INFLAMMATION FACTORS IN POSTPARTUM DEPRESSION

产后抑郁症的炎症因素

基本信息

批准号：
7608169
负责人：
TEODOR T POSTOLACHE
金额：
$ 0.53万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-03-01 至 2008-02-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7608169
关键词：
Affect Affective Age-Years Applications Grants Behavioral Biological Process Birth Blood C-reactive protein Cells Child Childbirth Cognitive Complication Computer Retrieval of Information on Scientific Projects Database Data Early Diagnosis Early treatment Emotional Etiology Family Freezing Funding Future Goals Grant Gynecology Hamilton Rating Scale for Depression Health Immune response Immune system Immunocompetent Infanticide Inflammation Inflammatory Institution Interleukin 6 Receptor Interleukin-6 Kynurenine Lead Lymphocyte Major Depressive Disorder Maryland Measurement Mental Depression Mothers Obstetrics Departments Patients Peripheral Personal Satisfaction Postpartum Depression Postpartum Period Pregnancy Pregnant Women Prophylactic treatment Public Health Purpose Rate Recruitment Activity Recurrence Research Research Personnel Resources Risk Score Serum Severities Source Standards of Weights and Measures Suicide Testing Therapeutic Time Tryptophan United States National Institutes of Health Universities Veins Week Woman child bearing cytokine day depressive symptoms macrophage novel therapeutics therapeutic target

项目摘要

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Postpartum depression, most often occurring 4-6 weeks postpartum, is the most common psychiatric complication of childbearing, affecting 10-15% of women and, as such, represents a significant public health concern. Depressive illness following childbirth can be detrimental to the mother, to her children, and to her immediate family. If untreated, postpartum depression can have serious long-term consequences. After one postpartum depressive episode, the risk of recurrence of major depression in is 25%. Untreated depression in the mother leads to long-term emotional, behavioral, cognitive, and interpersonal problems in her children. The most severe cases of postpartum affective or psychotic illness may lead to suicide in the mother or infanticide. Because of these serious consequences, early diagnosis, early treatment and continued research on the etiologies of postpartum depression is imperative in order to better understand the health and well being of both mother and child. Cytokines are a heterogeneous group of messenger molecules that are produced by immunocompetent cells such as lymphocytes and macrophages in order to regulate immune responses. Administration of certain cytokines to patients for therapeutic purposes and induction of cytokines experimentally in healthy subjects results in increased severity of depression. Descriptions of maternal immune system changes during pregnancy include evidence of immune system activation, immune system suppression, and immunological tolerance. Consistent with expected biological functions, cytokine levels in women at end of term are higher than cytokine levels in non-pregnant women. We hypothesize that inflammation in the immediate postpartum period may trigger depressive symptoms postpartum in vulnerable women. Primary aim: 1) To assess a possible relationship between markers of inflammation in the immediate postpartum period, and the severity of depressive symptoms in the late postpartum period. Secondary aims: 2) To assess the relationship between depressive scores and inflammatory markers at each time point: prepartum, early postpartum and late postpartum. 3) To evaluate the relationship between changes in depression scores and changes in inflammatory markers from prepartum to early postpartum, from prepartum to late postpartum, and from early postpartum to late postpartum. Fifty pregnant women 18 years of age or older who are at high risk for postpartum depression will be recruited from the University of Maryland Department of Obstetrics and Gynecology. Women will have to meet at least one of the high-risk criteria for postpartum depression. Subjects will be studied at three time points: at 35-38 weeks gestation, 1-5 days after delivery, and 5-6 weeks after delivery. At each time point there will be a rating of depressive scores and a blood draw of 5 teaspoons from a peripheral vein for measurement of subjects' serum levels for the following inflammatory markers: C-reactive protein, Interleukin-6, and Interleukin-6 Receptor. Additional serum for kynurenine and tryptophan measurements will be frozen for future study when additional funds become available. Initial analyses will be descriptive (means and standard deviations for continuous data and proportions for categorical data). Changes from pre-birth values on all continuous variables will be calculated for 1-5 days postpartum and 5-6 weeks postpartum. Correlations between changes in inflammatory markers and changes on the Hamilton Depression Scale, a standardized rating scale for the severity of depression will be calculated and then tested for significance of difference. Our long-term goal is to describe inflammatory mechanisms of postpartum depression and potentially identify novel therapeutic targets that may lead to prophylactic treatments of postpartum depression. The purpose of this application is to gather preliminary data for a larger NIH grant application.

该子项目是利用该技术的众多研究子项目之一资源由 NIH/NCRR 资助的中心拨款提供。子项目及研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金，因此可以在其他 CRISP 条目中表示。列出的机构是对于中心来说，它不一定是研究者的机构。产后抑郁症最常发生在产后 4-6 周，是生育过程中最常见的精神并发症，影响 10-15% 的女性，因此是一个重大的公共卫生问题。产后抑郁症可能对母亲、她的孩子和她的直系亲属有害。如果不治疗，产后抑郁症可能会产生严重的长期后果。产后抑郁发作一次后，重度抑郁症复发的风险为 25%。母亲的抑郁症若得不到治疗，会导致孩子出现长期的情绪、行为、认知和人际关系问题。最严重的产后情感或精神病可能导致母亲自杀或杀婴。由于这些严重后果，为了更好地了解母亲和孩子的健康和福祉，必须对产后抑郁症的病因进行早期诊断、早期治疗和持续研究。细胞因子是一组异质的信使分子，由淋巴细胞和巨噬细胞等免疫活性细胞产生，用于调节免疫反应。出于治疗目的向患者施用某些细胞因子以及在健康受试者中通过实验诱导细胞因子会导致抑郁症的严重程度增加。对怀孕期间母体免疫系统变化的描述包括免疫系统激活、免疫系统抑制和免疫耐受的证据。与预期的生物学功能一致，足月末女性的细胞因子水平高于非孕妇的细胞因子水平。我们假设产后初期的炎症可能会引发弱势女性产后抑郁症状。主要目的：1) 评估产后初期炎症标志物与产后后期抑郁症状严重程度之间可能存在的关系。次要目标：2）评估每个时间点（产前、产后早期和产后晚期）抑郁评分和炎症标志物之间的关系。 3)评估产前至产后早期、产前至产后晚期、产后早期至产后晚期抑郁评分变化与炎症标志物变化之间的关系。马里兰大学妇产科将招募 50 名 18 岁或以上、产后抑郁症高危孕妇。女性必须至少满足产后抑郁症的高风险标准之一。受试者将在三个时间点进行研究：妊娠 35-38 周、产后 1-5 天和产后 5-6 周。在每个时间点都会对抑郁评分进行评级，并从外周静脉抽取 5 茶匙的血液来测量受试者血清中以下炎症标志物的水平：C 反应蛋白、白细胞介素 6 和白细胞介素 6 受体。当额外的资金到位时，用于犬尿氨酸和色氨酸测量的额外血清将被冻结以供将来的研究。初始分析将是描述性的（连续数据的平均值和标准差以及分类数据的比例）。将计算产后 1-5 天和产后 5-6 周的所有连续变量相对于产前值的变化。将计算炎症标志物的变化与汉密尔顿抑郁量表（抑郁症严重程度的标准化评定量表）变化之间的相关性，然后测试差异的显着性。我们的长期目标是描述产后抑郁症的炎症机制，并可能确定可能导致产后抑郁症预防性治疗的新治疗靶点。本申请的目的是为更大的 NIH 拨款申请收集初步数据。