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Gudnadottir U, Kamau N, Fornes R, Nguyen MH, Callens S, Fransson E, Engstrand L, Bruyndonckx R, Brusselaers N. Antibiotic or gastric acid inhibitor use during pregnancy and postpartum depression: Population-based cohort study. Acta Obstet Gynecol Scand 2024; 103:1596-1605. [PMID: 38831623 PMCID: PMC11266723 DOI: 10.1111/aogs.14864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/22/2024] [Accepted: 04/08/2024] [Indexed: 06/05/2024]
Abstract
INTRODUCTION Postpartum depression is one of the most common non-obstetric postnatal complications. As the microbiome (and gut-brain axis) as well as inflammation may be involved in the mechanism, we aimed to assess if antibiotic or gastric acid inhibition use during pregnancy affects the risk of postpartum depression (clinical diagnosis and/or antidepressant use up to 1 year after childbirth). MATERIAL AND METHODS This population-based cohort study used first singleton pregnancy resulting in a live birth in Sweden from 2006 to 2016. Women with history of depression were excluded. Multivariable logistic regression models were used to assess the impact of antibiotics and gastric acid inhibitors and other risk factors, presented as odds ratios (ORs) with 95% confidence intervals (CI). RESULTS Overall, 29% of all 10 666 women with postpartum depression were exposed to antibiotics and 6.2% to gastric acid inhibitors, compared to, respectively, 21% and 3.2% of 613 205 women without postpartum depression. Antibiotic use during pregnancy was associated with postpartum depression (OR 1.43, 95% CI 1.37-1.49), particularly for quinolones and other antibacterials (including nitroimidazole derivatives). Gastric acid inhibition was associated with an even higher risk than antibiotics (OR 2.04, 95% CI 1.88-2.21). Both antibiotics and gastric acid inhibitors suggested higher risk with increased dose in a dose-response analysis. CONCLUSIONS The use of antibiotics and gastric acid inhibition drugs during pregnancy appeared to be associated with a higher risk of postpartum depression. However, it is important to consider that other predisposing factors could contribute to this increased risk, even after excluding individuals with a history of depression.
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Affiliation(s)
- Unnur Gudnadottir
- Department of Microbiology Tumor and Cell Biology, center for Translational Microbiome ResearchKarolinska InstitutetStockholmSweden
| | - Njeri Kamau
- Interuniversity Institute for Biostatistics and statistical Bioinformatics (I‑BIOSTAT), Data Science InstituteHasselt UniversityHasseltBelgium
| | - Romina Fornes
- School of Obstetrics, Faculty of Health Care SciencesUniversidad San SebastiánSantiagoChile
| | - Minh Hanh Nguyen
- Interuniversity Institute for Biostatistics and statistical Bioinformatics (I‑BIOSTAT), Data Science InstituteHasselt UniversityHasseltBelgium
| | - Steven Callens
- Department of General Internal MedicineGhent University HospitalGhentBelgium
| | - Emma Fransson
- Department of Microbiology Tumor and Cell Biology, center for Translational Microbiome ResearchKarolinska InstitutetStockholmSweden
- Department of Women's and Children's HealthUppsala UniversitySweden
| | - Lars Engstrand
- Department of Microbiology Tumor and Cell Biology, center for Translational Microbiome ResearchKarolinska InstitutetStockholmSweden
| | - Robin Bruyndonckx
- Interuniversity Institute for Biostatistics and statistical Bioinformatics (I‑BIOSTAT), Data Science InstituteHasselt UniversityHasseltBelgium
| | - Nele Brusselaers
- Department of Microbiology Tumor and Cell Biology, center for Translational Microbiome ResearchKarolinska InstitutetStockholmSweden
- Global Health Institute, Department of Family Medicine and Population HealthAntwerp UniversityAntwerpBelgium
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2
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Pawluski JL. The parental brain, perinatal mental illness, and treatment: A review of key structural and functional changes. Semin Perinatol 2024:151951. [PMID: 39030131 DOI: 10.1016/j.semperi.2024.151951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2024]
Abstract
The transition to parenthood is perhaps the only time in adult life when the brain changes to such a significant degree in such a short period, particularly in birthing parents. It is also a time when there is an increased risk of developing a mental illness, which may be due, in part, to the increased neuroplasticity. Thus, we must develop interventions and treatments that support parents and promote parental brain health. This review will highlight key findings from current research on how human brain structure and function are modified with 1) the transition to parenthood, 2) parenting stress and perinatal mental illness, and 3) treatments aimed at promoting perinatal mental health. The focus will be on birthing parents and mothers, but brain changes in non-birthing parents will also be discussed. Improvements in our understanding of the parental brain, in health and with illness, will promote the well-being of generations to come.
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Affiliation(s)
- Jodi L Pawluski
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, F-35000, Rennes, France.
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3
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Cui J, Zhai Q, Yang Z, Liu Y. The role of gut microbiota and blood metabolites in postpartum depression: a Mendelian randomization analysis. Front Cell Infect Microbiol 2024; 14:1416298. [PMID: 39050131 PMCID: PMC11266010 DOI: 10.3389/fcimb.2024.1416298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 06/25/2024] [Indexed: 07/27/2024] Open
Abstract
Background Postpartum depression (PPD) is a common complication of pregnancy that imposes a heavy health and economic burden on individuals, families and society. The etiology of PPD is complex and incompletely defined, and recent studies have identified an important role for gut microbiota (GM) and their metabolites in neurological disorders. However, fewer studies on GM and PPD are available and have not yielded uniform results. Methods Instrumental variables for GM and blood metabolites were obtained from the MiBioGen consortium and metabolomics GWAS server. Single nucleotide polymorphisms (SNPs) associated with PPD phenotypes were obtained from the FinnGen consortium. Inverse variance weighted (IVW), weighted median, weighted mode, and MR-Egger methods were used to assess causal effects. Inverse MR analysis and sensitivity analysis were also utilized to improve the stability of the results. Results In this study, 5 intestinal species and 24 blood metabolites causally associated with PPD were identified using MR analysis. In addition, MR analysis showed that Prevotellaceae and Bifidobacteria may reduce the risk of PPD by elevating Xanthine and 1-arachidonoylglycerophosphoinositol (LysoPI) levels. Conclusions This study identified GM and blood metabolites causally associated with PPD. The results of this study may provide a theoretical basis for the discovery of PPD-related biomarkers and the treatment of the disease by regulating the gut microenvironment.
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Affiliation(s)
- Ji Cui
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qilong Zhai
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhu Yang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yi Liu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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4
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Oancea M, Strilciuc Ș, Borza DB, Ciortea R, Diculescu D, Mihu D. Neurobiological and Behavioral Underpinnings of Perinatal Mood and Anxiety Disorders (PMADs): A Selective Narrative Review. J Clin Med 2024; 13:2088. [PMID: 38610853 PMCID: PMC11012341 DOI: 10.3390/jcm13072088] [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: 02/17/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Perinatal mood and anxiety disorders (PMADs) profoundly impact maternal and infant health, affecting women worldwide during pregnancy and postpartum. This review synthesizes current research on the neurobiological effects of PMADs, particularly their influence on brain structure, function, and corresponding cognitive, behavioral, and mental health outcomes in mothers. A literature search across PubMed, PsycINFO, and Google Scholar yielded studies utilizing neuroimaging (MRI, fMRI) and cognitive assessments to explore brain changes in PMADs. The key findings indicate significant neurobiological alterations in PMADs, such as glutamatergic dysfunction, neuronal damage, and altered neural connectivity, particularly in postpartum depression (PPD). Functional MRI studies reveal distinct patterns of brain function alteration, including amygdala non-responsivity in PPD, differing from traditional major depressive disorder (MDD). These neurobiological changes are connected with cognitive impairments and behavioral modifications, impacting maternal caregiving. Understanding these alterations is fundamental for developing effective treatments. The findings emphasize the importance of focusing on maternal mental health, advocating for early detection, and personalized treatment strategies to improve maternal and child outcomes.
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Affiliation(s)
- Mihaela Oancea
- Department of Obstetrics and Gynaecology, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
| | - Ștefan Strilciuc
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, 400337 Cluj-Napoca, Romania
| | - Dan Boitor Borza
- Department of Obstetrics and Gynaecology, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
| | - Răzvan Ciortea
- Department of Obstetrics and Gynaecology, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
| | - Doru Diculescu
- Department of Obstetrics and Gynaecology, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
| | - Dan Mihu
- Department of Obstetrics and Gynaecology, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
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5
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Lalonde-Bester S, Malik M, Masoumi R, Ng K, Sidhu S, Ghosh M, Vine D. Prevalence and Etiology of Eating Disorders in Polycystic Ovary Syndrome: A Scoping Review. Adv Nutr 2024; 15:100193. [PMID: 38408541 PMCID: PMC10973592 DOI: 10.1016/j.advnut.2024.100193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 02/06/2024] [Accepted: 02/14/2024] [Indexed: 02/28/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine-metabolic disorder affecting females across the lifespan. Eating disorders (EDs) are psychiatric conditions that may impact the development of PCOS and comorbidities including obesity, metabolic syndrome, and type 2 diabetes. The aim of this scoping review was to determine the prevalence of EDs and disordered eating, and to review the etiology of EDs in PCOS. The review was conducted using search terms addressing PCOS, EDs, and disordered eating in databases, including PubMed, Scopus, PsycINFO, and CINAHL. Structured interviews, self-administered questionnaires, chart review, or self-reported diagnosis were used to identify EDs in 38 studies included in the review. The prevalence of any ED in those with PCOS ranged from 0% to 62%. Those with PCOS were 3-6-fold more likely to have an ED and higher odds ratios (ORs) of an elevated ED score compared with controls. In those with PCOS, 30% had a higher OR of bulimia nervosa and binge ED was 3-fold higher compared with controls. Studies were limited on anorexia nervosa and other specified feeding or ED (such as night eating syndrome) and these were not reported to be higher in PCOS. To our knowledge, no studies reported on avoidant/restrictive food intake disorder, rumination disorder, or pica in PCOS. Studies showed strong associations between overweight, body dissatisfaction, and disordered eating in PCOS. The etiologic development of EDs in PCOS remains unclear; however, psychological, metabolic, hypothalamic, and genetic factors are implicated. The prevalence of any ED in PCOS varied because of the use of different diagnostic and screening tools. Screening of all individuals with PCOS for EDs is recommended and high-quality studies on the prevalence, pathogenesis of specific EDs, relationship to comorbidities, and effective interventions to treat ED in those with PCOS are needed.
