title: Is Toxoplasma gondii a Trigger of Bipolar Disorder?
abstract: Toxoplasma gondii, a ubiquitous intracellular parasite, has a strong tropism for the brain tissue, where it forms intracellular cysts within the neurons and glial cells, establishing a chronic infection. Although latent toxoplasmosis is generally assumed to be asymptomatic in immunocompetent individuals, it is now clear that it can induce behavioral manipulations in mice and infected humans. Moreover, a strong relation has emerged in recent years between toxoplasmosis and psychiatric disorders. The link betweenT. gondiiand schizophrenia has been the most widely documented; however, a significant association with bipolar disorder (BD) and suicidal/aggressive behaviors has also been detected.T. gondiimay play a role in the etiopathogenesis of psychiatric disorders affecting neurotransmitters, especially dopamine, that are implicated in the emergence of psychosis and behavioralToxoplasma-induced abnormalities, and inducing brain inflammation by the direct stimulation of inflammatory cytokines in the central nervous system. Besides this, there is increasing evidence for a prominent role of immune dysregulation in psychosis and BD. The aim of this review is to describe recent evidence suggesting a link betweenToxoplasma gondiiand BD, focusing on the interaction between immune responses and this infectious agent in the etiopathogenesis of psychiatric symptoms.
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Roma 67, 56127 Pisa, Italy. claudia_83@virgilio.it.
authors.forename: Claudia
authors.initials: C
authors.lastname: Del Grande
authors.affiliation: Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, 56126 Pisa, Italy. luca.galli18@virgilio.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Galli
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Roma 67, 56127 Pisa, Italy. el.schiavi@gmail.com.
authors.forename: Elisa
authors.initials: E
authors.lastname: Schiavi
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Roma 67, 56127 Pisa, Italy. liliana.dellosso@med.unipi.it.
authors.forename: Liliana
authors.initials: L
authors.lastname: Dell'Osso
authors.affiliation: Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, 56126 Pisa, Italy. fabrizio.bruschi@med.unipi.it.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Bruschi
keywords: Toxoplasma gondii; antipsychotics and mood stabilizers; bipolar disorder; dopaminergic pathways; immunity; pro-inflammatory cytokines