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Cardaci V, Carminati M, Tondello M, Pecorino B, Serretti A, Zanardi R. Understanding and treating postpartum depression: a narrative review. Int Clin Psychopharmacol 2024:00004850-990000000-00143. [PMID: 38941162 DOI: 10.1097/yic.0000000000000560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
Postpartum depression (PPD) is an increasingly prevalent but still poorly characterized disorder. Causal and modulating factors include hormones fluctuations, such as estrogen, progesterone, and allopregnolone, pathways imbalances, such as oxytocin and kynurenine, chronobiological factors, and brain imaging alterations. Treatment may differ from the traditional major depression management, while selective serotonin reuptake inhibitors such as sertraline are commonly used and suggested by guidelines, neurosteroids such as brexanolone and the more convenient zuranolone have been recently approved. Newer neurosteroids such as ganaxolone, valaxanolone, and lysaxanolone are currently under development, but also esketamine and psychedelics are promising potential treatments. Other somatic treatments including brain stimulation techniques and light therapy also showed benefit. PPD is therefore increasingly understood as, at least partially, independent from major depressive disorder. Specific and individualized treatments including pharmacological and non-pharmacological therapies are progressively being introduced in the routine clinical practice.
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Affiliation(s)
- Vincenzo Cardaci
- Department of Clinical Neurosciences, Vita-Salute San Raffaele University, Milan
| | - Matteo Carminati
- Department of Clinical Neurosciences, Vita-Salute San Raffaele University, Milan
| | - Mattia Tondello
- Department of Clinical Neurosciences, Vita-Salute San Raffaele University, Milan
| | - Basilio Pecorino
- Department of Medicine and Surgery, Kore University of Enna, Enna
| | | | - Raffaella Zanardi
- Department of Clinical Neurosciences, Vita-Salute San Raffaele University, Milan
- Department of Psychiatry, Mood Disorder Unit, IRCCS San Raffaele Hospital, Milan, Italy
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2
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DelaCuesta-Barrutia J, Hidema S, Caldwell HK, Nishimori K, Erdozain AM, Peñagarikano O. In need of a specific antibody against the oxytocin receptor for neuropsychiatric research: A KO validation study. J Psychiatr Res 2024; 173:260-270. [PMID: 38554622 DOI: 10.1016/j.jpsychires.2024.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/22/2024] [Accepted: 03/21/2024] [Indexed: 04/02/2024]
Abstract
Antibodies are one of the most utilized tools in biomedical research. However, few of them are rigorously evaluated, as there are no accepted guidelines or standardized methods for determining their validity before commercialization. Often, an antibody is considered validated if it detects a band by Western blot of the expected molecular weight and, in some cases, if blocking peptides result in loss of staining. Neither of these approaches are unquestionable proof of target specificity. Since the oxytocin receptor has recently become a popular target in neuropsychiatric research, the need for specific antibodies to be used in brain has arisen. In this work, we have tested the specificity of six commercially available oxytocin receptor antibodies, indicated by the manufacturers to be suitable for Western blot and with an available image showing the correct size band (45-55 KDa). Antibodies were first tested by Western blot in brain lysates of wild-type and oxytocin receptor knockout mice. Uterus tissue was also tested as control for putative differential tissue specificity. In brain, the six tested antibodies lacked target specificity, as both wild-type and receptor knockout samples resulted in a similar staining pattern, including the expected 45-55 KDa band. Five of the six antibodies detected a selective band in uterus (which disappeared in knockout tissue). These five specific antibodies were also tested for immunohistochemistry in uterus, where only one was specific. However, when the uterine-specific antibody was tested in brain tissue, it lacked specificity. In conclusion, none of the six tested commercial antibodies are suitable to detect oxytocin receptor in brain by either Western blot or immunohistochemistry, although some do specifically detect it in uterus. The present work highlights the need to develop standardized antibody validation methods, including a proper negative control, in order to grant quality and reproducibility of the generated data.
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Affiliation(s)
- Jon DelaCuesta-Barrutia
- Department of Pharmacology, School of Medicine, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain
| | - Shizu Hidema
- Department of Obesity and Inflammation, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Heather K Caldwell
- Department of Biological Sciences and School of Biomedical Sciences, Kent State University, Ohio, 44242, USA
| | - Katsuhiko Nishimori
- Department of Obesity and Inflammation, Fukushima Medical University, Fukushima, 960-1295, Japan
| | - Amaia M Erdozain
- Department of Pharmacology, School of Medicine, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Leioa, 48940, Spain
| | - Olga Peñagarikano
- Department of Pharmacology, School of Medicine, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Leioa, 48940, Spain.
