title: The role of inflammation in suicidal behaviour.
abstract: OBJECTIVE
  Over the past decade, clinical data have accumulated showing that inflammation might contribute to the pathophysiology of suicide. To evaluate the associations and to identify the support for pathways linking inflammatory processes with suicidal behaviour, a comprehensive review of the literature was undertaken.
  
  
  METHODS
  The search terms 'cytokine', 'risk factors', 'kynurenine', 'asthma', 'allergy', 'autoimmunity', 'traumatic brain injury', 'infection' along with the terms 'inflammation' and 'suicide' were entered into PubMed, and a thorough analysis of the publications and their reference lists was performed.
  
  
  RESULTS
  The effects of inflammation on mood and behaviour could partially be mediated by kynurenine pathway metabolites, modulating neuroinflammation and glutamate neurotransmission. At the same time, the triggers of the inflammatory changes documented in suicidal patients may be attributed to diverse mechanisms such as autoimmunity, neurotropic pathogens, stress or traumatic brain injury.
  
  
  CONCLUSIONS
  Targeting the inflammatory system might provide novel therapeutic approaches as well as potential biomarkers to identify patients at increased risk. For the goal of improved detection and treatment of suicidal individuals to be achieved, we need to develop a detailed understanding of the origin, mechanisms and outcomes of inflammation in suicidal behaviour.
authors.affiliation: Division of Psychiatry and Behavioral Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA.|Laboratory of Behavioral Medicine, Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA.
authors.forename: L
authors.initials: L
authors.lastname: Brundin
authors.affiliation: Department of Physiology & Pharmacology, Karolinska Institute, Stockholm, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Erhardt
authors.affiliation: Laboratory of Behavioral Medicine, Center for Neurodegenerative Science, Van Andel Research Institute, Grand Rapids, MI, USA.
authors.forename: E Y
authors.initials: EY
authors.lastname: Bryleva
authors.affiliation: Division of Psychiatry and Behavioral Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA.
authors.forename: E D
authors.initials: ED
authors.lastname: Achtyes
authors.affiliation: Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.|Veterans Integrated Service Network 19, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Denver, CO, USA.|Veterans Integrated Service Network 5, MIRECC, Baltimore, MD, USA.
authors.forename: T T
authors.initials: TT
authors.lastname: Postolache
mesh_terms: D016207:Cytokines / Q000276:immunology; D006801:Humans; D007249:Inflammation / Q000276:immunology* / Q000523:psychology*; D012307:Risk Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*
chemical_list: D016207:Cytokines
keywords: allergy; asthma; autoimmunity; cytokine; glutamate; infection; inflammation; kynurenine; neurobiology; neuroendocrinology; neuroimmunology; suicide; traumatic brain injury