IgA/IgM Responses to Gram-Negative Bacteria are not Associated with Perinatal Depression, but with Physio-somatic Symptoms and Activation of the Tryptophan Catabolite Pathway at the End of Term and Postnatal Anxiety.

BACKGROUND

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.

METHOD

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.

RESULTS

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.

CONCLUSIONS

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.

HIGHLIGHTS

• 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.