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3
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Xie H, Xie Z, Luan F, Zeng J, Zhang X, Chen L, Zeng N, Liu R. Potential therapeutic effects of Chinese herbal medicine in postpartum depression: Mechanisms and future directions. JOURNAL OF ETHNOPHARMACOLOGY 2024; 324:117785. [PMID: 38262525 DOI: 10.1016/j.jep.2024.117785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 11/15/2023] [Accepted: 01/15/2024] [Indexed: 01/25/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Postpartum depression (PPD) is a common psychiatric disorder in women after childbirth. Per data from epidemiologic studies, PPD affects about 5%-26.32% of postpartum mothers worldwide. Biological factors underlying this condition are multiple and complex and have received extensive inquiries for the roles they play in PPD. Chinese herbal medicine (CHM), which is widely used as a complementary and alternative therapy for neurological disorders, possesses multi-component, multi-target, multi-access, and low side effect therapeutic characteristics. CHM has already shown efficacy in the treatment of PPD, and a lot more research exploring the mechanisms of its potential therapeutic effects is being conducted. AIM OF THE REVIEW This review provides an in-depth and comprehensive overview of the underlying mechanisms of PPD, as well as samples the progress made in researching the potential role of CHM in treating the disorder. MATERIALS AND METHODS Literature was searched comprehensively in scholarly electronic databases, including PubMed, Web of Science, Scopus, CNKI and WanFang DATA, using the search terms "postpartum depression", "genetic", "hormone", "immune", "neuroinflammation", "inflammation", "neurotransmitter", "neurogenesis", "brain-gut axis", "traditional Chinese medicine", "Chinese herbal medicine", "herb", and an assorted combination of these terms. RESULTS PPD is closely associated with genetics, as well as with the hormones, immune inflammatory, and neurotransmitter systems, neurogenesis, and gut microbes, and these biological factors often interact and work together to cause PPD. For example, inflammatory factors could suppress the production of the neurotransmitter serotonin by inducing the regulation of tryptophan-kynurenine in the direction of neurotoxicity. Many CHM constituents improve anxiety- and depression-like behaviors by interfering with the above-mentioned mechanisms and have shown decent efficacy clinically against PPD. For example, Shen-Qi-Jie-Yu-Fang invigorates the neuroendocrine system by boosting the hormone levels of hypothalamic pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes, regulating the imbalance of Treg/T-helper cells (Th) 17 and Th1/Th2, and modulating neurotransmitter system to play antidepressant roles. The Shenguiren Mixture interferes with the extracellular signal-regulated kinase (ERK) pathway to enhance the number, morphology and apoptosis of neurons in the hippocampus of PPD rats. Other herbal extracts and active ingredients of CHM, such as Paeoniflorin, hypericin, timosaponin B-III and more, also manage depression by remedying the neuroendocrine system and reducing neuroinflammation. CONCLUSIONS The pathogenesis of PPD is complex and diverse, with the main pathogenesis not clear. Still, CHM constituents, like Shen-Qi-Jie-Yu-Fang, the Shenguiren Mixture, Paeoniflorin, hypericin and other Chinese Medicinal Formulae, active monomers and Crude extracts, treats PPD through multifaceted interventions. Therefore, developing more CHM components for the treatment of PPD is an essential step forward.
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Affiliation(s)
- Hongxiao Xie
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 611137, PR China.
| | - Zhiqiang Xie
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 611137, PR China.
| | - Fei Luan
- Shaanxi Province Key Laboratory of New Drugs and Chinese Medicine Foundation Research, Pharmacy College, Shaanxi University of Chinese Medicine, Xianyang, 712046, PR China.
| | - Jiuseng Zeng
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 611137, PR China.
| | - Xiumeng Zhang
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 611137, PR China.
| | - Li Chen
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 611137, PR China; Department of Pharmacy, Clinical Medical College and the First Affiliated Hospital of Chengdu Medical College, Chengdu, 610500, PR China.
| | - Nan Zeng
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 611137, PR China.
| | - Rong Liu
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 611137, PR China.