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Affiliation(s)
- Sophie Lalonde-Bester
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Mishal Malik
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Reihaneh Masoumi
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Katie Ng
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Simran Sidhu
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada
| | - Mahua Ghosh
- Division of Endocrinology and Metabolism, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Donna Vine
- Metabolic and Cardiovascular Disease Laboratory, University of Alberta, Edmonton, Alberta, Canada.
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Kimmel MC, Verosky B, Chen HJ, Davis O, Gur TL. The Maternal Microbiome as a Map to Understanding the Impact of Prenatal Stress on Offspring Psychiatric Health. Biol Psychiatry 2024; 95:300-309. [PMID: 38042328 PMCID: PMC10884954 DOI: 10.1016/j.biopsych.2023.11.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 11/16/2023] [Accepted: 11/18/2023] [Indexed: 12/04/2023]
Abstract
Stress and psychiatric disorders have been independently associated with disruption of the maternal and offspring microbiome and with increased risk of the offspring developing psychiatric disorders, both in clinical studies and in preclinical studies. However, the role of the microbiome in mediating the effect of prenatal stress on offspring behavior is unclear. While preclinical studies have identified several key mechanisms, clinical studies focusing on mechanisms are limited. In this review, we discuss 3 specific mechanisms by which the microbiome could mediate the effects of prenatal stress: 1) altered production of short-chain fatty acids; 2) disruptions in TH17 (T helper 17) cell differentiation, leading to maternal and fetal immune activation; and 3) perturbation of intestinal and microbial tryptophan metabolism and serotonergic signaling. Finally, we review the existing clinical literature focusing on these mechanisms and highlight the need for additional mechanistic clinical research to better understand the role of the microbiome in the context of prenatal stress.
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Affiliation(s)
- Mary C Kimmel
- University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Branden Verosky
- Ohio State University College of Medicine, Ohio State University, Columbus, Ohio
| | - Helen J Chen
- Ohio State University College of Medicine, Ohio State University, Columbus, Ohio
| | - Olivia Davis
- University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Tamar L Gur
- Ohio State University College of Medicine, Ohio State University, Columbus, Ohio
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7
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Zhang S, Lu B, Wang G. The role of gut microbiota in the pathogenesis and treatment of postpartum depression. Ann Gen Psychiatry 2023; 22:36. [PMID: 37759312 PMCID: PMC10523734 DOI: 10.1186/s12991-023-00469-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 09/22/2023] [Indexed: 09/29/2023] Open
Abstract
Postpartum depression (PPD) is a common complication of pregnancy in women, and its pathogenesis mainly involves disturbances of the neuroendocrine regulation, immune system, neurotransmitters, hormone secretion, and the gut microbiome. Gut microbes play essential physiological and pathological roles in the gut-brain axis' pathways which are involved in various central nervous system (CNS) and psychiatric disorders, including PPD. Numerous studies have identified the fundamental role of the gut-brain axis in the pathogenesis and treatment of PPD patients and also correlates with other pathogenic mechanisms of PPD. Disturbances in gut microbes are associated with the disruption of multiple signaling pathways and systems that ultimately lead to PPD development. This review aimed to elucidate the potential connections between gut microbes and the established PPD network, and this might serve as a guide for the development of new efficient diagnostic, therapeutic, and prognostic strategies in the management of PPD.
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Affiliation(s)
| | - Baili Lu
- Wuhan Mental Health Center, Wuhan, China
| | - Gang Wang
- Wuhan Mental Health Center, Wuhan, China.
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8
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Liu YW, Liu H, Huang K, Zhu BB, Yan SQ, Hao JH, Zhu P, Tao FB, Shao SS. The association between pregnancy-related anxiety and behavioral development in 18-month-old children: The mediating effects of parenting styles and breastfeeding methods. J Affect Disord 2023; 333:392-402. [PMID: 37086809 DOI: 10.1016/j.jad.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/07/2023] [Accepted: 04/10/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Pregnancy-related anxiety (PRA) is a distinct type of anxiety from general anxiety, affects many pregnant women, and is correlated with poor behavioral development in children. However, the mediation paths were unclear. METHODS A total of 2032 mother-infant pairs from the Ma'anshan Birth Cohort were included in the current study. Maternal PRA was assessed in the second and third trimesters. Children's behavioral development was evaluated at the age of 18 months. In addition, information on parenting styles and breastfeeding methods was obtained at postpartum. Multivariate regression and structural equation modeling were used to examine the associations between maternal PRA and children's behavioral development. RESULTS Significant intercorrelations were found between maternal PRA, the potential mediators (parenting styles and breastfeeding methods), and 18-month-old children's ASQ scores. Parenting styles played an intermediary role in the relationship between maternal PRA and children's behavioral development (β = 0.030, 95 % confidence interval: 0.017-0.051), and the mediating effect accounted for 29.1 % of the total effect. However, breastfeeding methods did not mediate the link between PRA and children's behavior. LIMITATIONS Depression and postpartum anxiety were not controlled for in our analysis, which left us unable to estimate the independent impact of PRA on children's behavior. CONCLUSIONS Parenting rather than breastfeeding is the mediating factor of behavioral problems in children caused by PRA.
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Affiliation(s)
- Yu-Wei Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Hui Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Bei-Bei Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Shuang-Qin Yan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Maternal and Child Health Care Center of Ma'anshan, No 24 Jiashan Road, Ma'anshan 243011, Anhui, China
| | - Jia-Hu Hao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Shan-Shan Shao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei 230032, Anhui, China.
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Long ES, Penalver Bernabe B, Xia K, Azcarate-Peril MA, Carroll IM, Rackers HS, Grewen KM, Meltzer-Brody S, Kimmel MC. The microbiota-gut-brain axis and perceived stress in the perinatal period. Arch Womens Ment Health 2023; 26:227-234. [PMID: 36897389 PMCID: PMC10063483 DOI: 10.1007/s00737-023-01300-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/08/2023] [Indexed: 03/11/2023]
Abstract
Perinatal perceived stress can contribute to worse health outcomes for the parent-child dyad. Given the emerging relationship between the microbiota-gut-brain axis and stress, this study sought to elucidate connections between bowel symptoms and the gut microbiome in relation to perceived stress at three time points in the perinatal period: two during pregnancy and one postpartum. Ninety-five pregnant individuals participated in a prospective cohort study from April 2017 to November 2019. Researchers assessed Perceived Stress Scale-10 (PSS); bowel symptoms (according to the IBS Questionnaire); psychiatrist assessment of new onset or exacerbated depression and anxiety; and fecal samples analyzed for alpha diversity (measures of gut microbiome diversity utilizing Shannon, Observed OTUs, and Faith's PD) at each timepoint. Covariates included weeks of gestation and weeks postpartum. PSS scores were divided into "Perceived Self-Efficacy" and "Perceived Helplessness." Increased gut microbial diversity was associated with decreased bowel symptoms, decreased overall perceived stress, increased ability to cope with adversity, and decreased distress in the postpartum period. This study found a significant association between a less diverse microbial community, lower self-efficacy early in pregnancy, and greater bowel symptoms and perceived helplessness later in the perinatal period, relationships that may ultimately point to novel diagnostic methods and interventions for perceived stress based on the microbiota-gut-brain axis.
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Affiliation(s)
- Emily S Long
- Department of Psychiatry, University of North Carolina School of Medicine, Campus Box #7160, Chapel Hill, NC, 27599-7160, USA
| | - Beatriz Penalver Bernabe
- Department of Biomedical Engineering, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Kai Xia
- Department of Psychiatry, University of North Carolina School of Medicine, Campus Box #7160, Chapel Hill, NC, 27599-7160, USA
| | - M Andrea Azcarate-Peril
- Departments of Medicine and Nutrition, Microbiome Core, University of North Carolina, Chapel Hill, NC, USA
| | - Ian M Carroll
- Department of Nutrition, University of North Carolina Gillings School of Public Health, Chapel Hill, NC, USA
| | - Hannah S Rackers
- Department of Psychiatry, University of North Carolina School of Medicine, Campus Box #7160, Chapel Hill, NC, 27599-7160, USA
| | - Karen M Grewen
- Department of Psychiatry, University of North Carolina School of Medicine, Campus Box #7160, Chapel Hill, NC, 27599-7160, USA
| | - Samantha Meltzer-Brody
- Department of Psychiatry, University of North Carolina School of Medicine, Campus Box #7160, Chapel Hill, NC, 27599-7160, USA
| | - Mary C Kimmel
- Department of Psychiatry, University of North Carolina School of Medicine, Campus Box #7160, Chapel Hill, NC, 27599-7160, USA.
