Influence of Lactation on Postpartum Stress and Immunity

哺乳对产后压力和免疫力的影响

• 批准号: 7373849
• 负责人: Maureen Edith Groer
• 金额: $ 35.83万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-08-01 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7373849
• 关键词: Address; Affect; Anti-Inflammatory Agents; Anti-inflammatory; Antigen Presentation; Atherosclerosis; Autoantibodies; Autoimmune Diseases; Autoimmune Process; Autoimmunity; Biological; Biological Markers; Biology; Breast Feeding; CD40 Ligand; CD8B1 gene; Cardiovascular Diseases; Cells; Cellular Immunity; Chronic Disease; Class; Complement; Cross-Sectional Studies; Development; Discipline of Nursing; Disease; Endocrine; Endocrinology; Environment; Environmental Risk Factor; Enzymes; Epithelial; Estrogens; Female; Flare; Functional disorder; Funding; Genetic; Grant; Graves' Disease; HLA-DR Antigens; Health; Health Sciences; High Risk Woman; Hormones; Hydrocortisone; Hypothyroidism; IL2RA gene; Immune; Immune response; Immune system; Immunity; Immunology; Incidence; Infection; Inflammation; Inflammatory; Inflammatory Response; Investigation; Iodide Peroxidase; Journals; L-Selectin; Lactation; Maternal Health; Measures; Mediator of activation protein; Mental Health; Modeling; Moods; Mothers; Multiple Sclerosis; NCAM1 gene; Numbers; Outcome; Pathogenesis; Pattern; Peptides; Perception; Phase; Physiology; Play; Postpartum Period; Postpartum Women; Pregnancy; Process; Progesterone; Prolactin; Proteins; Psychoneuroimmunology; Public Health; Publications; Rate; Research; Rheumatoid Arthritis; Risk; Role; Stress; Symptoms; T-Cell Activation; T-Lymphocyte; TNFRSF5 gene; Thyroid Diseases; Thyroid Gland; Thyroiditis; Thyrotropin; Thyroxine; Time; Up-Regulation; Week; Woman; Work; base; critical developmental period; cytokine; experience; improved; interest; lens; mortality; prevent; prospective; reproductive

DESCRIPTION (provided by applicant): This revised competing continuation proposal is a request for funding to explore the patterns of immune, endocrine, and inflammatory changes over the postpartum period and to analyze potential relationships between these variables and trajectories as well as the development of postpartum thyroiditis (PPT), a common autoimmune disease of the postpartum. The initial funded project explored the relationship between lactation status and stress and immunity in postpartum mothers. The major findings from that cross sectional study were the presence of significant upregulation of cytokines and proteins and inflammatory responses in 4-6 week postpartum women compared to controls. This has led to the competing continuation request that seeks to explore the pattern of these changes over time, from the first week through the sixth postpartum month, in healthy control mothers and mothers at risk for PPT. This prospective approach will also allow us to examine relationships among endocrine, demographic, stress, mood and immunity variables and determine which of these variables predict and accompany onset and course of PPT. Many autoimmune diseases flare or have their onset in the postpartum, and breastfeeding increases risk. We will use PPT as a model of autoimmune disease, and identify low and high risk for PPT groups on the basis of the presence or absence of thyroid peroxidase enzyme (TPO) autoantibodies measured during pregnancy. We will prospectively study relationships between immune and inflammatory processes and trajectories, breastfeeding status, postpartum hormones, stress and dysphoric moods, general health, and the onset and course of PPT, which we anticipate will occur in about 50% of the TPO+ mothers. In addition, exploration of the normal changes in immunity, inflammation, and hormones in TPO- mothers will provide new understanding about the physiology of the postpartum, and will lay the groundwork for relating this physiology to many maternal health outcomes. The significance of this research to public health lies in the prominent incidences of autoimmune diseases in women, and the debilitating and long-term chronic illnesses that result from autoimmune processes. Genetics only plays a part in the pathogenesis of these illnesses, and the role of environment is critical to understand. The immunology and endocrinology of the postpartum provides a lens through which to study autoimmune disease, as the postpartum is a critical period for development or exacerbation of many autoimmune diseases.

描述（由申请人提供）：本修订后的竞争性延续提案请求资助，以探索产后期间免疫、内分泌和炎症变化的模式，并分析这些变量和轨迹之间的潜在关系以及产后的发展甲状腺炎（PPT）是产后常见的自身免疫性疾病。最初资助的项目探讨了产后母亲的哺乳状态与压力和免疫力之间的关系。该横断面研究的主要发现是，与对照组相比，产后 4-6 周的女性细胞因子和蛋白质以及炎症反应显着上调。这导致了相互竞争的继续请求，旨在探索健康对照母亲和有 PPT 风险的母亲从产后第一周到第六个月随着时间的推移这些变化的模式。这种前瞻性方法还将使我们能够检查内分泌、人口、压力、情绪和免疫变量之间的关系，并确定这些变量中哪些可以预测和伴随 PPT 的发作和病程。许多自身免疫性疾病在产后发作或发作，母乳喂养会增加风险。我们将使用 PPT 作为自身免疫性疾病的模型，并根据怀孕期间测量的甲状腺过氧化物酶 (TPO) 自身抗体是否存在来识别 PPT 的低风险和高风险组。我们将前瞻性地研究免疫和炎症过程和轨迹、母乳喂养状态、产后激素、压力和烦躁情绪、总体健康状况以及 PPT 的发作和病程之间的关系，我们预计大约 50% 的 TPO+ 母亲会出现 PPT。此外，探索 TPO 母亲的免疫、炎症和激素的正常变化将为产后生理学提供新的认识，并将为将这种生理学与许多孕产妇健康结果联系起来奠定基础。 这项研究对公共卫生的意义在于女性自身免疫性疾病的高发病率，以及自身免疫过程导致的衰弱和长期慢性疾病。遗传学仅在这些疾病的发病机制中发挥一定作用，而环境的作用对于理解至关重要。产后的免疫学和内分泌学为研究自身免疫性疾病提供了一个视角，因为产后是许多自身免疫性疾病发生或恶化的关键时期。