Montpellier and Post Acute Care , CHU Montpellier , France.|b Inserm, University of Montpellier , Montpellier , France.|c FondaMental Foundation , France.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Guillaume
authors.affiliation: a Department of Emergency Psychiatry , Hôpital Lapeyronie, CHU Montpellier and Post Acute Care , CHU Montpellier , France.|b Inserm, University of Montpellier , Montpellier , France.|c FondaMental Foundation , France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Olie
authors.affiliation: a Department of Emergency Psychiatry , Hôpital Lapeyronie, CHU Montpellier and Post Acute Care , CHU Montpellier , France.|b Inserm, University of Montpellier , Montpellier , France.|c FondaMental Foundation , France.
authors.forename: Deborah
authors.initials: D
authors.lastname: Ducasse
mesh_terms: D015415:Biomarkers; D016207:Cytokines / Q000032:analysis*; D006801:Humans; D007249:Inflammation / Q000503:physiopathology*; D001523:Mental Disorders / Q000209:etiology; D017628:Microglia / Q000473:pathology*; D017397:Prefrontal Cortex / Q000503:physiopathology*; D016032:Randomized Controlled Trials as Topic; D013406:Suicide, Attempted
chemical_list: D015415:Biomarkers; D016207:Cytokines
keywords: biomarker; inflammation; microglia; social ties; suicidal behaviour