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Palacios-Hernández B, Ramírez-Alvarado G, Téllez-Alanís B, Lino-González AL, Penagos-Rivera M, Hernández-Galván A. Hormones, psychotic disorders, and cognition in perinatal women: a mini review. Front Psychiatry 2024; 14:1296638. [PMID: 38250263 PMCID: PMC10797067 DOI: 10.3389/fpsyt.2023.1296638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/04/2023] [Indexed: 01/23/2024] Open
Abstract
Previous scientific evidence has shown a relationship between hormones and the onset and relapse of perinatal psychotic disorders (PPD) in women during pregnancy, childbirth, and the postpartum period. In healthy women the interaction between hormones and cognitive changes has been confirmed mainly in memory, attention, and executive function during pregnancy and postpartum, which respond to adaptive demands related to parenting tasks. In women with psychotic episodes there is a significant impairment in several cognitive functions, but studies of the perinatal period are limited. The objective of this mini review is to analyze the main findings to identify whether hormonal changes interact with the onset of PPD and cognitive impairment in perinatal women. The studies included samples of women with psychosis, risk of developing psychosis, bipolar psychosis, schizoaffective psychosis, and psychotic symptoms, during pregnancy and postpartum. Findings contributed to knowledge about five hypotheses regarding the relationship between hormones in the perinatal period and the appearance of PPD. Nevertheless, this review did not find reports of evidence of a relationship between hormonal production and cognitive function among women with clinically diagnosed PPD, suggesting a research gap. Clinical implications of assessing hormonal production and cognitive function in PPD are discussed. Although the evidence identified is scarce and heterogeneous, the findings call for further research with clinical samples on the role of hormones in perinatal psychotic disorders, especially as they relate to the study of cognition. This will promote more consistent evidence and understanding of PPD etiopathology that can guide early and effective multidisciplinary interventions.
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Affiliation(s)
- Bruma Palacios-Hernández
- Cuerpo Académico “Cognición y Afectos” (UAEMor CA-81), Centro de Investigación Transdisciplinar en Psicología, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico
| | - Gabriela Ramírez-Alvarado
- Escuela de Estudios Superiores del Jicarero, Universidad Autónoma del Estado de Morelos, Jojutla de Juárez, Mexico
| | - Bernarda Téllez-Alanís
- Cuerpo Académico “Cognición y Afectos” (UAEMor CA-81), Centro de Investigación Transdisciplinar en Psicología, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico
- Facultad de Psicología, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico
| | - Ana Luisa Lino-González
- Cuerpo Académico “Cognición y Afectos” (UAEMor CA-81), Centro de Investigación Transdisciplinar en Psicología, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico
- Investigación Biomédica Neurociencias Clínica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Tlalpan, Mexico
| | - Miriam Penagos-Rivera
- Cuerpo Académico “Cognición y Afectos” (UAEMor CA-81), Centro de Investigación Transdisciplinar en Psicología, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico
| | - Adela Hernández-Galván
- Cuerpo Académico “Cognición y Afectos” (UAEMor CA-81), Centro de Investigación Transdisciplinar en Psicología, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico
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Zhang S, Zhang YD, Shi DD, Wang Z. Therapeutic uses of oxytocin in stress-related neuropsychiatric disorders. Cell Biosci 2023; 13:216. [PMID: 38017588 PMCID: PMC10683256 DOI: 10.1186/s13578-023-01173-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 11/18/2023] [Indexed: 11/30/2023] Open
Abstract
Oxytocin (OXT), produced and secreted in the paraventricular nucleus and supraoptic nucleus of magnocellular and parvocellular neurons. The diverse presence and activity of oxytocin suggests a potential for this neuropeptide in the pathogenesis and treatment of stress-related neuropsychiatric disorders (anxiety, depression and post-traumatic stress disorder (PTSD)). For a more comprehensive understanding of the mechanism of OXT's anti-stress action, the signaling cascade of OXT binding to targeting stress were summarized. Then the advance of OXT treatment in depression, anxiety, PTSD and the major projection region of OXT neuron were discussed. Further, the efficacy of endogenous and exogenous OXT in stress responses were highlighted in this review. To augment the level of OXT in stress-related neuropsychiatric disorders, current biological strategies were summarized to shed a light on the treatment of stress-induced psychiatric disorders. We also conclude some of the major puzzles in the therapeutic uses of OXT in stress-related neuropsychiatric disorders. Although some questions remain to be resolved, OXT has an enormous potential therapeutic use as a hormone that regulates stress responses.
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Affiliation(s)
- Sen Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, 200030, China
- College of Physical Education and Health, East China Normal University, Shanghai, China
| | - Ying-Dan Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, 200030, China
| | - Dong-Dong Shi
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, 200030, China.
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, 200030, China.
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China.
