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World J Psychiatry. Feb 19, 2025; 15(2): 98484
Published online Feb 19, 2025. doi: 10.5498/wjp.v15.i2.98484
Comprehensive view of suicide: A neuro-immune-endocrine approach
María D Ponce-Regalado, Enrique Becerril-Villanueva, José Luis Maldonado-García, Martha C Moreno-Lafont, Gabriela Martínez-Ramírez, Salomón Jacinto-Gutiérrez, Rodrigo Arreola, Karla Sánchez-Huerta, Arturo Contis-Montes de Oca, Karla María López-Martínez, Elizabeth Bautista-Rodríguez, José Miguel Chin-Chan, Lenin Pavón, Gilberto Pérez-Sánchez
María D Ponce-Regalado, Departamento de Ciencias de la Salud, Centro Universitario de los Altos, Universidad de Guadalajara, Tepatitlán de Morelos 47620, Jalisco, Mexico
Enrique Becerril-Villanueva, José Luis Maldonado-García, Gabriela Martínez-Ramírez, Salomón Jacinto-Gutiérrez, Lenin Pavón, Gilberto Pérez-Sánchez, Laboratorio de Psicoinmunología, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México 11340, Mexico
José Luis Maldonado-García, Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México, Coyoacán, Ciudad de México 04510, Mexico
José Luis Maldonado-García, Martha C Moreno-Lafont, Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México 11350, Mexico
Gabriela Martínez-Ramírez, Facultad de Medicina, Facultad de Estudios Superiores Iztacala, Universidad Nacional autónoma de México, Tlalnepantla 54090, Mexico
Rodrigo Arreola, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México 11340, Mexico
Karla Sánchez-Huerta, Laboratorio de Neurociencias, Subdirección de Medicina Experimental, Instituto Nacional de Pediatría, Ciudad de México 04530, Mexico
Arturo Contis-Montes de Oca, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico
Karla María López-Martínez, Facultad de Biotecnología, Universidad Popular Autónoma de Puebla, Puebla 72410, Mexico
Elizabeth Bautista-Rodríguez, Química Clínica, Facultad de Ciencias de la Salud, Universidad Autónoma de Tlaxcala, Tlaxcala 90750, Mexico
José Miguel Chin-Chan, Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Campeche, Campeche 24039, Mexico
Co-first authors: Ponce-Regalado MD and Becerril-Villanueva E.
Co-corresponding authors: Pavón L and Pérez-Sánchez G.
Author contributions: Ponce-Regalado MD, Becerril-Villanueva E, Pavón L and Pérez-Sánchez G designed the research and study conceptualization; Ponce-Regalado MD, Becerril-Villanueva E, Maldonado-García JL, Arreola R, Sánchez-Huerta K, Contis-Montes de Oca A, López-Martínez KM, Bautista-Rodríguez E, Chin-Chan JM and Pérez-Sánchez G wrote the original draft; Pavón L and Pérez-Sánchez G received the funding; Jacinto-Gutiérrez S, Martínez-Ramírez G and Moreno-Lafont MC reviewed the data; Ponce-Regalado MD, Sánchez-Huerta K and Pérez-Sánchez G revised the paper; All the authors approved the final version of the submitted paper. Ponce-Regalado MD designed the overall structure of the manuscript and coordinated the elaboration of the sections addressing social topics and Becerril-Villanueva E developed and coordinated the topics of immunology, neurobiology, endocrinology and genetics. Both authors have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper.
Supported by CONAHCYT Project, No. CF-2023-I-2663; and Instituto Nacional de Psiquiatría Project, No. NC24208.0 (to Pérez-Sánchez G, Pavón L, Sánchez-Huerta K, Maldonado-García JL, Chin-Chan JM, Ponce-Regalado MD, Arreola R, Contis-Montes de Oca A, and Moreno-Lafont MC).
Conflict-of-interest statement: All authors declare that there are no conflicts of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lenin Pavón, PhD, Professor, Laboratorio de Psicoinmunología, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, 101 Calz México-Xochimilco, Ciudad de México 11340, Mexico. lkuriaki@inprf.gob.mx
Received: June 29, 2024
Revised: November 26, 2024
Accepted: December 23, 2024
Published online: February 19, 2025
Processing time: 199 Days and 3.9 Hours
Abstract

Suicide is defined as the act of a person attempting to take their own life by causing death. Suicide is a complex phenomenon that is influenced by a multitude of factors, including psychosocial, cultural, and religious aspects, as well as genetic, biochemical, and environmental factors. From a biochemical perspective, it is crucial to consider the communication between the endocrine, immune, and nervous systems when studying the etiology of suicide. Several pathologies involve the bidirectional communication between the peripheral activity and the central nervous system by the action of molecules such as cytokines, hormones, and neurotransmitters. These humoral signals, when present in optimal quantities, are responsible for maintaining physiological homeostasis, including mood states. Stress elevates the cortisol and proinflammatory cytokines levels and alter neurotransmitters balance, thereby increasing the risk of developing a psychiatric disorder and subsequently the risk of suicidal behavior. This review provides an integrative perspective about the neurochemical, immunological, and endocrinological disturbances associated with suicidal behavior, with a particular focus on those alterations that may serve as potential risk markers and/or indicators of the state preceding such a tragic act.

Keywords: Suicide; Neuroimmune endocrine; Neurotransmitters; Hormones; Cytokines; Hypothalamic-pituitary adrenal axis; Early life adversity; Inflammation; Genetic predisposition; Psychiatric disorders

Core Tip: The World Health Organization defines suicide as 'any act by which an individual causes injury to himself or herself, regardless of the degree of lethal intent and knowledge of the true mobile'. The etiology of suicide is multifactorial and involves complex interactions among biological, genetic, psychological, social, and environmental factors. The purpose of this manuscript is to describe the complex interactions of neuroimmunoendocrine and genetic factors associated with suicide and their relationships with environmental factors such as exposure to early life adversity, with a focus on alterations in the hypothalamic-pituitary adrenal axis and immune system.