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10
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The Use of Prebiotics from Pregnancy and Its Complications: Health for Mother and Offspring—A Narrative Review. Foods 2023; 12:foods12061148. [PMID: 36981075 PMCID: PMC10048320 DOI: 10.3390/foods12061148] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023] Open
Abstract
Pregnancy involves a metabolic reprogramming that includes changes in the gut microbiota composition in women. Evidence shows that maternal dysbiosis is linked to neonatal dysbiosis, and this factor can determine health status in adulthood. Although there is little literature available on this topic, high heterogeneity is a limitation when examining nutritional interventions. Information has been gathered to contrast the benefits of prebiotic usage, specifically in pregnancy, in its possible complications and in newborns’ gut microbiota development. The objective pursued in this brief narrative review is to provide a clear summary of relevant content when searching with regard to the use of prebiotics in pregnancy, the effects in prenatal and postnatal periods, and to help in clinical decision-making in pregnancy management and lactation. A search has found that the nutritional status of the pregnant mother is key for the earliest microbial colonization in newborns, and thus intervention programs from pregnancy could assure better outcomes in both the mother and offspring. In this sense, prebiotics (administered to mothers who breastfeed or provided in formula milk) are feasible and cost-effective elements that can prevent allergies, colic, and other maladies in newborns.
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11
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Bienboire-Frosini C, Marcet-Rius M, Orihuela A, Domínguez-Oliva A, Mora-Medina P, Olmos-Hernández A, Casas-Alvarado A, Mota-Rojas D. Mother-Young Bonding: Neurobiological Aspects and Maternal Biochemical Signaling in Altricial Domesticated Mammals. Animals (Basel) 2023; 13:ani13030532. [PMID: 36766424 PMCID: PMC9913798 DOI: 10.3390/ani13030532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Mother-young bonding is a type of early learning where the female and their newborn recognize each other through a series of neurobiological mechanisms and neurotransmitters that establish a behavioral preference for filial individuals. This process is essential to promote their welfare by providing maternal care, particularly in altricial species, animals that require extended parental care due to their limited neurodevelopment at birth. Olfactory, auditory, tactile, and visual stimuli trigger the neural integration of multimodal sensory and conditioned affective associations in mammals. This review aims to discuss the neurobiological aspects of bonding processes in altricial mammals, with a focus on the brain structures and neurotransmitters involved and how these influence the signaling during the first days of the life of newborns.
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Affiliation(s)
- Cécile Bienboire-Frosini
- Department of Molecular Biology and Chemical Communication, Research Institute in Semiochemistry and Applied Ethology (IRSEA), 84400 Apt, France
| | - Míriam Marcet-Rius
- Animal Behaviour and Welfare Department, Research Institute in Semiochemistry and Applied Ethology (IRSEA), 84400 Apt, France
| | - Agustín Orihuela
- Facultad de Ciencias Agropecuarias, Universidad Autónoma del Estado de Morelos, Cuernavaca 62209, Mexico
| | - Adriana Domínguez-Oliva
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana, Xochimilco Campus, Mexico City 04960, Mexico
| | - Patricia Mora-Medina
- Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de Mexico (UNAM), Cuautitlán Izcalli 54740, Mexico
| | - Adriana Olmos-Hernández
- Division of Biotechnology—Bioterio and Experimental Surgery, Instituto Nacional de Rehabilitación-Luis Guillermo Ibarra Ibarra (INR-LGII), Tlalpan, Mexico City 14389, Mexico
| | - Alejandro Casas-Alvarado
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana, Xochimilco Campus, Mexico City 04960, Mexico
| | - Daniel Mota-Rojas
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana, Xochimilco Campus, Mexico City 04960, Mexico
- Correspondence:
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12
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Kasarello K, Cudnoch-Jedrzejewska A, Czarzasta K. Communication of gut microbiota and brain via immune and neuroendocrine signaling. Front Microbiol 2023; 14:1118529. [PMID: 36760508 PMCID: PMC9907780 DOI: 10.3389/fmicb.2023.1118529] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/12/2023] [Indexed: 01/27/2023] Open
Abstract
The gastrointestinal tract of the human is inhabited by about 5 × 1013 bacteria (of about 1,000 species) as well as archaea, fungi, and viruses. Gut microbiota is known to influence the host organism, but the host may also affect the functioning of the microbiota. This bidirectional cooperation occurs in three main inter-organ signaling: immune, neural, and endocrine. Immune communication relies mostly on the cytokines released by the immune cells into circulation. Also, pathogen-associated or damage-associated molecular patterns (PAMPs or DAMPs) may enter circulation and affect the functioning of the internal organs and gut microbiota. Neural communication relies mostly on the direct anatomical connections made by the vagus nerve, or indirect connections via the enteric nervous system. The third pathway, endocrine communication, is the broadest one and includes the hypothalamic-pituitary-adrenal axis. This review focuses on presenting the latest data on the role of the gut microbiota in inter-organ communication with particular emphasis on the role of neurotransmitters (catecholamines, serotonin, gamma-aminobutyric acid), intestinal peptides (cholecystokinin, peptide YY, and glucagon-like peptide 1), and bacterial metabolites (short-chain fatty acids).
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Peñalver Bernabé B, Maki PM, Cunningham JL, Eisenlohr-Moul T, Tussing-Humphreys L, Carroll IM, Meltzer-Brody S, Gilbert JA, Kimmel M. Interactions between perceived stress and microbial-host immune components: two demographically and geographically distinct pregnancy cohorts. Transl Psychiatry 2023; 13:3. [PMID: 36609477 PMCID: PMC9822983 DOI: 10.1038/s41398-022-02276-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 11/18/2022] [Accepted: 11/30/2022] [Indexed: 01/09/2023] Open
Abstract
Higher stress during pregnancy associates with negative outcomes and elevated inflammation. The gut microbiota, reflecting environment and social interactions, alongside host immune responses have the potential to better understand perceived stress and identify when stress is excessive in pregnancy. Two U.S. cohorts of 84 pregnant individuals, composed of urban women of color and suburban white women, completed the Perceived Stress Scale-10 (PSS-10) and provided fecal and blood samples at two time points. Confirmatory Factor Analysis assessed the robustness of a two-factor PSS-10 model (Emotional Distress/ED and Self-Efficacy/SE). Gut microbiota composition was measured by 16 S rRNA amplicon sequencing and the immune system activity was assessed with a panel of 21 T-cell related cytokines and chemokines. ED levels were higher in the suburban compared to the urban cohort, but levels of SE were similar. ED and SE levels were associated with distinct taxonomical signatures and the gut microbiota data improved the prediction of SE levels compared with models based on socio-demographic characteristics alone. Integration of self-reported symptoms, microbial and immune information revealed a possible mediation effect of Bacteroides uniformis between the immune system (through CXCL11) and SE. The study identified links between distinct taxonomical and immunological signatures with perceived stress. The data are congruent with a model where gut microbiome and immune factors, both impacting and reflecting factors such as close social relationships and dietary fiber, may modulate neural plasticity resulting in increased SE during pregnancy. The predictive value of these peripheral markers merit further study.
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Affiliation(s)
- Beatriz Peñalver Bernabé
- Department of Biomedical Engineering, College of Engineering and Medicine, University of Illinois Chicago, Chicago, IL, USA. .,Center of Bioinformatics and Quantitative Biology, University of Illinois Chicago, Chicago, IL, USA.
