Bränn Emma, Papadopoulos Fotios, Fransson Emma, White Richard, Edvinsson Åsa, Hellgren Charlotte, Kamali-Moghaddam Masood, Boström Adrian, Schiöth Helgi B, Sundström-Poromaa Inger, Skalkidou Alkistis
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden.
Psychoneuroendocrinology. 2017 May;79:146-159. doi: 10.1016/j.psyneuen.2017.02.029. Epub 2017 Feb 28.
Recent studies indicate that the immune system adaptation during pregnancy could play a significant role in the pathophysiology of perinatal depression. The aim of this study was to investigate if inflammation markers in a late pregnancy plasma sample can predict the presence of depressive symptoms at eight weeks postpartum. Blood samples from 291 pregnant women (median and IQR for days to delivery, 13 and 7-23days respectively) comprising 63 individuals with postpartum depressive symptoms, as assessed by the Edinburgh postnatal depression scale (EPDS≥12) and/or the Mini International Neuropsychiatric Interview (M.I.N.I.) and 228 controls were analyzed with an inflammation protein panel using multiplex proximity extension assay technology, comprising of 92 inflammation-associated markers. A summary inflammation variable was also calculated. Logistic regression, LASSO and Elastic net analyses were implemented. Forty markers were lower in late pregnancy among women with depressive symptoms postpartum. The difference remained statistically significant for STAM-BP (or otherwise AMSH), AXIN-1, ADA, ST1A1 and IL-10, after Bonferroni correction. The summary inflammation variable was ranked as the second best variable, following personal history of depression, in predicting depressive symptoms postpartum. The protein-level findings for STAM-BP and ST1A1 were validated in relation to methylation status of loci in the respective genes in a different population, using openly available data. This explorative approach revealed differences in late pregnancy levels of inflammation markers between women presenting with depressive symptoms postpartum and controls, previously not described in the literature. Despite the fact that the results do not support the use of a single inflammation marker in late pregnancy for assessing risk of postpartum depression, the use of STAM-BP or the novel notion of a summary inflammation variable developed in this work might be used in combination with other biological markers in the future.
最近的研究表明，孕期免疫系统的适应性变化可能在围产期抑郁症的病理生理过程中发挥重要作用。本研究旨在探讨妊娠晚期血浆样本中的炎症标志物是否能够预测产后8周抑郁症状的出现。对291名孕妇（分娩天数的中位数和四分位间距分别为13天和7 - 23天）的血液样本进行了分析，其中包括63名经爱丁堡产后抑郁量表（EPDS≥12）和/或迷你国际神经精神访谈（M.I.N.I.）评估有产后抑郁症状的个体以及228名对照者，采用多重邻近延伸分析技术对一个炎症蛋白组进行检测，该蛋白组包含92种与炎症相关的标志物。还计算了一个综合炎症变量。实施了逻辑回归、LASSO和弹性网络分析。产后有抑郁症状的女性在妊娠晚期有40种标志物水平较低。经Bonferroni校正后，STAM - BP（或AMSH）、AXIN - 1、ADA、ST1A1和IL - 10的差异仍具有统计学意义。在预测产后抑郁症状方面，综合炎症变量在有抑郁症个人史之后，被列为第二好的变量。利用公开可用数据，在另一人群中对STAM - BP和ST1A1的蛋白质水平结果与相应基因位点的甲基化状态进行了验证。这种探索性方法揭示了产后有抑郁症状的女性与对照组在妊娠晚期炎症标志物水平上的差异，这在以往文献中未曾描述。尽管研究结果不支持在妊娠晚期使用单一炎症标志物来评估产后抑郁症风险，但未来STAM - BP或本研究中提出的综合炎症变量这一新概念可能会与其他生物标志物联合使用。
