Background Cannabis use is a risk factor of psychiatric illness, such as bipolar disorder type-I (BDI). Indeed, cannabis use strongly influences the onset and clinical course of BDI, although the biological mechanisms underlying this interaction remain unknown. Therefore, we have reviewed the biological mechanisms affected by cannabis use that may trigger BD. Methods A systematic review was carried out of articles in which gene expression was studied in cannabis users or human-derived cells exposed to THC or CBD. A second systematic review was then performed to identify articles in which gene expression was studied in BDI samples, highlighting those that described alterations to the same molecular and cellular mechanisms affected by cannabis/THC/CBD. Results The initial search identified 82 studies on cannabis and 962 on BDI. After removing duplicates and applying the inclusion/exclusion criteria, 9 studies into cannabis and 228 on BDI were retained. The molecular and cellular mechanisms altered by cannabis use or THC/CBD exposure were then identified, including: neural development and function, cytoskeletal function, cell adhesion, mitochondrial biology, inflammatory related pathways, lipid metabolism, the endocannabinoid system, the hypocretin/orexin system, and apoptosis. Alterations to those activities were also described in 19 of 228 focussed on BDI. Conclusions The biological mechanisms described in this study may be good candidates to the search for diagnostic biomarkers and therapeutic targets for BDI. As cannabis use can trigger the onset of BD, further studies would be of interest to determine whether they are involved in the early development of the disorder, prompting early treatment.

中文翻译：

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对大麻引起的可能作为双相情感障碍危险因素的分子和细胞改变的系统评价

背景 吸食大麻是精神疾病的一个危险因素，例如 I 型双相情感障碍 (BDI)。事实上，大麻的使用强烈影响 BDI 的发病和临床病程，尽管这种相互作用背后的生物学机制仍然未知。因此，我们回顾了大麻使用可能引发双相情感障碍的生物机制。方法对研究大麻使用者或暴露于 THC 或 CBD 的人源细胞基因表达的文章进行了系统回顾。然后进行第二次系统审查，以确定在 BDI 样本中研究基因表达的文章，重点介绍那些描述受大麻/THC/CBD 影响的相同分子和细胞机制发生变化的文章。结果 初步检索发现了 82 项关于大麻的研究和 962 项关于 BDI 的研究。在删除重复项并应用纳入/排除标准后，9 项针对大麻的研究和 228 项关于 BDI 的研究被保留。然后确定了大麻使用或 THC/CBD 暴露改变的分子和细胞机制，包括：神经发育和功能、细胞骨架功能、细胞粘附、线粒体生物学、炎症相关途径、脂质代谢、内源性大麻素系统、下丘脑分泌素/食欲素系统和细胞凋亡。228 项活动中的 19 项还描述了对这些活动的改变，重点关注 BDI。结论 本研究中描述的生物学机制可能是寻找 BDI 诊断生物标志物和治疗靶点的良好候选者。由于大麻的使用会引发双相情感障碍的发作，因此进一步的研究将有利于确定它们是否参与了该疾病的早期发展，从而促进早期治疗。