# Neuroinflammatory and Epigenetic Mechanisms of Blood-Brain Barrier Compromise in Suicide

> **NIH VA I01** · JAMES J PETERS VA  MEDICAL CENTER · 2021 · —

## Abstract

We propose a set of studies focused on the association of suicide with neuroinflammation and
compromise of the blood-brain barrier, with the goal of identifying a pattern of quantifiable abnormalities that
could serve as a biomarker for imminent suicidal risk in our Veterans. Autopsy studies are uniquely suited to do
this, because they capture the state of the brain at the time of the suicidal act.
 Findings from our laboratories and others indicate that susceptibility to suicide includes inflammatory
activation in the brain and systemically, accompanied by compromised integrity of the blood-brain barrier: (1)
Most directly, we reported increased densities of microglia or other phagocytic cells associated with blood
vessels in dorsal prefrontal white matter of people who died by suicide, Similar results are reported in cingulate
white matter. (2) Studies of brains from individuals who died by suicide and studies of blood and CSF from live
individuals who had previously attempted suicide found elevations of inflammatory cytokines. (3) Various
infectious diseases are associated with increased risk of suicide, as is a history of hospitalization for any
infection. (4) Laboratory animals exposed to stress show elevated levels of inflammatory cytokines, increased
permeability of the blood-brain barrier, behavioral abnormalities, and activation of microglia. (5) We have
reported an association of suicide with a polymorphism and decreased frontal and cingulate transcripts for
CD44, which is involved in the normal function of the BBB. (6) Biochemical measures suggesting BBB
impairment are reportedly associated with attempted suicide and with suicidal ideation. (7) In MDD subjects
who died by suicide, compared with nonpsychiatric non-suicide cases, we found differential methylation of
genes associated with cell death, both in whole cortical homogenates and in purified neuronal fractions. We
also found significantly lower methylation in the promoter of the gene for CCL3, a powerful inflammatory
cytokine synthesized by microglia and astrocytes and an attractant for microglia and white blood cells, but this
difference was not present in the purified neuronal fraction.
 Taken together, these findings lead us to hypothesize a suicidal state characterized by impaired BBB
function, elevation of pro-inflammatory cytokines, and abnormalities in DNA methylation of genes stimulating
inflammation, all of which can be assessed in live individuals. To confirm this phenotype, we propose three
specific aims, each employing the same set of 90 autopsy brains, already collected. In order to distinguish
features of suicide from those of psychiatric illness, we employ a 3-group design with 30 cases of psychiatric
disease and suicide, 30 cases of psychiatric disease without suicide, and 30 cases with neither psychiatric
disease nor suicide, all from a well-characterized collection with a single collection protocol at a single autopsy
service. To optimize our ability to distingu...

## Key facts

- **NIH application ID:** 10212972
- **Project number:** 5I01BX003794-04
- **Recipient organization:** JAMES J PETERS VA  MEDICAL CENTER
- **Principal Investigator:** FATEMEH G HAGHIGHI
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-01-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10212972

## Citation

> US National Institutes of Health, RePORTER application 10212972, Neuroinflammatory and Epigenetic Mechanisms of Blood-Brain Barrier Compromise in Suicide (5I01BX003794-04). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10212972. Licensed CC0.

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