| | - Pauline M. Maki
- grid.185648.60000 0001 2175 0319Department of Psychology, College of Medicine, University of Illinois Chicago, Chicago, IL USA ,grid.185648.60000 0001 2175 0319Department of Psychiatry, College of Medicine, University of Illinois Chicago, Chicago, IL USA ,grid.185648.60000 0001 2175 0319Department of Obstetrics and Gynecology, College of Medicine, University of Illinois Chicago, Chicago, IL USA
| | - Janet L. Cunningham
- grid.8993.b0000 0004 1936 9457Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Tory Eisenlohr-Moul
- grid.185648.60000 0001 2175 0319Department of Psychology, College of Medicine, University of Illinois Chicago, Chicago, IL USA ,grid.185648.60000 0001 2175 0319Department of Psychiatry, College of Medicine, University of Illinois Chicago, Chicago, IL USA
| | - Lisa Tussing-Humphreys
- grid.185648.60000 0001 2175 0319Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL USA
| | - Ian M. Carroll
- grid.410711.20000 0001 1034 1720Department of Nutrition, School of Public Health, University of North Carolina, Chapel Hill, NC USA
| | - Samantha Meltzer-Brody
- grid.410711.20000 0001 1034 1720Department of Psychiatry, University of North Carolina, Chapel Hill, NC USA
| | - Jack A. Gilbert
- grid.266100.30000 0001 2107 4242Department of Pediatrics and Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA USA
| | - Mary Kimmel
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA. .,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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Wang R, Zhao F, Li Y, Zhu J, Liu Y, Li J, Yao G, Liu H, Guan S, Ma S. The effects of chronic unpredicted mild stress on maternal negative emotions and gut microbiota and metabolites in pregnant rats. PeerJ 2023; 11:e15113. [PMID: 37090110 PMCID: PMC10117386 DOI: 10.7717/peerj.15113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 03/02/2023] [Indexed: 04/25/2023] Open
Abstract
Background Chronic long-term stress is associated with a range of disorders, including depression and a variety of other chronic illnesses. It is well known that maternal exposure to psychosocial stress during pregnancy significantly increases the likelihood of adverse pregnancy outcomes. The gut microbiota has been a popular topic, it is a key mediator of the gut-brain axis and plays an important role in human health; changes in the gut microbiota have been related to chronic stress-induced health impairment, however, the relationship between maternal negative emotions and abnormal gut microbiota and its metabolites during maternal exposure to chronic stress during pregnancy remains unclear. Methods Pregnant rats were subjected to chronic unpredicted mild stress (CUMS) to establish the rat model of chronic stress during pregnancy. The behavioral changes were recorded using sucrose preference test (SPT) and open-field test (OFT), plasma corticosterone levels were determined by radioimmunoassay, and a comprehensive method combining 16S rRNA gene sequencing and gas chromatography-mass spectrometry (GC-MS) metabolomics was used to study the effects of stress during pregnancy on the function of intestinal microbiota and its metabolites. Results Chronic stress during pregnancy not only increased maternal plasma corticosterone (P < 0.05), but also caused maternal depression-like behaviors (P < 0.05). Chronic stress during pregnancy changed the species composition at the family level of maternal gut microbiota, the species abundance of Ruminococcaceae in the stress group (23.45%) was lower than the control group (32.67%) and the species abundance of Prevotellaceae in the stress group (10.45%) was higher than the control group (0.03%) (P < 0.05). Vertical locomotion and 1% sucrose preference percentage in pregnant rats were negatively correlated with Prevotellaceae (r = - 0.90, P < 0.05). Principal component analysis with partial least squares discriminant analysis showed that the integration points of metabolic components in the stress and control groups were completely separated, indicating that there were significant differences in the metabolic patterns of the two groups, and there were seven endogenous metabolites that differed (P < 0.05). Conclusions The negative emotional behaviors that occur in pregnant rats as a result of prenatal chronic stress may be associated with alterations in the gut microbiota and its metabolites. These findings provide a basis for future targeted metabolomics and gut flora studies on the effects of chronic stress during pregnancy on gut flora.
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Affiliation(s)
- Rui Wang
- Ningxia Medical University, Ningxia, People’s Republic of China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia, People’s Republic of China
| | - Feng Zhao
- Chongqing Medical University, Chongqing, People’s Republic of China
| | - Ye Li
- Ningxia Medical University, Ningxia, People’s Republic of China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia, People’s Republic of China
| | - Jiashu Zhu
- Ningxia Medical University, Ningxia, People’s Republic of China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia, People’s Republic of China
| | - Yifei Liu
- Ningxia Medical University, Ningxia, People’s Republic of China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia, People’s Republic of China
| | - Jiaqi Li
- Ningxia Medical University, Ningxia, People’s Republic of China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia, People’s Republic of China
| | - Guixiang Yao
- Ningxia Medical University, Ningxia, People’s Republic of China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia, People’s Republic of China
| | - Hongya Liu
- Chongqing Medical University, Chongqing, People’s Republic of China
| | - Suzhen Guan
- Ningxia Medical University, Ningxia, People’s Republic of China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia, People’s Republic of China
| | - Shuqin Ma
- General hospital of Ningxia Medical University, Ningxia, People’s Republic of China
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Ma Y, Liu T, Li X, Kong A, Xiao R, Xie R, Gao J, Wang Z, Cai Y, Zou J, Yang L, Wang L, Zhao J, Xu H, Margaret W, Xu X, Gustafsson JA, Fan X. Estrogen receptor β deficiency impairs gut microbiota: a possible mechanism of IBD-induced anxiety-like behavior. MICROBIOME 2022; 10:160. [PMID: 36175956 PMCID: PMC9520828 DOI: 10.1186/s40168-022-01356-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 08/24/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Although the lack of estrogen receptor β (ERβ) is a risk factor for the development of inflammatory bowel disease (IBD) and psychiatric disorders, the underlying cellular and molecular mechanisms are not fully understood. Herein, we revealed the role of gut microbiota in the development of IBD and related anxiety-like behavior in ERβ-deficient mice. RESULTS In response to dextran sodium sulfate (DSS) insult, the ERβ knockout mice displayed significant shift in α and β diversity in the fecal microbiota composition and demonstrated worsening of colitis and anxiety-like behaviors. In addition, DSS-induced colitis also induced hypothalamic-pituitary-adrenal (HPA) axis hyperactivity in ERβ-deficient mice, which was associated with colitis and anxiety-like behaviors. In addition, RNA sequencing data suggested that ErbB4 might be the target of ERβ that is involved in regulating the HPA axis hyperactivity caused by DSS insult. Gut microbiota remodeling by co-housing showed that both the colitis and anxiety-like behaviors were aggravated in co-housed wild-type mice compared to single-housed wild-type mice. These findings suggest that gut microbiota play a critical role in mediating colitis disease activity and anxiety-like behaviors via aberrant neural processing within the gut-brain axis. CONCLUSIONS ERβ has the potential to inhibit colitis development and anxiety-like behaviors via remodeling of the gut microbiota, which suggests that ERβ is a promising therapeutic target for the treatment of IBD and related anxiety-like behaviors. Video Abstract.
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Affiliation(s)
- Yuanyuan Ma
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Tianyao Liu
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Xin Li
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Anqi Kong
- Institute of Neuroscience, Soochow University, Suzhou, China
| | - Rui Xiao
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Ruxin Xie
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Junwei Gao
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Zhongke Wang
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Yun Cai
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Jiao Zou
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Ling Yang
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Lian Wang
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Jinghui Zhao
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China
| | - Haiwei Xu
- Southwest Eye Hospital, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Warner Margaret
- Center for Innovative Medicine, Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden
| | - Xingshun Xu
- Institute of Neuroscience, Soochow University, Suzhou, China.
| | - Jan-Ake Gustafsson
- Center for Innovative Medicine, Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden.
- Center for Nuclear Receptors and Cell Signaling, University of Houston, Houston, USA.
| | - Xiaotang Fan
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University, Chongqing, China.
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Toh MPS, Yang CY, Lim PC, Loh HLJ, Bergonzelli G, Lavalle L, Mardhy E, Samuel TM, Suniega-Tolentino E, Silva Zolezzi I, Fries LR, Chan SY. A probiotic intervention with Bifidobacterium longum NCC3001 on perinatal mood (PROMOTE: PRobiotics On MOThErs’ mood and stress): Protocol for a decentralized randomized controlled trial (Preprint). JMIR Res Protoc 2022; 12:e41751. [PMID: 37018024 PMCID: PMC10131660 DOI: 10.2196/41751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 02/07/2023] [Accepted: 02/07/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Perinatal mood disorders such as depression and anxiety are common, with subclinical symptomology manifesting as perinatal mood disturbances being even more prevalent. These could potentially affect breastfeeding practices and infant development. Pregnant and lactating women usually limit their exposure to medications, including those for psychological symptoms. Interestingly, the naturally occurring probiotic Bifidobacterium longum (BL) NCC3001 has been shown to reduce anxious behavior in preclinical models and feelings of low mood in nonpregnant human adults. During the COVID-19 pandemic, mental health issues increased, and conventionally conducted clinical trials were restricted by social distancing regulations. OBJECTIVE This study, Probiotics on Mothers' Mood and Stress (PROMOTE), aimed to use a decentralized clinical trial design to test whether BL NCC3001 can reduce symptoms of depression, anxiety, and stress over the perinatal period. METHODS This double-blind, placebo-controlled, randomized, and 3-parallel-arm study aimed to recruit 180 women to evaluate the efficacy of the probiotic taken either during pregnancy and post partum (from 28-32 weeks' gestation until 12 weeks after delivery; n=60, 33.3%) or post partum only (from birth until 12 weeks after delivery; n=60, 33.3%) in comparison with a placebo control group (n=60, 33.3%). Participants consumed the probiotic or matched placebo in a drink once daily. Mood outcomes were measured using the State-Trait Anxiety Inventory and Edinburgh Postnatal Depression Scale questionnaires, captured electronically at baseline (28-32 weeks' gestation) and during e-study sessions over 5 further time points (36 weeks' gestation; 9 days post partum; and 4, 8, and 12 weeks post partum). Saliva and stool samples were collected longitudinally at home to provide mechanistic insights. RESULTS In total, 520 women registered their interest on our website, of whom 184 (35.4%) were eligible and randomized. Of these 184 participants, 5 (2.7%) withdrew after randomization, leaving 179 (97.3%) who completed the study. Recruitment occurred between November 7, 2020, and August 20, 2021. Advertising on social media brought in 46.9% (244/520) of the prospective participants, followed by parenting-specific websites (116/520, 22.3%). Nationwide recruitment was achieved. Data processing is ongoing, and there are no outcomes to report yet. CONCLUSIONS Multiple converging factors contributed to speedy recruitment and retention of participants despite COVID-19-related restrictions. This decentralized trial design sets a precedent for similar studies, in addition to potentially providing novel evidence on the impact of BL NCC3001 on symptoms of perinatal mood disturbances. This study was ideal for remote conduct: because of the high digital literacy and public trust in digital security in Singapore, the intervention could be self-administered without regular clinical monitoring, and the eligibility criteria and outcomes were measured using electronic questionnaires and self-collected biological samples. This design was particularly suited for a group considered vulnerable-pregnant women-during the challenging times of COVID-19-related social restrictions. TRIAL REGISTRATION ClinicalTrials.gov NCT04685252; https://clinicaltrials.gov/ct2/show/NCT04685252. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41751.
