Thérapeutique des troubles anxieux et dépressifs de la grossesse et du post-partum. Revue et synthèse

Analysis of the effect of triclosan on gonadal differentiation of zebrafish based on metabolome

Although the previous research confirmed that triclosan (TCS) affects the female proportion at the early stage of zebrafish (Danio rerio) and has an estrogen effect, the mechanism by which TCS affects the sex differentiation of zebrafish is not entirely clear. In this study, zebrafish embryos were exposed to different concentrations of TCS (0, 2, 10, and 50 μg/L) for 50 consecutive days. The expression of sex differentiation related genes and metabolites were then determined in larvae using reverse transcription quantitative polymerase chain reaction (RT-qPCR) and Liquid Chromatography-Mass Spectrometer (LC-MS), respectively. TCS upregulated the expression of the sox9a, dmrt1a and amh genes, down-regulating the expression of wnt4a, cyp19a1b, cyp19a1a, and vtg2 gene. The overlapped classification of Significant Differential Metabolites (SDMs) between the control group and three TCS treated groups related to gonadal differentiation was Steroids and steroid derivatives, including 24 down-regulated SDMs. The enriched pathways related to gonadal differentiation were Steroid hormone biosynthesis, Retinol metabolism, Metabolism of xenobiotics by cytochrome P450, and Cortisol synthesis and secretion. Moreover, SDMs were significantly enriched in Steroid hormone biosynthesis in the 2 μg/L TCS group, which included Dihydrotestosterone, Cortisol, 11beta-hydroxyandrost-4-ene-3, 17-dione, 21-Hydroxypregnenolone, Androsterone, Androsterone glucuronide, Estriol, Estradiol, 19-Hydroxytestosterone, Cholesterol, Testosterone, and Cortisone acetate. Results showed that TCS affects the female proportion mainly through Steroid hormone biosynthesis, in which aromatase plays a key role in zebrafish. Retinol metabolism, metabolism of xenobiotics by cytochrome P450, and cortisol synthesis and secretion may also participate in TCS-mediated sex differentiation. These findings reveal the molecular mechanisms of TCS-induced sex differentiation, and provide theoretical guidance for the maintenance of water ecological balance.

[GABAergic approach of postpartum depression: A translational review of literature]

INTRODUCTION

Prevalence of postpartum depression (PPD) ranges from 10 to 15 % of parturients. The impact of the PPD is major on the maternal bond and the health of both mother and child. Its physiopathological mechanisms appear to differ from other types of depression. Today, pharmacotherapy is based on nonspecific treatment, and recent therapeutic advances in this field require a comprehensive approach of the implication of the GABAergic system in the development of PPD. Neurosteroid levels during pregnancy and after parturition and the GABA-A-r modulation are thought to be involved in PPD.

OBJECTIVE

To evaluate if the GABAergic approach is relevant in postpartum depression management.

METHODS

We conducted a systematic review of literature based on the MEDLINE database with the following Medical Subject Headings (MeSH): "postpartum depression", "GABA", "ganaxolone", "brexanolone", "allopregnanolone", prior to September 2019. We selected articles in English: preclinical and clinical studies, literature review, observational and therapeutic studies.

RESULTS

Preclinical models (mouse and rat) show changes in GABAergic inhibition in the peripartum period and correlation between allopregnanolone and GABA-A-r plasticity. This plasticity in the peripartum period maintains levels of inhibition adapted despite increased neurosteroid levels. KO models for the GABA-A-r δ subunit develop depression and anxiety symptoms in the postpartum period, and a change in the expression of the gene coding for the GABA-R alpha-4 subunit was found. Artificial inhibition of progesterone metabolism during post-partum increased depression symptoms. GABAergic fluctuation seems to be interrelated with other systems such as those of oxytocins. A synthetic neurosteroid (SGE-516) was tested on mouse models of PPD, KO for δ-GABA-A-r or KCC2, and showed decreased depressive symptoms and better mothering. Clinical studies confirm neurosteroid fluctuation and changes in the GABAergic system during the peripartum period. Allopregnanolone is the neurosteroid the most studied in PPD, and it is elevated in the brain during the pregnancy. Studies disagree on the presence of significant differences in allopregnanolone plasma levels during pregnancy or postpartum between women with PPD or not. Women with a history of PPD have greater susceptibility to neurosteroid withdrawal. Imagery and genetical data also show a link between allopregnanolone and PPD. The GABA-A-r may not recover in time following a reduced number during pregnancy, and this mismatch between neurosteroid levels and their receptor may trigger PPD. Several randomized controlled trials investigated brexanolone administrated IV, a synthetic formulation of allopregnanolone, and demonstrated a rapid and well tolerated reduction in depressive symptoms. In March 2019 brexanolone obtained FDA approval in PPD indication under the name Zulresso. However, there are differences in the time of beginning of PPD, which could constitute different subgroups of this disease, and which physiopathology could respond to different mechanisms. Prenatal depression does not respond to a GABAergic approach, but women without any risk factor or previous mood disorder developing PPD in the weeks following childbirth could be particularly responsive to this kind of treatment.

CONCLUSION

Disability to modulate GABA-A-r expression during pregnancy and restore its previous state after parturition appears to trigger PPD. The GABAergic system is a promising pharmacotherapy target. From preclinical to clinical studies for about twenty years the GABAergic system has been incriminated and targeted in this challenging mental disease.

