Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA.
Psychol Med. 2012 May;42(5):943-56. doi: 10.1017/S0033291711002121.
Major depressive disorder during pregnancy associates with potentially detrimental consequences for mother and child. The current study examined peripheral blood gene expression as a potential biomarker for prenatal depressive symptoms.
Maternal RNA from whole blood, plasma and the Beck Depression Inventory were collected longitudinally from preconception through the third trimester of pregnancy in 106 women with a lifetime history of mood or anxiety disorders. The expression of 16 genes in whole blood involved in glucorticoid receptor (GR) signaling was assessed using real-time polymerase chain reaction. In parallel, plasma concentrations of progesterone, estradiol and cortisol were measured. Finally, we assessed ex vivo GR sensitivity in peripheral blood cells from a subset of 29 women.
mRNA expression of a number of GR-complex regulating genes was up-regulated over pregnancy. Women with depressive symptoms showed significantly smaller increases in mRNA expression of four of these genes - FKBP5, BAG1, NCOA1 and PPID. Ex vivo stimulation assays showed that GR sensitivity diminished with progression of pregnancy and increasing maternal depressive symptoms. Plasma concentrations of gonadal steroids and cortisol did not differ over pregnancy between women with and without clinically relevant depressive symptoms.
The presence of prenatal depressive symptoms appears to be associated with altered regulation of GR sensitivity. Peripheral expression of GR co-chaperone genes may serve as a biomarker for risk of developing depressive symptoms during pregnancy. The presence of such biomarkers, if confirmed, could be utilized in treatment planning for women with a psychiatric history.
怀孕期间的重度抑郁症可能会对母亲和孩子造成潜在的不良后果。本研究旨在探讨外周血基因表达作为产前抑郁症状潜在生物标志物的可能性。
106 名有心境或焦虑障碍病史的女性在妊娠前至妊娠第 3 期期间进行了纵向研究,采集了全血、血浆和贝克抑郁量表(Beck Depression Inventory)的母亲 RNA。使用实时聚合酶链反应(polymerase chain reaction)评估全血中参与糖皮质激素受体(glucocorticoid receptor,GR)信号的 16 个基因的表达。同时,还测量了血浆中孕激素、雌二醇和皮质醇的浓度。最后,我们评估了 29 名女性中一部分人的外周血单个核细胞的体外 GR 敏感性。
随着妊娠的进行,许多 GR 复合物调节基因的 mRNA 表达上调。有抑郁症状的女性中,这四个基因(FKBP5、BAG1、NCOA1 和 PPID)的 mRNA 表达增加幅度明显较小。体外刺激实验表明,随着妊娠的进展和产妇抑郁症状的增加,GR 敏感性降低。有和没有临床相关抑郁症状的女性在妊娠期间的血浆性腺类固醇和皮质醇浓度没有差异。
产前抑郁症状的存在似乎与 GR 敏感性的改变调节有关。GR 共伴侣基因的外周表达可能作为妊娠期间发生抑郁症状的风险标志物。如果得到证实,此类生物标志物的存在可用于有精神病史的女性的治疗计划。