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Affiliation(s)
- Melissa P S Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Chui Yuen Yang
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Phei Cze Lim
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Hui Li J Loh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | | | - Luca Lavalle
- Nestle Research, Lausanne, Lausanne, Switzerland
| | - Elias Mardhy
- Nestle Research, Lausanne, Lausanne, Switzerland
| | | | | | | | | | - Shiao Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Luo H, Li W, Wu L, Zhong S, Du C, Liu Y, Xu Y, Huang X, Bahru AH, Tang X, Zhou J, Wang D, Lou X, Bin X, Xiao X. Differences in cognition, short-chain fatty acids and related metabolites in pregnant versus non-pregnant women: a cross-sectional study. BMC Pregnancy Childbirth 2022; 22:533. [PMID: 35778690 PMCID: PMC9248184 DOI: 10.1186/s12884-022-04853-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background Pregnancy induces cognitive reorganization which can lead to mental disorders. The aim of this study is to determine differences in cognitive scores, short-chain fatty acids (SCFAs) and related metabolites between pregnant and non-pregnant participants. Methods This cross-sectional study included 67 full-term pregnant women and 31 non-pregnant women. We compared scores of mental state and cognitive assessment tests, as well as serum concentrations of SCFAs, hormones, inflammatory factors, and neurotransmitters between these groups. Results Scores for information processing speed, immediate visual memory, motor response speed and accuracy, execution ability and verbal use ability in the pregnant group were lower than those in the non-pregnant group (p < 0.05 for all tests). Total serum SCFAs in the pregnant group were significantly lower than those in the non-pregnant group (P = 0.031). Among them, acetate and propionate were significantly decreased (P = 0.013 and 0.037, respectively) whereas butyrate was significantly increased (P = 0.035). Serum peptide YY, glucagon-like peptide-1, γ-aminobutyric acid, and dopamine showed no differences between the two groups. However, cortisol, adrenocorticotropic hormone, and acetylcholine were significantly increased in the pregnant group as compared with the non-pregnant group (P = 0.039, 0.016, and 0.012, respectively). Tumor necrosis factor-α was increased and interleukin-10 significantly decreased in the pregnant group (P = 0.045 and 0.019, respectively). Conclusion According to our study findings, cognitive reorganization in the third trimester of pregnancy showed that both the passive storage capacity of working memory and the executive function of online information processing were decreased to varying degrees. At the same time, the changes in total SCFAs, the proportions of SCFAs and related metabolites were also detected. These changes in the internal environment may be increasing the risk of perinatal mental illness.
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Affiliation(s)
- Huijuan Luo
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, No.601, West Huangpu Avenue, Guangzhou, Guangdong, 510630, China
| | - Wengxiang Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, No.601, West Huangpu Avenue, Guangzhou, Guangdong, 510630, China
| | - Lulu Wu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, No.601, West Huangpu Avenue, Guangzhou, Guangdong, 510630, China
| | - Shuming Zhong
- Department of Psychology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, China
| | - Chengrong Du
- Department of Clinical Medicine, International College, Jinan University, Guangzhou, Guangdong, 510630, China
| | - Yimeng Liu
- Department of Clinical Medicine, International College, Jinan University, Guangzhou, Guangdong, 510630, China
| | - Yating Xu
- Department of Clinical Medicine, International College, Jinan University, Guangzhou, Guangdong, 510630, China
| | - Xinyu Huang
- Department of Clinical Medicine, International College, Jinan University, Guangzhou, Guangdong, 510630, China
| | - Awol Hanan Bahru
- Department of Clinical Medicine, International College, Jinan University, Guangzhou, Guangdong, 510630, China
| | - Xiaomei Tang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, No.601, West Huangpu Avenue, Guangzhou, Guangdong, 510630, China
| | - Juan Zhou
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, No.601, West Huangpu Avenue, Guangzhou, Guangdong, 510630, China
| | - Dongju Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, No.601, West Huangpu Avenue, Guangzhou, Guangdong, 510630, China
| | - Xiangying Lou
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, No.601, West Huangpu Avenue, Guangzhou, Guangdong, 510630, China
| | - Xuefan Bin
- Shanghai Medical College, Fudan University (SMCFU), 138 Yi xue yuan Road, Shanghai, 200032, China
| | - Xiaomin Xiao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, No.601, West Huangpu Avenue, Guangzhou, Guangdong, 510630, China.
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Zhang S, Wu L, Zhang M, He K, Wang X, Lin Y, Li S, Chen J. Occlusal Disharmony-A Potential Factor Promoting Depression in a Rat Model. Brain Sci 2022; 12:brainsci12060747. [PMID: 35741632 PMCID: PMC9221239 DOI: 10.3390/brainsci12060747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/13/2022] [Accepted: 06/03/2022] [Indexed: 02/04/2023] Open
Abstract
Objectives: Patients with occlusal disharmony (OD) may be susceptible to depression. The hypothalamus−pituitary−adrenal axis, 5-HT and 5HT2AR in the prefrontal cortex (PFC), amygdala, and hippocampus are involved in the modulation of emotion and depression. This study investigated whether OD affects the HPA axis and 5-HT system and, subsequently, produces depression-like behaviors in rats. Materials and methods: OD was produced by removing 0.5 and 0.25 mm of hard tissue from the cusps of the maxillary molars in randomly selected sides of Sprague−Dawley rats. CUS involved exposure to 2 different stressors per day for 35 days. OD-, CUS-, and OD + CUS-treated groups and an untreated control group were compared in terms of behavior, endocrine status and brain histology. Results: There were significant differences among the four groups in the behavior tests (p < 0.05), especially in the sucrose preference test, where there was a significant decrease in the OD group compared to the control group. ACTH and CORT concentrations were significantly higher in the OD + CUS group than the control group (p < 0.05). Expression of GR and 5-HT2AR in the PFC, amygdala and hippocampal CA1 was significantly higher in the OD, CUS and OD + CUS groups than the control group (p < 0.05). Conclusion: OD promotes depression-like behaviors through peripheral and central pathways via the HPA axis, GR and 5-HT system.
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Affiliation(s)
- Sihui Zhang
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350004, China; (S.Z.); (L.W.); (M.Z.); (K.H.); (Y.L.)
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350004, China; (X.W.); (S.L.)
| | - Ling Wu
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350004, China; (S.Z.); (L.W.); (M.Z.); (K.H.); (Y.L.)
| | - Mi Zhang
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350004, China; (S.Z.); (L.W.); (M.Z.); (K.H.); (Y.L.)
| | - Kaixun He
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350004, China; (S.Z.); (L.W.); (M.Z.); (K.H.); (Y.L.)
| | - Xudong Wang
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350004, China; (X.W.); (S.L.)
| | - Yuxuan Lin
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350004, China; (S.Z.); (L.W.); (M.Z.); (K.H.); (Y.L.)
| | - Shuxian Li
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350004, China; (X.W.); (S.L.)
| | - Jiang Chen
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350004, China; (S.Z.); (L.W.); (M.Z.); (K.H.); (Y.L.)
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350004, China; (X.W.); (S.L.)
- Correspondence:
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19
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Sibeko L, Johns T, Cordeiro LS. Traditional plant use during lactation and postpartum recovery: Infant development and maternal health roles. JOURNAL OF ETHNOPHARMACOLOGY 2021; 279:114377. [PMID: 34192598 DOI: 10.1016/j.jep.2021.114377] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/11/2021] [Accepted: 06/25/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Evidence of phytochemical roles in infant development and maternal recovery offers insights into beneficial functions of traditional plant use during lactation and the postpartum period. Ethnopharmacological research has relevance to global priorities on maternal and child health, to understanding origins and determinants of human self-medication, and for reconciling traditional postpartum practices and mainstream healthcare. AIM OF THE STUDY Present emerging evidence, within evolutionary and socio-cultural contexts, on the role of maternal consumption on transfer of phytochemicals into breast milk with impacts on maternal and child health, and on infant development. Establish current state of knowledge and an ethnopharmacological research agenda that is attentive to cross-cultural and regional differences in postpartum plant use. MATERIALS AND METHODS An extensive literature review using Medline, Scopus, and Web of Science focused on traditional and contemporary use and socio-cultural context, as well as physiological, pharmacological, toxicological, and behavioral activities of plants used medicinally by women during postpartum recovery and lactation. RESULTS The most widely reported postpartum plants show antimicrobial, anti-inflammatory, immunological, and neurophysiological activities, with low toxicity. Phytochemicals transfer from maternal consumption into breast milk in physiological concentrations, while animal studies demonstrate immunomodulation and other actions of medicinal plants during lactation. Reporting on the use and diverse traditional knowledge of women about plants during the postpartum period is obscured by the marginal place of obstetric issues and by gender biases in ethnobotanical research. In many contemporary contexts use is prejudiced by precautionary risk warnings in health literature and practice that confound lactation with pregnancy. CONCLUSIONS Although systematic investigation of postpartum plant use is lacking, known pharmacological activities support potential benefits on infant development and maternal health with immediate and long-term consequences in relation to allergic, inflammatory, autoimmune, and other diseases. An ethnopharmacological agenda focused on the perinatal period requires directed methodologies and a regional approach in relation to culturally-specific knowledge and practices, traditional plant use, and local health needs. Testing the hypothesis that phytochemicals transferred from medicinal plants into breast milk impact the human immune system and other aspects of infant development requires extended analysis of phytochemicals in human milk and infant lumen and plasma, as well as effects on gastrointestinal and milk microbiome.
