Weaver Samantha R, Hernandez Laura L
Endocrine and Reproductive Physiology Program, University of Wisconsin-Madison, Madison, WI, USA.
Department of Dairy Science, University of Wisconsin-Madison, Madison, WI, USA.
J Mammary Gland Biol Neoplasia. 2018 Jun;23(1-2):5-25. doi: 10.1007/s10911-018-9390-6. Epub 2018 Mar 30.
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.
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。
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