Human Microbiome and Perinatal Depression

人类微生物组和围产期抑郁症

• 批准号: 9767273
• 负责人: Jack Anthony Gilbert
• 金额: $ 8.32万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-20 至 2021-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9767273
• 关键词: Address; Adherence; Adverse effects; Affect; African American; Age; Antidepressive Agents; Appointment; Bacteria; Behavioral; Bioinformatics; Child; Clinical; Clinical Research; Clinical Trials; Cognitive Therapy; Collection; Complex; Complication; Consent; Data; Depressed mood; Development; Diagnosis; Diet; Disease; Eligibility Determination; Endocrine system; Epidemiology; Exclusion; Family; Feasibility Studies; Feces; Germ-Free; Gestational Age; Goals; Guidelines; Habits; Health; Healthcare; Hispanics; Home environment; Hormonal; Human; Human Microbiome; Immune system; Immunology; Infant; Insurance Coverage; Intestines; Knowledge; Link; Longitudinal Studies; Low income; Machine Learning; Major Depressive Disorder; Mental Depression; Mental Health; Microbe; Microbiology; Minority; Monitor; Mothers; Mus; Nested Case-Control Study; Neurologic; Neurotransmitters; Nutritional; Observational Study; Participant; Patient Recruitments; Perinatal; Pharmaceutical Preparations; Pharmacological Treatment; Phenotype; Postpartum Period; Pregnancy; Pregnancy Complications; Pregnant Women; Premature Birth; Prenatal care; Preparation; Prevalence; Probiotics; Process; Prospective cohort study; Questionnaires; Race; Reporting; Research; Research Design; Research Infrastructure; Risk; Role; Safety; Sample Size; Sampling; Schedule; Socioeconomic Status; Structure; System; Systems Biology; Techniques; Testing; Therapeutic; Time; Transportation; Visit; Woman; Work; adverse outcome; alternative treatment; antepartum depression; antidepressant effect; bacterial community; demographics; depressive symptoms; drug development; dysbiosis; effective therapy; fecal microbiome; fecal transplantation; follow-up; gut microbiome; gut microbiota; gut-brain axis; health data; improved; infant outcome; insight; maternal stress; microbial; microbial community; microbiome; microbiome analysis; microorganism; mood symptom; network models; neuropsychiatry; novel; novel marker; nutrition; perinatal mental health; peripartum depression; probiotic therapy; process optimization; programs; prospective; relating to nervous system; sample collection; social stigma; stool sample; targeted treatment; treatment as usual; uptake

Project Summary/Abstract Depression is the most common complication of pregnancy and affects 10-20% of women. Up to 75% of women with perinatal depression do not receive mental health care. In lower income African American and Hispanic women, the prevalence of perinatal depression (PND) is particularly high and the treatment rates are lower. Cognitive behavioral therapy (CBT) is an effective treatment but practical barriers such as time commitment, insurance coverage, and transportation, as well as stigma, limit uptake of CBT particularly for minority women. Similarly, concern about the adverse effects of antidepressant treatment on maternal and infant outcomes limits uptake of pharmacological treatments. A novel avenue for the development of safe therapeutics for depression focuses on the brain-gut axis and is supported by initial demonstrations that probiotics can improve mood symptoms. Our long-term goal is to assist in the discovery of potential microbes that are correlated with PND, and could be novel biomarkers for the diagnosis and treatment of this disorder, particularly in minority women. As a first step, we propose a multi-PI feasibility study involving the implementation and optimization of processes for participant recruitment and stool sample collection, as well as the initial assessments of longitudinal differences in gut microbiota between pregnant women with and without major depressive disorder (MDD). To meet these goals, we will leverage an established research infrastructure to conduct a prospective, nested case-control study. We will prospectively collect depression diagnoses and gut microbiome samples on 300 women at four points during pregnancy and after delivery to yield a total of 58 women, 29 cases with MDD and 29 controls without MDD. The two groups will be matched on key covariates (e.g., age, race, socio- economic status, gestational age, health). At their scheduled usual care, prenatal appointment, consented participants will complete mental health, demographics, microbiome-related, and dietary and physical habits questionnaires and provide a fecal sample either at that time of their appointment or at home. To achieve our first aim - to determine the feasibility of a larger similarly designed study - we will estimate the total number of potential participants, the number assessed and not assessed for eligibility (and reasons), the number excluded and reasons for exclusion, the number lost to follow-up, and the data available for analysis at each of the 4 visits. To achieve our second aim - to determine whether the gut microbiome dynamically differs in pregnant women with and without MDD - we will employ a suite of systems level approaches, including multivariate statistical techniques, network modeling and machine learning techniques. This R03 will allow us to optimize our research processes for the prospective collection of stool samples and mental health data in preparation for larger nested case-control studies, and ultimately clinical trials of probiotic therapies for PND.

项目摘要/摘要 抑郁症是怀孕最常见的并发症，影响10-20％的女性。多达75％的女性 围产期抑郁症无法获得心理保健。在低收入的非裔美国人和西班牙裔 妇女，围产期抑郁症（PND）的患病率特别高，治疗率较低。 认知行为疗法（CBT）是一种有效的治疗方法，但实用的障碍，例如时间承诺， 保险范围，运输以及污名限制了CBT的吸收，特别是对于少数民族妇女。 同样，关注抗抑郁药对孕产妇和婴儿结果限制的不利影响 吸收药理治疗。开发安全抑郁症的新型途径 专注于脑脉管轴，并受到初步证明，即益生菌可以改善情绪 症状。我们的长期目标是协助发现与PND相关的潜在微生物 并且可能是诊断和治疗这种疾病的新型生物标志物，尤其是在少数族裔女性中。 作为第一步，我们提出了一项涉及实施和优化的多PI可行性研究 参与者招聘和粪便样本收集的过程，以及 有和没有重度抑郁症的孕妇肠道菌群的纵向差异 （MDD）。为了实现这些目标，我们将利用既定的研究基础设施来实现潜在的， 嵌套的病例对照研究。我们将前瞻性地收集抑郁诊断和肠道微生物组样本 怀孕期间四分和分娩后的300名妇女总共产生58名妇女，29例MDD病例 和29个没有MDD的控件。这两个小组将与关键协变量（例如年龄，种族，社会 - 经济状况，胎龄，健康）。在他们计划的常规护理中，预约，同意 参与者将完成心理健康，人口统计，微生物组相关以及饮食和身体习惯 问卷调查并在约会时或在家中提供粪便样本。实现我们的 第一个目的 - 确定较大类似设计的研究的可行性 - 我们将估计 潜在的参与者，评估的数字和未评估的资格（和原因），数字排除在外 以及排除的原因，丢失了随访的数字以及可在4个中的每个数据进行分析的数据 访问。为了实现我们的第二个目标 - 确定肠道微生物组是否在怀孕中动态不同 有和没有MDD的妇女 - 我们将采用一套系统级别的方法，包括多元 统计技术，网络建模和机器学习技术。此R03将使我们能够优化 我们的研究过程，用于准备粪便样本和心理健康数据进行准备 用于较大的嵌套病例对照研究，以及最终对PND的益生菌疗法的临床试验。