Zhu Jialei, Jin Jing, Tang Jing
Department of Pharmacy, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Front Pharmacol. 2022 Nov 3;13:955672. doi: 10.3389/fphar.2022.955672. eCollection 2022.
Postpartum Depression (PPD) is a serious psychiatric disorder of women within the first year after delivery. It grievously damages women's physical and mental health. Inflammatory reaction theory is well-established in depression, and also has been reported associated with PPD. This review summarized the inflammatory pathophysiological mechanisms implicated in PPD, including decreased T cell activation, increased proinflammatory cytokines secretion, active kynurenine pathway, and initiated NLRP3 inflammasome. Clinical and preclinical research are both gathered. Potential therapeutical alternatives targeting the inflammatory mechanisms of PPD were introduced. In addition, this review briefly discussed the differences of inflammatory mechanisms between PPD and depression. The research of inflammation in PPD is limited and seems just embarking, which indicates the direction we can further study. As a variety of risky factors contribute to PPD collectively, therapy for women with PPD should be comprehensive, and clinical heterogeneity should be taken into consideration. As PPD has a predictability, early clinical screening and interventions are also needed. This review aims to help readers better understand the inflammatory pathological mechanisms in PPD, so as to identify biomarkers and potential therapeutic targets in the future.
产后抑郁症(PPD)是女性在分娩后第一年内发生的一种严重精神障碍。它严重损害女性的身心健康。炎症反应理论在抑郁症中已得到充分确立,并且也有报道称其与产后抑郁症有关。本综述总结了与产后抑郁症相关的炎症病理生理机制,包括T细胞活化降低、促炎细胞因子分泌增加、犬尿氨酸途径激活以及NLRP3炎性小体的启动。同时收集了临床和临床前研究。介绍了针对产后抑郁症炎症机制的潜在治疗选择。此外,本综述简要讨论了产后抑郁症与抑郁症在炎症机制上的差异。产后抑郁症中炎症的研究有限,似乎才刚刚起步,这指明了我们可以进一步研究的方向。由于多种风险因素共同导致产后抑郁症,对产后抑郁症女性的治疗应具有综合性,并且应考虑临床异质性。由于产后抑郁症具有可预测性,因此也需要进行早期临床筛查和干预。本综述旨在帮助读者更好地理解产后抑郁症的炎症病理机制,以便未来识别生物标志物和潜在治疗靶点。