Roomruangwong Chutima, Kanchanatawan Buranee, Sirivichayakul Sunee, Anderson George, Carvalho Andre F, Duleu Sebastien, Geffard Michel, Maes Michael
Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
CNS Neurol Disord Drug Targets. 2017;16(4):472-483. doi: 10.2174/1871527316666170407145533.
Evidence has implicated the translocation of commensal Gram-negative bacteria (Gram-B) due to leaky gut in the pathophysiology of depression and physio-somatic symptoms (e.g. fatigue, pain, irritable bowel syndrome, malaise, etc.). In addition, the leaky gut may contribute to immune- inflammatory activation and oxidative stress. This study investigated whether bacterial translocation is associated with perinatal depression and anxiety scores and with prenatal physio-somatic symptoms and immune-inflammatory biomarkers, including the tryptophan catabolite (TRYCAT) pathway.
Data were collected in pregnant women at the end of term (T1) and 4-6 weeks after delivery (T2) as well as in non-pregnant controls. We examined the associations between serum IgM/IgA responses to Gram-B at the end of term and depression (Edinburgh Postnatal Depression Scale -EPDS) and anxiety (Spielberger's State Anxiety Inventory -STAI) symptoms.
Levels of C-reactive protein, zinc, haptoglobin, hematocrit and IgA/IgM responses to 9 TRYCATs were also measured. No significant associations of the IgA/IgM responses to Gram-B with prenatal depression and anxiety were observed. Increased IgA/IgM responses to Gram-B predict higher levels of haptoglobin, hematocrit and TRYCATs, in particular quinolinic acid and the quinolinic acid / kynurenic acid ratio. IgA responses to Gram-B were significantly lowered in pregnant women compared to age-matched non-pregnant women, while IgM responses were significantly elevated in participants with alcohol consumption. Physio-somatic symptoms at the end of term were significantly associated with IgM responses to Klebsiella pneumonia. Postnatal anxiety was significantly predicted by IgA responses to Pseudomonas aeruginosa.
Our findings suggest that pregnancy may protect against bacterial translocation, while alcohol use may increase bacterial translocation. The results suggest that end of term mucosa-derived immune responses to Gram-B contribute to immune activation, physio-somatic symptoms at the end of term and postnatal anxiety.
• Immune responses to Gram - Bacteria associate with physio-somatic symptoms in pregnancy. • IgA responses to Pseudomonas aeruginosa predict anxiety symptoms after delivery. • Pregnancy may have a protective effect against bacterial translocation. • Alcohol use increases leaky gut and bacterial translocation.
有证据表明，由于肠道渗漏导致共生革兰氏阴性菌（Gram-B）易位，这与抑郁症和身心症状（如疲劳、疼痛、肠易激综合征、不适等）的病理生理学有关。此外，肠道渗漏可能导致免疫炎症激活和氧化应激。本研究调查了细菌易位是否与围产期抑郁和焦虑评分以及产前身心症状和免疫炎症生物标志物有关，包括色氨酸分解代谢产物（TRYCAT）途径。
收集足月时（T1）和产后4 - 6周（T2）的孕妇以及非孕对照组的数据。我们研究了足月时血清中针对Gram-B的IgM/IgA反应与抑郁（爱丁堡产后抑郁量表-EPDS）和焦虑（斯皮尔伯格状态焦虑量表-STAI）症状之间的关联。
还测量了C反应蛋白、锌、触珠蛋白、血细胞比容水平以及对9种TRYCAT的IgA/IgM反应。未观察到针对Gram-B的IgA/IgM反应与产前抑郁和焦虑之间存在显著关联。针对Gram-B的IgA/IgM反应增加预示着触珠蛋白、血细胞比容和TRYCAT水平升高，尤其是喹啉酸以及喹啉酸/犬尿烯酸比值。与年龄匹配的非孕女性相比，孕妇针对Gram-B的IgA反应显著降低，而饮酒参与者的IgM反应显著升高。足月时的身心症状与针对肺炎克雷伯菌的IgM反应显著相关。产后焦虑可由针对铜绿假单胞菌的IgA反应显著预测。
我们的研究结果表明，怀孕可能预防细菌易位，而饮酒可能增加细菌易位。结果表明，足月时源自黏膜的针对Gram-B的免疫反应会导致免疫激活、足月时的身心症状和产后焦虑。
• 对革兰氏阴性菌的免疫反应与孕期身心症状相关。
• 对铜绿假单胞菌的IgA反应可预测产后焦虑症状。
• 怀孕可能对细菌易位有保护作用。
• 饮酒会增加肠道渗漏和细菌易位。
