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Importantly, 40%60% of patients present with allergic multimorbidity, particularly concurrent allergic rhinitis and atopic dermatitis, which synergistically exacerbate disease progression and substantially impair quality of life metrics ( The gut microbiota, comprising a complex ecosystem of commensal microorganisms, exerts systemic immunomodulatory effects through bidirectional gut-lung axis communication

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This review presents an updated overview of some of the most prominent pathophysiologic mechanisms in bipolar disorder, from mitochondrial, endoplasmic reticular, and calcium homeostasis, to purinergic, kynurenic, and hormonal/neurotransmitter signaling, showing inflammation to act as a powerful nexus between these systems