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6
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Oberfichtner K, Oppelt P, Fritz D, Hrauda K, Fritz C, Schildberger B, Lastinger J, Stelzl P, Enengl S. Breastfeeding in primiparous women - expectations and reality: a prospective questionnaire survey. BMC Pregnancy Childbirth 2023; 23:654. [PMID: 37689660 PMCID: PMC10493027 DOI: 10.1186/s12884-023-05971-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/04/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND Breastfeeding provides the optimal nutrition for infants and offers numerous benefits for both mother and child. The World Health Organisation recommends exclusive breastfeeding during the first 6 months of life and the introduction of complementary feeding between the fifth and seventh months of life. There is a discrepancy between breastfeeding recommendations and the actual duration of breastfeeding. The aim of this study was to analyse breastfeeding behaviour in primiparous women in order to be able to provide support for mothers. METHODS In this prospective, questionnaire-based study conducted between 2020 and 2022, primiparous women were asked to complete three questionnaires at three defined survey time points (routine prepartum presentation, postpartum hospitalization, completed sixth month of life). RESULTS A total of 140 women were included and returned all three questionnaires. Fifty-eight percent performed breastfeeding exclusively at least until their baby had reached the age of 6 months, whereas 20% already stopped within the first 6 months. The main reasons given for early cessation were insufficient milk supply and inadequate infant weight gain. A comprehensive level of prepartum knowledge had a significant positive effect on participants' sense of confidence with breastfeeding. Sociodemographic factors such as age and educational level were also associated with breastfeeding behaviour, but significant corresponding differences in the duration of breastfeeding were not observed. Women with postpartum midwifery care breastfed significantly longer (p < 0.05). CONCLUSIONS Breastfeeding behaviour and duration are influenced by multiple factors. Although certain sociodemographic factors are unalterable, comprehensive prepartum knowledge transfer and postpartum midwifery care have a positive impact on breastfeeding behaviour. TRIAL REGISTRATION The study was retrospectively registered at the German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS) on 6 December 2022 (DRKS00030763).
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Affiliation(s)
- Katrin Oberfichtner
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria.
| | - Peter Oppelt
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Daniela Fritz
- University of Applied Sciences for the Health Professions, Linz, Austria
| | - Katharina Hrauda
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Christian Fritz
- Institute for Statistical Analysis Jaksch & Partner GmbH, Linz, Austria
| | | | - Julia Lastinger
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Patrick Stelzl
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Sabine Enengl
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University, Altenbergerstrasse 69, 4040, Linz, Austria
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7
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Jin Y, Song D, Yan Y, Quan Z, Qing H. The Role of Oxytocin in Early-Life-Stress-Related Neuropsychiatric Disorders. Int J Mol Sci 2023; 24:10430. [PMID: 37445607 DOI: 10.3390/ijms241310430] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
Early-life stress during critical periods of brain development can have long-term effects on physical and mental health. Oxytocin is a critical social regulator and anti-inflammatory hormone that modulates stress-related functions and social behaviors and alleviates diseases. Oxytocin-related neural systems show high plasticity in early postpartum and adolescent periods. Early-life stress can influence the oxytocin system long term by altering the expression and signaling of oxytocin receptors. Deficits in social behavior, emotional control, and stress responses may result, thus increasing the risk of anxiety, depression, and other stress-related neuropsychiatric diseases. Oxytocin is regarded as an important target for the treatment of stress-related neuropsychiatric disorders. Here, we describe the history of oxytocin and its role in neural circuits and related behaviors. We then review abnormalities in the oxytocin system in early-life stress and the functions of oxytocin in treating stress-related neuropsychiatric disorders.
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Affiliation(s)
- Yue Jin
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Da Song
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Yan Yan
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Zhenzhen Quan
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Hong Qing
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
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8
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Moreira LKS, Moreira CVL, Custódio CHX, Dias MLP, Rosa DA, Ferreira-Neto ML, Colombari E, Costa EA, Fajemiroye JO, Pedrino GR. Post-partum depression: From clinical understanding to preclinical assessments. Front Psychiatry 2023; 14:1173635. [PMID: 37143780 PMCID: PMC10151489 DOI: 10.3389/fpsyt.2023.1173635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/29/2023] [Indexed: 05/06/2023] Open
Abstract
Post-partum depression (PPD) with varying clinical manifestations affecting new parents remains underdiagnosed and poorly treated. This minireview revisits the pharmacotherapy, and relevant etiological basis, capable of advancing preclinical research frameworks. Maternal tasks accompanied by numerous behavioral readouts demand modeling different paradigms that reflect the complex and heterogenous nature of PPD. Hence, effective PPD-like characterization in animals towards the discovery of pharmacological intervention demands research that deepens our understanding of the roles of hormonal and non-hormonal components and mediators of this psychiatric disorder.