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Affiliation(s)
- Lindiwe Sibeko
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, 01003, USA.
| | - Timothy Johns
- School of Human Nutrition, McGill University, Ste. Anne de Bellevue, QC, H9X 3V9, Canada.
| | - Lorraine S Cordeiro
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, 01003, USA.
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Controversies involving the use of SSRIs during pregnancy and the increased risk of having a child with autism spectrum disorders – a case report and literature review. CURRENT PROBLEMS OF PSYCHIATRY 2021. [DOI: 10.2478/cpp-2020-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Summary
Introduction: There is an ongoing debate as to whether the use of selective serotonin reuptake inhibitors (SSRIs) by pregnant women increases the risk of developing autism spectrum disorders (ASD) in the offspring.
Aim: The aim of the study was to
1) present, based on a case report, the potential factors that may affect the development of ASD in a child,
2) review the literature on the risk of ASD in the case of using SSRIs by a pregnant woman.
Case report: The case report concerns a child of a 33-year-old patient, previously treated for an episode of depression at the age of 23. At the beginning of the 15th week of planned pregnancy, when she was 28 years old, sleep disturbances were observed. Over the next few weeks, she gradually developed a full-blown depressive syndrome which required the use of sertraline. The child was born through a natural delivery, a healthy boy, who was diagnosed with ASD at the age of 2.5 years, which was the trigger for the development of the third episode of depression in the patient.
Conclusions: The results of the research indicate that SSRIs can penetrate the placental barrier, influencing the processes of serotoninergic transmission in the fetus, disrupting neurodevelopmental processes. On the other hand, a higher risk of ASD development in children of depressed mothers who do not use pharmacotherapy was confirmed, compared to the general population and in the case of the occurrence of depressive episodes in mother in the past and in relation to the male fetuses. The greater risk of ASD in children of mothers who take SSRIs may not only be associated with the medication itself but also with the presence of depression and the probable common genetic basis for both disorders. In each case, other risk factors for the development of ASD should also be taken into consideration, e.g. vitamin D3 deficiencies, unsaturated fatty acids, oxytocin levels, the presence of intestinal dysbiosis.
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Wang L, Wu X, Ma Y, Li X, Zhang J, Zhao L. Supplementation with soy isoflavones alleviates depression-like behaviour via reshaping the gut microbiota structure. Food Funct 2021; 12:4995-5006. [PMID: 34100484 DOI: 10.1039/d0fo03254a] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Soy isoflavones (SI) are known for their beneficial effects in alleviating neurodegenerative diseases, while the mechanism of alleviation of depression-like behaviour by SI remains unclear. In this study, a chronic unpredictable mild stress (CUMS)-induced depression rat model was used to determine the effect of SI in alleviating depression-like behaviour and its possible mechanisms. SI supplements significantly improved the CUMS-induced depression-like behaviour by increasing the monoamine neurotransmitter levels. A specific SI dose significantly modulated the composition of the gut microbiota, which in turn improved the maximum biotransformation ability of SI. Spearman's correlation analysis illustrated that some of the gut microbiota genera were strongly correlated with monoamine neurotransmitters. Moreover, more attention should be paid to gender differences, which may be related to changes in the gut microbiota. These results suggest that SI might affect monoamine neurotransmitters of CUMS rats by reshaping the structure of the gut microbiota, thereby alleviating depression-like behaviour.
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Affiliation(s)
- Li Wang
- College of Food Science, South China Agricultural University, Guangzhou, 510642, China.
| | - Xuejiao Wu
- College of Food Science, South China Agricultural University, Guangzhou, 510642, China.
| | - Yuhao Ma
- College of Food Science, South China Agricultural University, Guangzhou, 510642, China.
| | - Xian Li
- College of Food Science, South China Agricultural University, Guangzhou, 510642, China.
| | - Jingfeng Zhang
- College of Food Science, South China Agricultural University, Guangzhou, 510642, China.
| | - Lichao Zhao
- College of Food Science, South China Agricultural University, Guangzhou, 510642, China. and Guangdong Provincial Key Laboratory of Nutraceuticals and Functional Foods, South China Agricultural University, Guangzhou, 510642, China
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22
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Miller ES, Sakowicz A, Roy A, Wang A, Yang A, Ciolino J, Grobman WA, Wisner KL, Yee LM. Is peripartum magnesium sulfate associated with a reduction in postpartum depressive symptoms? Am J Obstet Gynecol MFM 2021; 3:100407. [PMID: 34058422 DOI: 10.1016/j.ajogmf.2021.100407] [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: 03/15/2021] [Revised: 05/17/2021] [Accepted: 05/25/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND The prevention of postpartum depression is an important area of investigation given its association with major maternal and neonatal sequelae, yet few evidence-based treatments to reduce the frequency of postpartum depression are used. Recent data suggest that N-methyl-D-aspartate receptor antagonists may lead to rapid improvement of depressive symptoms lasting up to 2 weeks. We hypothesized that the N-methyl-D-aspartate receptor antagonist magnesium sulfate would elicit antidepressant effects subsequent to its receipt by women receiving peripartum seizure prophylaxis for a hypertensive disorder of pregnancy. OBJECTIVE This study aimed to compare the frequency of depressive symptoms at 2 weeks and 6 weeks after delivery between women who did and did not receive peripartum magnesium sulfate for a hypertensive disorder of pregnancy. STUDY DESIGN This prospective cohort study included women with a hypertensive disorder of pregnancy at ≥34 weeks' gestation with singleton gestations. Magnesium sulfate for seizure prophylaxis was administered at the obstetrician's discretion. The Quick Inventory of Depressive Symptomatology survey was administered before hospital discharge and again at 2 weeks and 6 weeks after delivery to assess for postpartum depressive symptoms. The primary outcome for this study was the change in Quick Inventory of Depressive Symptomatology score from baseline to 2 weeks after delivery, which was analyzed both continuously and categorically (any symptom worsening vs stability or improvement). Secondary outcomes included the change in Quick Inventory of Depressive Symptomatology score from baseline to 6 weeks after delivery and the proportion of women who experienced an increase in Quick Inventory of Depressive Symptomatology score at 6 weeks after delivery. RESULTS Of the 342 women enrolled, 39% (n=134) received magnesium sulfate. Compared with women who did not receive magnesium, women who received magnesium had a significantly smaller change in their mean Quick Inventory of Depressive Symptomatology score (0.6±3.4 vs 1.6±3.0; P=.015) and also were less likely to have an increase in Quick Inventory of Depressive Symptomatology score at 2 weeks after delivery (52% vs 67%; P=.022). These differences were not present at 6 weeks after delivery. After controlling for potential confounders, women who received magnesium continued to have a lower odds of having an increased Quick Inventory of Depressive Symptomatology score from baseline at 2 weeks after delivery than women who did not receive magnesium (adjusted odds ratio, 0.88; 95% confidence interval, 0.78-0.98). CONCLUSION Peripartum magnesium was associated with less of an exacerbation in depressive symptoms in the immediate postpartum period. Given the implications of postpartum depression on maternal and child health and the lack of existing prophylaxis, randomized trials should examine this novel potential prophylactic therapy.
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Affiliation(s)
- Emily S Miller
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Miller, Ms Sakowicz, and Drs Roy, Grobman, and Yee); Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL (Drs Miller and Wisner).
| | - Allie Sakowicz
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Miller, Ms Sakowicz, and Drs Roy, Grobman, and Yee)
| | - Archana Roy
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Miller, Ms Sakowicz, and Drs Roy, Grobman, and Yee)
| | - Ann Wang
- Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Wang)
| | - Amy Yang
- Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Ms Yang and Dr Ciolino)
| | - Jody Ciolino
- Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Ms Yang and Dr Ciolino)
| | - William A Grobman
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Miller, Ms Sakowicz, and Drs Roy, Grobman, and Yee)
| | - Katherine L Wisner
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL (Drs Miller and Wisner)
| | - Lynn M Yee
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Miller, Ms Sakowicz, and Drs Roy, Grobman, and Yee)
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Jahnke JR, Roach J, Azcarate-Peril MA, Thompson AL. Maternal precarity and HPA axis functioning shape infant gut microbiota and HPA axis development in humans. PLoS One 2021; 16:e0251782. [PMID: 34015045 PMCID: PMC8136730 DOI: 10.1371/journal.pone.0251782] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 05/03/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Early life exposure to adverse environments, and maternal stress in particular, has been shown to increase risk for metabolic diseases and neurobehavioral disorders. While many studies have examined the hypothalamic-pituitary-adrenal axis (HPA axis) as the primary mechanism behind these relationships, emerging research on the brain-gut axis suggests that the microbiome may play a role. In this study, we tested the relationships among maternal precarity and HPA axis dysregulation during the peripartum period, infant gut microbiome composition, and infant HPA axis functioning. METHODS Data come from 25 mother-infant dyads in the Galápagos, Ecuador. Women completed surveys on precarity measures (food insecurity, low social support, depression, and stress) and gave salivary cortisol samples during and after pregnancy. Infant salivary cortisol and stool were collected in the postpartum. Statistical significance of differences in microbial diversity and relative abundance were assessed with respect to adjusted linear regression models. RESULTS Maternal precarity was associated with lower diversity and higher relative abundance of Enterobacteriaceae and Streptococcaceae and a lower relative abundance of Bifidobacterium and Lachnospiraceae. These patterns of colonization for Enterobacteriaceae and Bifidobacterium mirrored those found in infants with HPA axis dysregulation. Maternal HPA axis dysregulation during pregnancy was also associated with a greater relative abundance of Veillonella. CONCLUSIONS Overall, exposures to precarity and HPA axis dysregulation were associated with an increase in groups that include potentially pathogenic bacteria, including Enterobacteriaceae, Streptococcaceae, and Veillonella, and a decrease in potentially protective bacteria, including Bifidobacterium and Lachnospiraceae, as well as a decrease in overall diversity.
