Department of Anesthesia, The Third Xiangya Hospital of Central South University, Changsha, China.
Department of Anesthesia, Changsha Taihe Hospital, Changsha, China.
Brain Behav. 2020 Apr;10(4):e01566. doi: 10.1002/brb3.1566. Epub 2020 Feb 26.
A growing body of data indicates that the kynurenine pathway may play a role in the pathogenesis of postpartum depressive symptoms (PDS). Kynurenic aminotransferase (KAT) is an important kynurenine pathway enzyme, catalyzing kynurenine (KYN) into kynurenic acid (KYNA). This study investigated as to whether genetic variations in KAT are associated with PDS.
A cohort of 360 Chinese women scheduled to undergo cesarean delivery was enrolled into this study. PDS was determined by an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 13. A total of eight KAT single nucleotide polymorphisms (SNPs) were genotyped and their association with PDS investigated. Serum concentrations of KYN, KYNA, and quinolinic acid (QUIN) in women with or without PDS were also measured. This allowed the determination of the KYNA/KYN ratio, which is reflective of KAT activity.
Postpartum depressive symptoms incidence was 7.2%. Advanced maternal age, lower education, antenatal depression, and postpartum blues were risk factors for PDS (p < .05). Women with PDS, versus non-PDS, had heightened KYN levels one day prior to surgery (ante-d1) (p < .05), as well as having significantly lower KYNA and higher QUIN levels at postnatal day three (post-d3) (p < .05). Women with, versus without, PDS also had a significantly higher QUIN/KYNA ratio at post-d3 (p < .05). KAT activity was significantly lower in women with, versus without, PDS at ante-d3 (p < .05). No significant association was evident between the KAT SNPs and PDS.
Our data support a role for alterations in the kynurenine pathway in the pathogenesis of PDS, although no significant association was found for the eight tested KAT SNPs with PDS.
越来越多的数据表明，犬尿氨酸途径可能在产后抑郁症状（PDS）的发病机制中起作用。犬尿氨酸氨基转移酶（KAT）是犬尿氨酸途径中的一种重要酶，可催化犬尿氨酸（KYN）生成犬尿喹啉酸（KYNA）。本研究旨在探讨 KAT 基因变异是否与 PDS 相关。
本研究纳入了 360 名计划行剖宫产的中国女性。采用爱丁堡产后抑郁量表（EPDS）评分≥13 分来确定 PDS。共检测了 8 个 KAT 单核苷酸多态性（SNP），并研究了其与 PDS 的关系。还检测了患有或未患有 PDS 的女性的血清犬尿氨酸（KYN）、犬尿喹啉酸（KYNA）和喹啉酸（QUIN）浓度。这可以确定 KYNA/KYN 比值，反映 KAT 活性。
PDS 的发生率为 7.2%。高龄产妇、受教育程度低、产前抑郁和产后忧郁是 PDS 的危险因素（p<.05）。与非 PDS 组相比，PDS 组女性在术前 1 天（ante-d1）的 KYN 水平升高（p<.05），产后第 3 天（post-d3）的 KYNA 水平降低，QUIN 水平升高（p<.05）。与非 PDS 组相比，PDS 组女性在产后第 3 天的 QUIN/KYNA 比值明显更高（p<.05）。与非 PDS 组相比，PDS 组女性在术前第 3 天（ante-d3）的 KAT 活性明显更低（p<.05）。在 8 个 KAT SNP 中，没有发现与 PDS 显著相关的 SNP。
本研究数据支持犬尿氨酸途径的改变在 PDS 的发病机制中起作用，尽管未发现 8 个检测到的 KAT SNP 与 PDS 显著相关。
