INFLAMMATION FACTORS IN POSTPARTUM DEPRESSION

产后抑郁症的炎症因素

• 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
• 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

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.

该副本是利用众多研究子项目之一 由NIH/NCRR资助的中心赠款提供的资源。子弹和 调查员（PI）可能已经从其他NIH来源获得了主要资金， 因此可以在其他清晰的条目中代表。列出的机构是 对于中心，这不一定是调查员的机构。 产后抑郁症最常见于产后4-6周，是育儿的最常见的精神病并发症，影响了10-15％的妇女，因此代表了一个重大的公共健康问题。分娩后的抑郁症可能不利于母亲，她的孩子以及她的直系亲属。如果未经治疗，产后抑郁症可能会带来严重的长期后果。产后抑郁发作后，重大抑郁症复发的风险为25％。母亲未经治疗的抑郁导致她的孩子的长期情感，行为，认知和人际问题。产后情感或精神病疾病最严重的病例可能导致母亲或杀婴。由于这些严重的后果，必须对产后抑郁症的病因进行早期诊断，早期治疗以及持续的研究，以便更好地了解母亲和儿童的健康和健康。细胞因子是由免疫能力细胞（如淋巴细胞和巨噬细胞）产生的一组异质的允许分子，以调节免疫反应。在健康受试者中为治疗目的和诱导细胞因子的患者施用某些细胞因子会导致抑郁症的严重程度增加。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性的证据。与预期的生物学功能一致，期结束时女性的细胞因子水平高于非怀孕妇女的细胞因子水平。我们假设在产后立即炎症可能会引发弱势妇女产后抑郁症状。主要目的：1）评估产后直接炎症标志物与产后晚期抑郁症状的严重程度之间的可能关系。次要目的：2）评估每个时间点抑郁得分与炎症标记之间的关系：产前，产后早期和产后晚期。 3）评估抑郁评分的变化与从产前到产后早期的炎症标记变化，从产前到产后晚期，从产后早期到产后晚期的关系。 18岁或以上的五十名孕妇将从马里兰州大学妇产科系招募有产后抑郁症的高风险。妇女将必须符合产后抑郁症的至少一个高风险标准。受试者将在三个时间点进行研究：妊娠35-38周，分娩后1-5天以及交货后5-6周。在每个时间点，都会从外周静脉中获得抑郁评分和5茶匙的血液吸血，以测量以下炎症标记的受试者血清水平：C反应蛋白，白介素6和白介素-6受体。当额外的资金可用时，将冻结Kynurenine和色氨酸测量的其他血清。初始分析将具有描述性（用于分类数据的连续数据和比例的均值和标准偏差）。从所有连续变量上出生前值的变化将在产后1-5天和产后5-6周计算。炎症标志物变化与汉密尔顿抑郁量表的变化之间的相关性，将计算出抑郁症严重程度的标准化评分量表，然后测试是否具有差异的显着性。我们的长期目标是描述产后抑郁症的炎症机制，并可能识别出可能导致产后抑郁症预防治疗的新型治疗靶标。本应用程序的目的是为更大的NIH赠款应用程序收集初步数据。