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Affiliation(s)
| | | | | | - Matheus L. P. Dias
- Institute of Biological Sciences, Federal University of Goiás, Goiania, GO, Brazil
| | - Daniel A. Rosa
- Institute of Biological Sciences, Federal University of Goiás, Goiania, GO, Brazil
| | - Marcos L. Ferreira-Neto
- Department of Physiology, Institute of Biomedical Sciences, Federal University of Uberlândia, Uberlândia, Brazil
| | - Eduardo Colombari
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Elson A. Costa
- Institute of Biological Sciences, Federal University of Goiás, Goiania, GO, Brazil
| | - James O. Fajemiroye
- Institute of Biological Sciences, Federal University of Goiás, Goiania, GO, Brazil
- Graduate Program in Pharmaceutical Sciences, Campus Arthur Wesley Archibald, Evangelical University of Goiás, Anápolis, Brazil
- *Correspondence: James O. Fajemiroye,
| | - Gustavo R. Pedrino
- Institute of Biological Sciences, Federal University of Goiás, Goiania, GO, Brazil
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9
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Zhu J, Jin J, Tang J. Oxytocin and Women Postpartum Depression: A Systematic Review of Randomized Controlled Trials. Neuropsychiatr Dis Treat 2023; 19:939-947. [PMID: 37096027 PMCID: PMC10122502 DOI: 10.2147/ndt.s393499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 04/05/2023] [Indexed: 04/26/2023] Open
Abstract
Previous studies have demonstrated that oxytocin was a viable therapy option for postpartum depression. However, the role remains controversial. To evaluate the efficacy of oxytocin on women postpartum depression, we searched PubMed, Web of Science, Cochrane Library, and EmBase for literatures from inception of the database to April 18th, 2022. Randomized controlled trials (RCTs) that investigated the effects of oxytocin on postpartum depression were selected for this study. Six RCTs (195 women) were gathered. The effects of oxytocin were roughly divided into emotion and cognition. The modulation of oxytocin to women's emotion was demonstrated in four of the trials. The results were conflicting: One trial showed that oxytocin alleviated the depressive mood; two trials showed that oxytocin had no effect (but reduce negative thoughts in healthy mothers, or decrease the narcissistic trait); another trial showed that oxytocin aggravated depression. Women's cognition was shown to be regulated by oxytocin in four of the trials. In general, oxytocin enhanced postpartum depressive women's perception of their relationship with the infants. This systematic review showed that the effect of oxytocin on postpartum depression is still uncertain. We partly support that exogenous oxytocin might improve the cognition of women with postpartum depression to their infants, while the effect on emotion is still controversial. Further RCTs with larger samples and more diversified evaluation criteria are needed to better reveal its efficacy on postpartum depression.
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Affiliation(s)
- Jialei Zhu
- Department of Pharmacy, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People’s Republic of China
| | - Jing Jin
- Department of Pharmacy, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People’s Republic of China
| | - Jing Tang
- Department of Pharmacy, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, People’s Republic of China
- Correspondence: Jing Tang, Department of Pharmacy, Obstetrics and Gynecology Hospital of Fudan University, 128 Shenyang Road, Yangpu District, Shanghai, 200090, People’s Republic of China, Tel +86-21-33189900, Email
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10
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Marazziti D, Carter CS, Carmassi C, Della Vecchia A, Mucci F, Pagni G, Carbone MG, Baroni S, Giannaccini G, Palego L, Dell’Osso L. Sex matters: The impact of oxytocin on healthy conditions and psychiatric disorders. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2022; 13:100165. [PMID: 36590869 PMCID: PMC9800179 DOI: 10.1016/j.cpnec.2022.100165] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 12/12/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Oxytocin (OT) is involved in the regulation of physiological processes and emotional states, with increasing evidence for its beneficial actions being mediated by the autonomic and immune systems. Growing evidence suggests that OT plays a role in the pathophysiology of different psychiatric disorders. Given the limited information in humans the aim of this study was to retrospectively explore plasma OT levels in psychiatric patients, particularly focusing on sex-related differences, as compared with healthy controls. The patients studied here were divided into three groups diagnosed with obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD) or major depressive disorder (MDD). Plasma OT levels were significantly different between healthy men and women, with the latter showing higher values, while none of the three psychiatric groups showed sex-related differences in the parameters measured here. The intergroup analyses showed that the OT levels were significantly higher in OCD, lower in PTSD and even more reduced in MDD patients than in healthy subjects. These differences were also confirmed when gender was considered, with the exception of PTSD men, in whom OT levels were similar to those of healthy men. The present results indicated that OT levels were higher amongst healthy women than men, while a sex difference was less apparent or reversed in psychiatric patients. Reductions in sex differences in psychopathologies may be related to differential vulnerabilities in processes associated with basic adaptive and social functions.
