Lambert Mathilde, Gressier Florence
1 Interne DES psychiatrie Ile de France, Service de Psychiatrie, Hôpital de Bicêtre, Assistance Publique Hôpitaux de Paris, Le Kremlin Bicêtre, France.
2 Responsable de l'Unité de Psychiatrie Périnatale du CHU de Bicêtre, CESP, Inserm UMR1178, Univ Paris Sud, Service de Psychiatrie, Hôpital de Bicêtre, Assistance Publique Hôpitaux de Paris, Le Kremlin Bicêtre, France.
Can J Psychiatry. 2019 Jul;64(7):471-481. doi: 10.1177/0706743719828970. Epub 2019 Feb 26.
Postpartum Depression (PPD) affects over 15% new mothers. Its etiology is multifactorial and still partly unknown. Some hypotheses suggest a link with inflammation. This review aims to explore the existence of inflammatory biomarkers associated with PPD. The possibility of potential adjunct treatments, linked with these biomarkers, will be discussed.
The systematic review of literature was performed using in PubMed, PsycInfo and Embase, and 25 articles were included. Various biomarkers were identified. The most often studied are C-reactive protein (CRP), interleukins 6 and 10, tumor necrosis factor-alpha and interferon-gamma.
Although few results appear as significant during the various testing times, the dosage of some inflammation biomarkers, including CRP, at the very end of pregnancy or immediately after delivery could predict PPD. Interactions between inflammation and the corticotropic axis could explain PPD onset. Epigenetic mechanisms could lead to pro-inflammatory state. Several therapeutics provide interest due to their anti-inflammatory property.
Further studies are needed to assess these biomarkers value as predictive factors of PPD and to consider adjunct treatments to antidepressants. If this value is confirmed, the inflammatory marker dosage, in particular CRP, could help to provide early screening of women at risk of PPD, parallel of the clinical evaluation. A zinc supplementation could then be offered.
产后抑郁症（PPD）影响超过15%的新妈妈。其病因是多因素的，仍有部分未知。一些假说表明与炎症有关。本综述旨在探讨与PPD相关的炎症生物标志物的存在情况。还将讨论与这些生物标志物相关的潜在辅助治疗的可能性。
在PubMed、PsycInfo和Embase中进行文献系统综述，纳入了25篇文章。确定了各种生物标志物。研究最多的是C反应蛋白（CRP）、白细胞介素6和10、肿瘤坏死因子-α和干扰素-γ。
尽管在不同测试时间很少有结果显示具有显著性，但在妊娠末期或分娩后立即检测某些炎症生物标志物（包括CRP）的剂量可以预测PPD。炎症与促肾上腺皮质轴之间的相互作用可以解释PPD的发病机制。表观遗传机制可能导致促炎状态。几种治疗方法因其抗炎特性而具有研究价值。
需要进一步研究来评估这些生物标志物作为PPD预测因子的价值，并考虑抗抑郁药的辅助治疗。如果这一价值得到证实，炎症标志物（特别是CRP）的检测剂量可以帮助在临床评估的同时对有PPD风险的女性进行早期筛查。然后可以提供锌补充剂。