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Affiliation(s)
- Johanna R. Jahnke
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Jeffrey Roach
- Research Computing Center, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, United States of America
- UNC Microbiome Core, Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - M. Andrea Azcarate-Peril
- UNC Microbiome Core, Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Amanda L. Thompson
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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24
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Analysis of gut microbiota and intestinal integrity markers of inpatients with major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2021; 106:110076. [PMID: 32827611 DOI: 10.1016/j.pnpbp.2020.110076] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 12/21/2022]
Abstract
Previous studies have reported on the relationship between gut microbiota and major depressive disorder (MDD). However, there remain gaps in literature concerning the role of the intestinal barrier and microflora in the pathogenesis of depression. This study analyzes the potential causative relationship between gut microbiota and inflammatory and gut integrity markers and clinical symptoms in inpatients with depressive episodes. Sixteen inpatients (50% females) being treated with escitalopram (5-20 mg daily) in standardized conditions were included in the study. The composition of fecal microbiota was evaluated at baseline and endpoint using 16S rRNA sequencing. A significant correlation between depression severity was found, as measured with HDRS24 (Hamilton Depression Rating Scale-24 item), and the following abundance in bacteria: positive correlation with Paraprevotella (r = 0.80, q = 0.012), strong, negative correlations with Clostridiales (r = -0.70, q = 0.016), Clostridia (r = -0.71, q = 0.026), Firmicutes (r = -0.67. q = 0.032), and the RF32 order (r = -0.70, p = 0.016) in the Alphaproteobacteria (r = -0.66, q = 0.031). After six weeks of treatment, clinical outcomes were found to have a negative correlation with levels of plasma intestinal fatty acid-binding protein (IFABP) at the beginning of the study. Still they had a positive correlation with changes in fecal calprotectin during hospitalization. In conclusion, gut microbiota was associated with the severity of depressive symptoms. However, these findings do not serve as predictors of symptomatic improvement during antidepressant treatment in inpatient treatment for MDD. In turn, intestinal integrity and inflammation markers were associated with the response to treatment of patients with MDD and symptom severity. Additional studies are needed to confirm and extend these findings.
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25
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Moyer SW, Kinser PA. A Comprehensive Conceptual Framework to Guide Clinical Practice and Research About Mental Health During the Perinatal Period. J Perinat Neonatal Nurs 2021; 35:46-56. [PMID: 33528187 DOI: 10.1097/jpn.0000000000000535] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Perinatal mood and anxiety disorders (PMADs) affect up to 20% of pregnant and postpartum women and can have negative sequelae for maternal-child health. Nurses with clinical and research roles are on the front line of efforts to assess for and assist with prevention and intervention with PMAD symptoms. Thus, they can play an essential role in enhancing the mental well-being of women in the perinatal period and maternal-child health outcomes. The aim of this article is to assist nurses in this work by outlining the Comprehensive Model of Mental Health during the Perinatal Period, a conceptual framework for considering clinical and research opportunities to enhance perinatal mental health. The framework uses key principles that recognize biopsychoneuroimmunologic mechanisms involved in mental health; the key role that the experience of matrescence ("becoming a mother") plays in mental health and maternal-child health; and the mother-infant dyad as the functional unit during the perinatal period. Examples are provided of how the key principles of this framework might be used to enhance research and clinical practice about PMADs and, ultimately, enhance maternal-child health outcomes.
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26
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Polycystic Ovary Syndrome: A Brain Disorder Characterized by Eating Problems Originating during Puberty and Adolescence. Int J Mol Sci 2020; 21:ijms21218211. [PMID: 33153014 PMCID: PMC7663730 DOI: 10.3390/ijms21218211] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 02/07/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is an endocrine condition associated with reproductive and psychiatric disorders, and with obesity. Eating disorders, such as bulimia and recurrent dieting, are also linked to PCOS. They can lead to the epigenetic dysregulation of the hypothalamic-pituitary-gonadal (HPG) axis, thereby impacting on ovarian folliculogenesis. We postulate that PCOS is induced by psychological distress and episodes of overeating and/or dieting during puberty and adolescence, when body dissatisfaction and emotional distress are often present. We propose that upregulated activation of the central HPG axis during this period can be epigenetically altered by psychological stressors and by bulimia/recurrent dieting, which are common during adolescence and which can lead to PCOS. This hypothesis is based on events that occur during a largely neglected stage of female reproductive development. To date, most research into the origins of PCOS has focused on the prenatal induction of this disorder, particularly in utero androgenization and the role of anti-Müllerian hormone. Establishing causality in our peripubertal model requires prospective cohort studies from infancy. Mechanistic studies should consider the role of the gut microbiota in addition to the epigenetic regulation of (neuro) hormones. Finally, clinicians should consider the importance of underlying chronic psychological distress and eating disorders in PCOS.
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Qiu W, Hodges TE, Clark EL, Blankers SA, Galea LAM. Perinatal depression: Heterogeneity of disease and in animal models. Front Neuroendocrinol 2020; 59:100854. [PMID: 32750403 DOI: 10.1016/j.yfrne.2020.100854] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/14/2020] [Accepted: 07/21/2020] [Indexed: 12/15/2022]
Abstract
Perinatal depression (PND) can have either an antepartum or postpartum onset. Although the greatest risk factor for PND is previous depression history,de novoPND occurs with the majority of cases occurring in the postpartum. Timing of depression can impact etiology, prognosis, and response to treatment. Thus, it is crucial to study the impact of the heterogeneity of PND for better health outcomes. In this review, we outline the differences between antepartum and postpartum depression onset of PND. We discuss maternal physiological changes that differ between pregnancy and postpartum and how these may differentially impact depression susceptibility. We highlight changes in the maternal steroid and peptide hormone levels, immune signalling, serotonergic tone, metabolic factors, brain morphology, and the gut microbiome. Finally, we argue that studying the heterogeneity of PND in clinical and preclinical models can lead to improved knowledge of disease etiopathology and treatment outcomes.
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Affiliation(s)
- Wansu Qiu
- Graduate Program in Neuroscience, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada
| | - Travis E Hodges
- Department of Psychology, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada
| | - Emily L Clark
- Graduate Program in Neuroscience, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada
| | - Samantha A Blankers
- Graduate Program in Neuroscience, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada
| | - Liisa A M Galea
- Graduate Program in Neuroscience, University of British Columbia, Canada; Department of Psychology, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada.
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28
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Perinatal outcomes and offspring long-term neuropsychiatric hospitalizations of mothers with anxiety disorder. Arch Womens Ment Health 2020; 23:681-688. [PMID: 31993742 DOI: 10.1007/s00737-020-01018-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 01/07/2020] [Indexed: 12/27/2022]
Abstract
Studies regarding the association between anxiety disorders and obstetrical and neonatal complications are inconclusive and sometimes contradictive. The aim of the present study was to assess perinatal outcome of mothers with anxiety disorder and to determine the association between maternal anxiety and long-term neuropsychiatric hospitalizations of the offspring. A hospital-based retrospective cohort study was conducted, comparing pregnancy complications and long-term neuropsychiatric hospitalizations of offspring of mothers with anxiety disorder, during or before the pregnancy and mothers without anxiety. All singleton deliveries between the years 1991 and 2014 in a tertiary medical center were included. To evaluate perinatal outcome of women with anxiety disorders, generalized estimation equation (GEE) models were used to control for confounders. A Kaplan-Meier survival curve was used to compare cumulative incidence of long-term neuropsychiatric hospitalizations, and a Cox proportional hazards model was constructed to control for confounders. During the study period, 242,038 deliveries met the inclusion criteria, of them 0.1% (n = 304) were mothers with anxiety. Using GEE models, controlling for maternal age, maternal anxiety was noted as an independent risk factor for preterm delivery (adjusted OR 1.8, 95% CI 1.32-2.69; P < 0.001), hypertensive disorders (adjusted OR 1.7, 95% CI 1.08-2.69; P = 0.02) and cesarean delivery (adjusted OR 1.6, 95% CI 1.32-2.1; P < 0.001). Offspring born to mothers with anxiety disorders had higher rates of neuropsychiatric-related hospitalizations (6.3 vs 3.1% P = 0.002; Kaplan-Meier log-rank test P < 0.001). Using a Cox proportional hazards model, controlling for confounders such as maternal age, hypertensive disorders, gestational age, birth weight, and cesarean delivery, being born to a mother with anxiety disorders was found to be an independent risk factor for long-term neuropsychiatric hospitalizations of the offspring (adjusted HR 2.4, 95% CI 1.58-3.89; P < 0.001). Pregnancy of women with anxiety disorders is independently associated with adverse perinatal outcome and higher risk for long-term neuropsychiatric hospitalizations of the offspring.