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Affiliation(s)
- Donatella Marazziti
- Department of Clinical and Experimental Medicine, University of Pisa, Italy,Saint Camillus International University of Health and Medical Sciences – UniCamillus, Rome, Italy,Corresponding author. Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 57, 56100, Pisa, Italy.
| | - C. Sue Carter
- Kinsey Institute, Indiana University, Bloomington, IN, USA,Department of Psychology, University of Virginia, Charlottesville, VA, USA
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | | | - Federico Mucci
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Italy,Department of Psychiatry, North-Western Tuscany Region NHS Local Health Unit, Lucca Zone, Lucca, Italy
| | - Giovanni Pagni
- Department of Psychiatry, North-Western Tuscany Region NHS Local Health Unit, Lunigiana Zone, Aulla, Italy
| | - Manuel G. Carbone
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Varese, Italy
| | - Stefano Baroni
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | | | | | - Liliana Dell’Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
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11
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Chen J, Lai X, Zhou L, Retnakaran R, Wen SW, Krewski D, Huang L, Li M, Xie RH. Association between exclusive breastfeeding and postpartum post-traumatic stress disorder. Int Breastfeed J 2022; 17:78. [PMID: 36419193 PMCID: PMC9685859 DOI: 10.1186/s13006-022-00519-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 11/05/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Research on the association between breastfeeding and postpartum post-traumatic stress disorder (PTSD) is sparse. This study aimed to examine the association between exclusive breastfeeding up to 42 days after childbirth and postpartum PTSD. METHODS An epidemiologic study was conducted in a tertiary hospital in China between October 2019 and October 2020. Eligible mothers were recruited at 3 days after childbirth and assessed using the Post-Traumatic Stress Disorder Checklist - Civilian version (PCL-C) for PTSD at 42 days postpartum. The independent association between exclusive breastfeeding up to 42 days after childbirth and postpartum PTSD was estimated using log-binomial regression models, after adjusting for potential confounders. RESULTS Ninety-two of 759 (12.1%) mothers developed postpartum PTSD within 42 days after childbirth. Compared with partially breastfeeding mothers, exclusively breastfeeding mothers had lower risks of postpartum PTSD (relative risk [RR] 0.28; 95% confidence interval [CI] 0.13, 0.59), re-experience (RR 0.48; 95% CI 0.30, 0.76), avoidance (RR 0.55; 95% CI 0.32, 0.97), and hyperarousal (RR 0.52; 95% CI 0.34, 0.78). After adjustment for family support, parity, mode of delivery, perceived birth trauma, early contact / suckling, and rooming-in, associations between exclusive breastfeeding and postpartum PTSD remained significant: the overall PTSD adjusted relative risk [aRR] was 0.31; (95% CI 0.15, 0.66), with a re-experience aRR of 0.48; (95% CI 0.30, 0.77) and hyperarousal aRR of 0.56; (95% CI 0.37, 0.85). CONCLUSION Exclusive breastfeeding up to 42 days after childbirth was associated with reduced risk of postpartum PTSD. While the potential for reverse causation cannot be ruled out, strategies to improve rates of exclusive breastfeeding through teaching, counselling, and support may benefit mothers and their infants by reducing the risk of postpartum PTSD.
