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哺乳期使用选择性5-羟色胺再摄取抑制剂会对母体骨骼产生持续影响吗?

Could use of Selective Serotonin Reuptake Inhibitors During Lactation Cause Persistent Effects on Maternal Bone?

作者信息

Weaver Samantha R, Hernandez Laura L

机构信息

Endocrine and Reproductive Physiology Program, University of Wisconsin-Madison, Madison, WI, USA.

Department of Dairy Science, University of Wisconsin-Madison, Madison, WI, USA.

出版信息

J Mammary Gland Biol Neoplasia. 2018 Jun;23(1-2):5-25. doi: 10.1007/s10911-018-9390-6. Epub 2018 Mar 30.


DOI:10.1007/s10911-018-9390-6
PMID:29603039
Abstract

The lactating mammary gland elegantly coordinates maternal homeostasis to provide calcium for milk. During lactation, the monoamine serotonin regulates the synthesis and release of various mammary gland-derived factors, such as parathyroid hormone-related protein (PTHrP), to stimulate bone resorption. Recent evidence suggests that bone mineral lost during prolonged lactation is not fully recovered following weaning, possibly putting women at increased risk of fracture or osteoporosis. Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants have also been associated with reduced bone mineral density and increased fracture risk. Therefore, SSRI exposure while breastfeeding may exacerbate lactational bone loss, compromising long-term bone health. Through an examination of serotonin and calcium homeostasis during lactation, lactational bone turnover and post-weaning recovery of bone mineral, and the effect of peripartum depression and SSRI on the mammary gland and bone, this review will discuss the hypothesis that peripartum SSRI exposure causes persistent reductions in bone mineral density through mammary-derived PTHrP signaling with bone.

摘要

泌乳期乳腺能巧妙地协调母体的内环境稳定,为乳汁提供钙。在泌乳期间,单胺类物质血清素调节各种乳腺衍生因子的合成与释放,如甲状旁腺激素相关蛋白(PTHrP),以刺激骨吸收。最近的证据表明,长时间泌乳期间流失的骨矿物质在断奶后并未完全恢复,这可能会增加女性骨折或患骨质疏松症的风险。选择性5-羟色胺再摄取抑制剂(SSRI)类抗抑郁药也与骨矿物质密度降低和骨折风险增加有关。因此,母乳喂养期间接触SSRI可能会加剧泌乳期骨质流失,损害长期骨骼健康。通过研究泌乳期间的血清素和钙稳态、泌乳期骨转换及断奶后骨矿物质的恢复情况,以及围产期抑郁症和SSRI对乳腺和骨骼的影响,本综述将探讨围产期接触SSRI通过乳腺衍生的PTHrP与骨骼的信号传导导致骨矿物质密度持续降低这一假说。

相似文献

[1]
Could use of Selective Serotonin Reuptake Inhibitors During Lactation Cause Persistent Effects on Maternal Bone?

J Mammary Gland Biol Neoplasia. 2018-6

[2]
Peripartum Fluoxetine Reduces Maternal Trabecular Bone After Weaning and Elevates Mammary Gland Serotonin and PTHrP.

Endocrinology. 2018-8-1

[3]
TRIENNIAL LACTATION SYMPOSIUM/BOLFA: Serotonin and the regulation of calcium transport in dairy cows.

J Anim Sci. 2017-12

[4]
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Physiol Rep. 2022-3

[5]
The Serotonergic System and Bone Metabolism During Pregnancy and Lactation and the Implications of SSRI Use on the Maternal-Offspring Dyad.

J Mammary Gland Biol Neoplasia. 2023-4-22

[6]
In utero and lactational exposure to the Selective Serotonin Reuptake Inhibitor fluoxetine compromises pup bones at weaning.

Sci Rep. 2019-1-18

[7]
Suppression of lactation and acceleration of involution in the bovine mammary gland by a selective serotonin reuptake inhibitor.

J Endocrinol. 2011-2-9

[8]
Mammary-specific deletion of parathyroid hormone-related protein preserves bone mass during lactation.

J Clin Invest. 2003-11

[9]
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J Bone Miner Res. 2017-8-2

[10]
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PLoS One. 2014-10-9

引用本文的文献

[1]
Evaluation of the increased risk of spine fracture in patients with mood disorder compared with matched controls: a longitudinal follow-up study using a national sample cohort in Korea.

BMJ Open. 2019-11-28

[2]
Peripartum dietary supplementation of a small-molecule inhibitor of tryptophan hydroxylase 1 compromises infant, but not maternal, bone.

Am J Physiol Endocrinol Metab. 2018-10-23

本文引用的文献

[1]
Characterization of mammary-specific disruptions for Tph1 and Lrp5 during murine lactation.

Sci Rep. 2017-11-9

[2]
Use of Selective Serotonin Reuptake Inhibitors and Bone Mineral Density Change: A Population-Based Longitudinal Study in Middle-Aged and Elderly Individuals.

J Clin Psychopharmacol. 2017-10

[3]
The Effect of Depression, Generalized Anxiety, and Selective Serotonin Reuptake Inhibitors on Change in Bone Metabolism in Adolescents and Emerging Adults.

J Bone Miner Res. 2017-9-22

[4]
Association of Selective Serotonin Reuptake Inhibitors and Bone Mineral Density in Elderly Women.

J Clin Densitom. 2017-7-13

[5]
Associations between subclinical hypocalcemia and postparturient diseases in dairy cows.

J Dairy Sci. 2017-7-6

[6]
Epigenetic adaptation of the placental serotonin transporter gene (SLC6A4) to gestational diabetes mellitus.

PLoS One. 2017-6-26

[7]
Associations of Parity, Breastfeeding, and Fractures in the Women's Health Observational Study.

Obstet Gynecol. 2017-7

[8]
Breastfeeding as the sole source of milk for 6 months and adolescent bone mineral density.

Osteoporos Int. 2017-6-6

[9]
Endocrine and metabolic changes in transition dairy cows are affected by prepartum infusions of a serotonin precursor.

J Dairy Sci. 2017-4-21

[10]
Effects of prepartum dietary cation-anion difference on aspects of peripartum mineral and energy metabolism and performance of multiparous Holstein cows.

J Dairy Sci. 2017-4-21

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