Research Progress on Toxic Effects and Water Quality Criteria of Triclosan

Triclosan (TCS) is an effective broad-spectrum antimicrobial agent that is widely used in personal care products. It has been detected in different environmental media, and poses high potential ecological risk. In this article, we carried out a literature review of recent studies on the toxic effects of TCS from different aspects at the molecular, cell, tissue, organ, and individual level. TCS can exhibit acute toxicity to aquatic organisms, affect the normal expression and physiological function of enzymes and genes, and produce cytotoxicity. Many studies have demonstrated that TCS exerts significant endocrine-disrupting effects on organisms, interfering the normal physiological functions of the reproductive, thyroid, and nervous systems via related signaling pathways. Moreover, we reported current research on the water quality criteria of TCS and discuss possible future research directions.

Emotional state of “young” fathers

<b>Background</b><br /> The birth of the first child begins a new stage in family life, and the woman and the man must adopt new roles in society. However, adapting to the new conditions of life and the requirements of the new role can be difficult.<br /> <b>Participants and procedure</b><br /> The main tools used in the study were the SUPIN scale, the STAI inventory and a questionnaire constructed by the authors. The participants were 90 men who became first time fathers in the period of 6 months prior to the study.<br /> <b>Results</b><br /> The results indicate that the first time fathers show a medium level of state anxiety related to the current situation and a low level of trait anxiety understood as an enduring disposition. The level of anxiety is related to the age of the child, but only in the men who fathered a son: the older the son was, the greater was the intensity of state anxiety in the father.<br /> <b>Conclusions</b><br /> The deep conviction that the father should be a role model for the son can be a source of anxiety about the ability to manage and the ability to meet the related responsibility. According to the tradition of our culture, the father has to prepare the son to be a man, to assume a man’s roles in society and teach him how to live. The lower intensity of positive emotions related to the birth of a daughter can be explained from the point of view of the true man stereotype – a daughter does not fulfil it.

Effects of triclosan on reproductive prarmeters and embryonic development of sea urchin, Strongylocentrotus nudus

Triclosan (TCS, 2,4,4'-trichloro-2'-hydroxydiphenyl ether), a broad-spectrum antibacterial agent, is commonly found in the aquatic environment. In this study, we investigated TCS toxicity with pertaining to gamete viability, fertilization, and embryogenesis up to pluteus stage of the sea urchin, (Strongylocentrotus nudus). When the sperm and eggs were exposed to TCS (0-3.0 μM), the viability of sperm was significantly decreased at molarities higher than 1 μM of TCS. In addition, for exposure of 2.0 μM TCS the viability of eggs was not influenced and none of the sperm was viable. Fertilization rate was significantly decreased when sperm were exposed to 0.5 and 1 μM of TCS (p<0.001) and no fertilization was observed for the exposure of 1.5 μM of TCS. In embryonic development, embryos are treated with higher than 1.0 μM levels of TCS displayed arrested development. For TCS, the EC50 and LOECs values were 1.8, 1.49 and 0.99 μM and 0.53, 0.62 and 0.39 μM for sperm viability, fertilization rate, and larval development to pluteus, respectively. In the recovery test regarding normal development of arrested embryos based upon TCS exposure time, it was observed that embryos exposed to 1 μM TCS for 15 h were normally recovered for normal development, while embryos with more than 30 h exposure were not recovered to normal larvae. Overall, the results of this study strongly suggest that the gametes and embryos of S. nudus can provide the basis for an effective bioassay, with a fast and sensitive means of evaluating TCS contamination in the marine ecosystem.

Developmental model of depression applied to prenatal depression: role of present and past life events, past emotional disorders and pregnancy stress

Background

Several risk factors for depression during pregnancy have already been established. However, very few studies have conducted a multivariate analysis incorporating both the major predictors of depression in women, in accordance with comprehensive developmental models of depression, and specific stressors associated with the biological and psychosocial state of the mother-to-be.

Methodology/Principal Findings

We used a cross-sectional cohort design to analyze the associations between prenatal depression and potential risk factors. 693 French-speaking women with singleton pregnancies at 20–28 weeks' gestation were consecutively recruited at Caen University Hospital. Fifty women with missing values were subsequently excluded from the analysis. Depressive symptoms were assessed on the Edinburgh Postnatal Depression Scale. Risk factors were either extracted from the computerized obstetric records or assessed by means of self-administered questionnaires. The associations between prenatal depression and the potential risk factors were assessed using log-binomial regression models to obtain a direct estimate of relative risk (RR). The following factors were found to be significant in the multivariate analysis: level of education (p<0.001), past psychiatric history (adjusted RR = 1.8, 95% confidence interval (CI): 1.1;2.8, p = 0.014), stress related to the health and viability of the fetus (adjusted RR = 2.6, 95% CI: 1.6;4.1, p<0.001), and stress related to severe marital conflicts (adjusted RR = 2.4, 95% CI: 1.5;3.9, p<0.001) or to serious difficulties at work (adjusted RR = 1.6, 95% CI :1.04;2.4, p = 0.031). An association was also found with the previous delivery of a child with a major or minor birth defect (adjusted RR = 2.0, 95% CI: 1.04;4.0, p = 0.038). Univariate analyses revealed a strong association with childhood adversity (parental rejection: RR = 1.8, 95% CI: 1.2;2.8, p = 0.0055 and family secrets: RR = 2.0, 95% CI: 1.2;3.1, p = 0.0046) and with lack of partner support (RR = 0.50, 95% CI: 0.30;0.84, p = 0.0086).

Conclusions/Significance

Our study identifies several risk factors that could easily be assessed in clinical practice. It draws attention to the impact of previously delivering a child with a birth defect. The association with childhood adversity warrants further study.