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Affiliation(s)
- Jingfen Chen
- grid.284723.80000 0000 8877 7471School of Nursing, Southern Medical University, Guangzhou, China
| | - Xiaolu Lai
- grid.284723.80000 0000 8877 7471School of Nursing, Southern Medical University, Guangzhou, China
| | - Lepeng Zhou
- grid.284723.80000 0000 8877 7471School of Nursing, Southern Medical University, Guangzhou, China
| | - Ravi Retnakaran
- grid.416166.20000 0004 0473 9881Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario Canada ,grid.250674.20000 0004 0626 6184Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario Canada ,grid.17063.330000 0001 2157 2938Division of Endocrinology, University of Toronto, Toronto, Ontario Canada
| | - Shi Wu Wen
- grid.412687.e0000 0000 9606 5108Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario Canada ,grid.28046.380000 0001 2182 2255Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario Canada ,grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario Canada
| | - Daniel Krewski
- grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario Canada ,grid.28046.380000 0001 2182 2255McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Ontario Canada ,Risk Science International, Ottawa, Ontario Canada
| | - Liping Huang
- grid.284723.80000 0000 8877 7471Department of Obstetrics and Gynecology, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Meng Li
- grid.284723.80000 0000 8877 7471The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China ,grid.284723.80000 0000 8877 7471Department of Obstetrics, The Seventh Affiliated Hospital, Southern Medical University, Foshan, China
| | - Ri-hua Xie
- grid.284723.80000 0000 8877 7471Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, China ,grid.284723.80000 0000 8877 7471School of Nursing, Southern Medical University, Guangzhou, China ,grid.28046.380000 0001 2182 2255The Telfer School of Management, University of Ottawa, Ottawa, Ontario Canada
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12
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Marazziti D, Diep PT, Carter S, Carbone MG. Oxytocin: An Old Hormone, A Novel Psychotropic Drug And Possible Use In Treating Psychiatric Disorders. Curr Med Chem 2022; 29:5615-5687. [PMID: 35894453 DOI: 10.2174/0929867329666220727120646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/17/2022] [Accepted: 04/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Oxytocin is a nonapeptide synthesized in the paraventricular and supraoptic nuclei of the hypothalamus. Historically, this molecule has been involved as a key factor in the formation of infant attachment, maternal behavior and pair bonding and, more generally, in linking social signals with cognition, behaviors and reward. In the last decades, the whole oxytocin system has gained a growing interest as it was proposed to be implicated in etiopathogenesis of several neurodevelopmental and neuropsychiatric disorders. METHODS With the main goal of an in-depth understanding of the oxytocin role in the regulation of different functions and complex behaviors as well as its intriguing implications in different neuropsychiatric disorders, we performed a critical review of the current state of art. We carried out this work through PubMed database up to June 2021 with the search terms: 1) "oxytocin and neuropsychiatric disorders"; 2) "oxytocin and neurodevelopmental disorders"; 3) "oxytocin and anorexia"; 4) "oxytocin and eating disorders"; 5) "oxytocin and obsessive-compulsive disorder"; 6) "oxytocin and schizophrenia"; 7) "oxytocin and depression"; 8) "oxytocin and bipolar disorder"; 9) "oxytocin and psychosis"; 10) "oxytocin and anxiety"; 11) "oxytocin and personality disorder"; 12) "oxytocin and PTSD". RESULTS Biological, genetic, and epigenetic studies highlighted quality and quantity modifications in the expression of oxytocin peptide or in oxytocin receptor isoforms. These alterations would seem to be correlated with a higher risk of presenting several neuropsychiatric disorders belonging to different psychopathological spectra. Collaterally, the exogenous oxytocin administration has shown to ameliorate many neuropsychiatric clinical conditions. CONCLUSION Finally, we briefly analyzed the potential pharmacological use of oxytocin in patient with severe symptomatic SARS-CoV-2 infection due to its anti-inflammatory, anti-oxidative and immunoregulatory properties.
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Affiliation(s)
- Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy.,Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Phuoc-Tan Diep
- Department of Histopathology, Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom
| | - Sue Carter
- Director Kinsey Institute, Indiana University, Bloomington, IN, USA
| | - Manuel G Carbone
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, 21100 Varese, Italy
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13
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Utility of Downstream Biomarkers to Assess and Optimize Intranasal Delivery of Oxytocin. Pharmaceutics 2022; 14:pharmaceutics14061178. [PMID: 35745751 PMCID: PMC9228821 DOI: 10.3390/pharmaceutics14061178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 02/05/2023] Open
Abstract
Oxytocin (OT), a mammalian neurohormone associated with social cognition and behavior, can be administered in its synthetic form intranasally (IN) and impact brain chemistry and behavior. IN-OT shows potential as a noninvasive intervention for disorders characterized by social challenges, e.g., autism spectrum disorder (ASD) and anorexia nervosa (AN). To evaluate IN-OT’s efficacy, we must quantify OT uptake, availability, and clearance; thus, we assessed OT levels in urine (uOT) before and after participants (26 ASD, 7 AN, and 7 healthy controls) received 40 IU IN-OT or placebo across two sessions using double-blind, placebo-controlled crossover designs. We also measured uOT and plasma (pOT) levels in a subset of participants to compare the two sampling methods. We found significantly higher uOT and pOT following intranasal delivery of active compound versus placebo, but analyses yielded larger effect sizes and more clearly differentiated pre–post-OT levels for uOT than pOT. Further, we applied a two-step cluster (TSC), blinded backward-chaining approach to determine whether active/placebo groups could be identified by uOT and pOT change alone; uOT levels may serve as an accessible and accurate systemic biomarker for OT dose–response. Future studies will explore whether uOT levels correlate directly with behavioral targets to improve dosing for therapeutic goals.
