Immune System Dysregulation in First-Onset Postpartum Psychosis
Immune System Dysregulation in First-Onset Postpartum Psychosis
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DOI：
10.1016/j.biopsych.2012.11.006
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发表时间：
2013-05-15
影响因子：
10.6
通讯作者：
Drexhage, Hemmo A.
中科院分区：
文献类型：
--
作者：
Bergink, Veerle;Burgerhout, Karin M.;Drexhage, Hemmo A.
背景：越来越多的证据表明，免疫系统的失调是情绪障碍的一个重要的脆弱性因素。产后精神病（PP）是一种严重的情绪障碍，发生在分娩后4周内，这是一段免疫反应增强和内分泌设定点改变的时期。因此，本研究的目的是研究免疫激活的患者首次发作PP在单核细胞，T细胞和血清细胞因子/chemokines.Methods的水平：我们纳入了63名女性首次发作PP入院。对照组包括健康产后（n = 56）和非产后（n = 136）妇女。定量聚合酶链反应单核细胞基因表达分析与43个基因先前确定为异常调节的非产后情绪障碍患者，包括糖皮质激素受体的亚型。外周血单个核细胞的百分比测定荧光激活细胞分选仪分析，而血清细胞因子/趋化因子测定与流式细胞仪珠array.Results：在健康妇女，产后T细胞水平显着升高相比，nonpostpartum。PP患者未能显示正常的产后T细胞升高。与此相反，这些患者表现出显着的单核细胞水平和显着上调几个免疫相关的单核细胞基因与对照组相比，产后和非产后。此外，糖皮质激素受体α/β基因的表达比例下降，在单核细胞的PP患者，强烈相关的免疫activation.Conclusions：这项研究表明一个强大的失调的免疫神经内分泌设定点PP，与一个显着的过度激活的单核细胞/巨噬细胞手臂的免疫系统。
Background: Accumulating evidence suggests that dysregulation of the immune system represents an important vulnerability factor for mood disorders. Postpartum psychosis (PP) is a severe mood disorder occurring within 4 weeks after delivery, a period of heightened immune responsiveness and an altered endocrine set point. Therefore, the aim of this study was to examine immune activation in patients with first-onset PP at the level of monocytes, T cells, and serum cytokines/chemokines.Methods: We included 63 women admitted with first-onset PP. Control groups included healthy postpartum (n = 56) and nonpostpartum (n = 136) women. A quantitative-polymerase chain reaction monocyte gene expression analysis was performed with 43 genes previously identified as abnormally regulated in nonpostpartum mood disorder patients including the isoforms of the glucocorticoid receptor. Peripheral blood mononuclear cells percentages were measured by fluorescence-activated cell sorter analysis, whereas serum cytokines/chemokines were determined with a cytometric bead array.Results: In healthy women, postpartum T cell levels were significantly elevated compared with nonpostpartum. Patients with PP failed to show the normal postpartum T cell elevation. In contrast, these patients showed a significant elevation of monocyte levels and a significant upregulation of several immune-related monocyte genes compared with control subjects postpartum and nonpostpartum. Furthermore, the glucocorticoid receptor alpha/beta gene expression ratio was decreased in monocytes of PP patients, strongly correlating with their immune activation.Conclusions: This study demonstrates a robust dysregulation of the immuno-neuro-endocrine set point in PP, with a notable over-activation of the monocyte/macrophage arm of the immune system.