Background: Suicide attempts (SA) frequently occur in patients with mood disorders and schizophrenia, which are both accompanied by activated immune-inflammatory and nitro-oxidative (IO&NS) pathways. Methods: We searched PubMed, Google Scholar, and Web of Science, for articles published from inception until February 1, 2021. We included studies that compared blood biomarkers in psychiatric patients with (SA+) and without SA (SA-) and heathy controls and we combined different IO&NS biomarkers into immune, inflammatory, and neurotoxic profiles and used meta-analysis (random-effect model with restricted maximum-likelihood) to delineate effect sizes with 95% confidence interval (CI). Findings: Our search included 51 studies comprising 4.945 SA+ patients and 24.148 controls. We stratified the control group into healthy controls and SA- patients. SA+ patients showed significantly (p<0.001) increased immune activation (SMD: 1.044; CI: 0.599-1.489), inflammation (SMD: 1.109; CI: 0.505, 1.714), neurotoxicity (SMD: 0.879; CI: 0.465, 1.293), and lowered neuroprotection (SMD: 0.648; CI: 0.354, 0.941) as compared with healthy controls. When compared with SA- patients, those with SA+ showed significant (p<0.001) immune activation (SMD: 0.290; CI: 0.183, 0.397), inflammation (SMD: 0.311; CI: 0.191, 0.432), and neurotoxicity (SMD: 0.315; CI: 0.198, 0.432), and lowered neuroprotection (SMD: 0.341; CI: 0.167, 0.515). Patients with current, but not lifetime, SA showed significant (p<0.001) levels of inflammation and neurotoxicity as compared with controls. Conclusions: Patients with immune activation are at a higher risk of SA which may be explained by increased neurotoxicity due to inflammation and nitro-oxidative stress. This meta-analysis discovered new biomarkers of SA and therapeutic targets to treat individuals with SA.

中文翻译：

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自杀未遂患者中由于激活的免疫炎症和硝基氧化应激途径而引起的神经毒性增加：系统评价和荟萃分析。

背景：情绪障碍和精神分裂症患者经常发生自杀尝试（SA），并伴有激活的免疫炎症和硝基氧化（IO＆NS）途径。方法：我们搜索了PubMed，Google Scholar和Web of Science，从开始到2021年2月1日发表的文章。我们纳入了比较具有（SA +）和不具有SA（SA-）以及健康对照和精神病患者的精神病患者血液生物标志物的研究。我们将不同的IO＆NS生物标记物组合成免疫，炎性和神经毒性谱，并使用荟萃分析（具有最大可能性限制的随机效应模型）以95％的置信区间（CI）描绘效应量。结果：我们的搜索包括51项研究，其中包括4.945名SA +患者和24.148名对照。我们将对照组分为健康对照组和SA患者。SA +患者表现出显着（p <0.001）的免疫激活增强（SMD：1.044; CI：0.599-1.489），炎症（SMD：1.109; CI：0.505，1.714），神经毒性（SMD：0.879; CI：0.465，1.293），与健康对照组相比，神经保护作用降低（SMD：0.648； CI：0.354、0.941）。与SA-患者相比，SA +患者表现出显着（p <0.001）的免疫激活（SMD：0.290; CI：0.183，0.397），炎症（SMD：0.311; CI：0.191，0.432）和神经毒性（SMD：0.315） ； CI：0.198，0.432），并降低了神经保护作用（SMD：0.341； CI：0.167，0.515）。与对照组相比，患有当前但并非终生SA的患者显示出显着（p <0.001）的炎症和神经毒性水平。结论：具有免疫激活作用的患者患SA的风险较高，这可以通过炎症和硝基氧化应激引起的神经毒性增加来解释。这项荟萃分析发现了SA的新生物标志物和治疗SA个体的治疗靶标。