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14
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Cevik A, Alan S. Are pregnancy and postpartum oxytocin level a predictive biomarker for postpartum depression? J Obstet Gynaecol Res 2021; 47:4280-4288. [PMID: 34545656 DOI: 10.1111/jog.15023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/14/2021] [Accepted: 08/31/2021] [Indexed: 12/15/2022]
Abstract
AIM This study aims to determine the relationship between the late pregnancy and postpartum oxytocin levels and postpartum depression (PPD) symptoms. METHODS This longitudinal study was conducted with 70 pregnant women. Data collection was performed through two interviews. While the first interview was conducted in the 30th to 38th gestational weeks, the second interview was conducted in the 4th to 12th weeks in the postpartum period. Oxytocin level measurement was performed with a saliva sample. Saliva samples were analyzed with enzyme-linked immunosorbent assay kits. RESULTS The prevalence of depressive symptoms in the postpartum period was found significantly higher than the prevalence in late pregnancy. Depression symptoms reached the highest level in the 12th week. The late pregnancy oxytocin level was significantly higher than the postpartum oxytocin level. A weak, negative correlation was found between PPD symptoms and the late pregnancy oxytocin level. However, when linear regression analysis was performed, it was concluded that there was a medium, negative relationship model between PPD symptoms and the late pregnancy oxytocin level. However, no relationships were found between PPD symptoms and oxytocin level. CONCLUSION In conclusion, this study found that the late pregnancy oxytocin level could be a predictive biomarker for postpartum depression. Predicting the risk of PPD in the pregnancy period could provide an opportunity for early diagnosis and treatment.
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Affiliation(s)
- Ayseren Cevik
- Department of Midwifery, Cukurova University, Faculty of Health Science, Adana, Turkey
| | - Sultan Alan
- Department of Midwifery, Cukurova University, Faculty of Health Science, Adana, Turkey
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15
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Li T, Jia SW, Hou D, Liu X, Li D, Liu Y, Cui D, Wang X, Hou C, Brown CH, Wang YF. Intranasal Oxytocin Restores Maternal Behavior and Oxytocin Neuronal Activity in the Supraoptic Nucleus in Rat Dams with Cesarean Delivery. Neuroscience 2021; 468:235-246. [PMID: 34166764 DOI: 10.1016/j.neuroscience.2021.06.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/25/2021] [Accepted: 06/13/2021] [Indexed: 10/21/2022]
Abstract
Oxytocin (OT) is a key factor for maternal behavior. However, neurochemical regulation of OT neurons, the major source of OT, remains incompletely understood. Here we report the effect of intranasally-applied OT (IAO) on OT neuronal activity in the supraoptic nucleus (SON) and on maternal behavior in a rat model of cesarean delivery (CD) at day 4-5 (stage I) and day 8-9 (stage II) following delivery. We found that at stage I, CD dams exhibited significantly longer latency of pup retrieval, lower number of anogenital licks and smaller acinar area of the mammary glands. In the SON, the number of OT neurons expressing phosphorylated extracellular signal-regulated protein kinase 1/2 (pERK 1/2) decreased significantly. IAO reversed the depressive-like maternal behavior and involution-like change in the mammary glands, and restored the number of pERK1/2-positive OT neurons in CD dams. At stage II, CD did not significantly influence the latency of retrieval and pERK1/2 expression in the SON. However, CD still reduced the number of anogenital licks during suckling, which was reversed by IAO. Notably, IAO but not hypodermic OT application in CD dams significantly increased litter's body weight gains. In brain slices, CD but not CD plus IAO significantly depolarized membrane potential and increased spike duration in OT neurons. In vasopressin neurons, CD, but not CD plus IAO, significantly depolarized membrane potential and increased the firing rate. Thus, decreased OT neuronal activity and increased vasopressin neuronal activity impair maternal behavior in CD dams, which can be prevented by IAO .
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Affiliation(s)
- Tong Li
- Department of Physiology, School of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Shu-Wei Jia
- Department of Physiology, School of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Dan Hou
- Department of Physiology, School of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Xiaoyu Liu
- Department of Physiology, School of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Dongyang Li
- Department of Physiology, School of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Yang Liu
- Department of Physiology, School of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Dan Cui
- Department of Physiology, School of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Xiaoran Wang
- Department of Physiology, School of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Chunmei Hou
- Department of Physiology, School of Basic Medical Sciences, Harbin Medical University, Harbin, China
| | - Colin H Brown
- Department of Physiology and Center for Neuroendocrinology, University of Otago, Dunedin, New Zealand
| | - Yu-Feng Wang
- Department of Physiology, School of Basic Medical Sciences, Harbin Medical University, Harbin, China.
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