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The HPA axis dysregulation in severe mental illness: Can we shift the blame to gut microbiota? Prog Neuropsychopharmacol Biol Psychiatry 2020; 102:109951. [PMID: 32335265 DOI: 10.1016/j.pnpbp.2020.109951] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 04/15/2020] [Accepted: 04/21/2020] [Indexed: 12/12/2022]
Abstract
Accumulating evidence indicates that patients with severe mental disorders, including major depression, bipolar disorder and schizophrenia present with various alterations of the gut microbiota and increased intestinal permeability. In addition, the hypothalamic-pituitary-adrenal (HPA) axis dysregulation and subclinical inflammation have been reported in this group of patients. Although it has been found that the HPA axis dysregulation appears as a consequence of psychosocial stress, especially traumatic life events, the exact mechanisms of this observation remain unclear. Animal model studies have unraveled several mechanisms linking the gut microbiota with the HPA axis dysfunction. Indeed, the gut microbiota can activate the HPA axis through several mediators that cross the blood-brain barrier and include microbial antigens, cytokines and prostaglandins. There is also evidence that various microbial species can affect ileal corticosterone production that may impact the activity of the HPA axis. However, some metabolites released by various microbes, e.g., short-chain fatty acids, can attenuate the HPA axis response. Moreover, several bacteria release neurotransmitters that can directly interact with vagal afferents. It has been postulated that the HPA axis activation can impact the gut microbiota and intestinal permeability. In this article, we discuss various mechanisms linking the gut microbiota with the HPA axis activity and summarize current evidence for a cross-talk between the gut-brain axis and the HPA axis from studies of patients with mood and psychotic disorders. Finally, we show potential clinical implications that can arise from future studies investigating the HPA axis activity with respect to the gut microbiota in severe mental disorders.
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Hayes CL, Peters BJ, Foster JA. Microbes and mental health: Can the microbiome help explain clinical heterogeneity in psychiatry? Front Neuroendocrinol 2020; 58:100849. [PMID: 32497560 DOI: 10.1016/j.yfrne.2020.100849] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 03/09/2020] [Accepted: 05/18/2020] [Indexed: 02/06/2023]
Abstract
Trillions of microbes cover the surfaces of our bodies and inhabit our gastrointestinal tract. In the past decade, research efforts examining the role of the microbiome in mental health have moved to the forefront of neuroscience and psychiatry. Based on a foundation of animal studies demonstrating the vital role for microbiota-brain communication in brain development, behavior, and brain function over the life span, clinical studies have started to consider the microbiome in psychiatric disorders. The composition, diversity and function of commensal microbes is influenced by genetic, lifestyle, and environmental factors. This review provides an overview of the factors contributing to individual differences in the microbiome, reviews recent work in psychiatric disorders, and considers what is needed to advance a better understanding of how the microbiome impacts mental health which may help us understand the heterogeneity observed in clinical psychiatric populations.
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Affiliation(s)
- Christina L Hayes
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Brett J Peters
- Department of Psychology, Ohio University, Athens, OH, USA
| | - Jane A Foster
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
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31
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Inta D, Wölnerhanssen BK, Meyer-Gerspach AC, Lang E, Schweinfurth N, Mallien AS, Vasilescu AN, Schmidt A, Rea K, Westendorf AM, Tremblay MÈ, Sartorius A, Gass P, Cryan JF, Borgwardt S, Lang UE. Common Pathways in Depression and Obesity: The Role of Gut Microbiome and Diets. Curr Behav Neurosci Rep 2020. [DOI: 10.1007/s40473-020-00199-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Jaggar M, Rea K, Spichak S, Dinan TG, Cryan JF. You've got male: Sex and the microbiota-gut-brain axis across the lifespan. Front Neuroendocrinol 2020; 56:100815. [PMID: 31805290 DOI: 10.1016/j.yfrne.2019.100815] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/16/2019] [Accepted: 11/11/2019] [Indexed: 02/07/2023]
Abstract
Sex is a critical factor in the diagnosis and development of a number of mental health disorders including autism, schizophrenia, depression, anxiety, Parkinson's disease, multiple sclerosis, anorexia nervosa and others; likely due to differences in sex steroid hormones and genetics. Recent evidence suggests that sex can also influence the complexity and diversity of microbes that we harbour in our gut; and reciprocally that our gut microbes can directly and indirectly influence sex steroid hormones and central gene activation. There is a growing emphasis on the role of gastrointestinal microbiota in the maintenance of mental health and their role in the pathogenesis of disease. In this review, we introduce mechanisms by which gastrointestinal microbiota are thought to mediate positive health benefits along the gut-brain axis, we report how they may be modulated by sex, the role they play in sex steroid hormone regulation, and their sex-specific effects in various disorders relating to mental health.
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Affiliation(s)
- Minal Jaggar
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Kieran Rea
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Simon Spichak
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Timothy G Dinan
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland
| | - John F Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.
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Golofast B, Vales K. The connection between microbiome and schizophrenia. Neurosci Biobehav Rev 2019; 108:712-731. [PMID: 31821833 DOI: 10.1016/j.neubiorev.2019.12.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/01/2019] [Accepted: 12/06/2019] [Indexed: 12/15/2022]
Abstract
There has been an accumulation of knowledge about the human microbiome, some detailed investigations of the gastrointestinal microbiota and its functions, and the highlighting of complex interactions between the gut, the gut microbiota, and the central nervous system. That assumes the involvement of the microbiome in the pathogenesis of various CNS diseases, including schizophrenia. Given this information and the fact, that the gut microbiota is sensitive to internal and environmental influences, we have speculated that among the factors that influence the formation and composition of gut microbiota during life, possible key elements in the schizophrenia development chain are hidden where gut microbiota is a linking component. This article aims to describe and understand the developmental relationships between intestinal microbiota and the risk of developing schizophrenia.
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Affiliation(s)
- Bogdana Golofast
- National Institute of Mental Health, Topolova 748, 250 67 Klecany, Prague East, Czech Republic; Third Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague 10, Czech Republic.
| | - Karel Vales
- National Institute of Mental Health, Topolova 748, 250 67 Klecany, Prague East, Czech Republic
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34
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Ishaq SL, Rapp M, Byerly R, McClellan LS, O'Boyle MR, Nykanen A, Fuller PJ, Aas C, Stone JM, Killpatrick S, Uptegrove MM, Vischer A, Wolf H, Smallman F, Eymann H, Narode S, Stapleton E, Cioffi CC, Tavalire HF. Framing the discussion of microorganisms as a facet of social equity in human health. PLoS Biol 2019; 17:e3000536. [PMID: 31770370 PMCID: PMC6879114 DOI: 10.1371/journal.pbio.3000536] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
What do “microbes” have to do with social equity? These microorganisms are integral to our health, that of our natural environment, and even the “health” of the environments we build. The loss, gain, and retention of microorganisms—their flow between humans and the environment—can greatly impact our health. It is well-known that inequalities in access to perinatal care, healthy foods, quality housing, and the natural environment can create and arise from social inequality. Here, we focus on the argument that access to beneficial microorganisms is a facet of public health, and health inequality may be compounded by inequitable microbial exposure. What do microbes have to do with social equity? This Essay explores the argument that access to beneficial microorganisms is a facet of public health, and that health inequality may be compounded by inequitable microbial exposure.
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Affiliation(s)
- Suzanne L Ishaq
- Biology and the Built Environment Center, University of Oregon, Eugene, Oregon, United States of America.,Robert D. Clark Honors College, University of Oregon, Eugene, Oregon, United States of America
| | - Maurisa Rapp
- Robert D. Clark Honors College, University of Oregon, Eugene, Oregon, United States of America.,Department of Human Physiology, University of Oregon, Eugene, Oregon, United States of America
| | - Risa Byerly
- Robert D. Clark Honors College, University of Oregon, Eugene, Oregon, United States of America.,Department of Human Physiology, University of Oregon, Eugene, Oregon, United States of America
| | - Loretta S McClellan
- Robert D. Clark Honors College, University of Oregon, Eugene, Oregon, United States of America
| | - Maya R O'Boyle
- Robert D. Clark Honors College, University of Oregon, Eugene, Oregon, United States of America
| | - Anika Nykanen
- Robert D. Clark Honors College, University of Oregon, Eugene, Oregon, United States of America
| | - Patrick J Fuller
- Robert D. Clark Honors College, University of Oregon, Eugene, Oregon, United States of America.,Charles H. Lundquist College of Business, University of Oregon, Eugene, Oregon, United States of America
| | - Calvin Aas
- Robert D. Clark Honors College, University of Oregon, Eugene, Oregon, United States of America
| | - Jude M Stone
- Robert D. Clark Honors College, University of Oregon, Eugene, Oregon, United States of America
| | - Sean Killpatrick
- Robert D. Clark Honors College, University of Oregon, Eugene, Oregon, United States of America.,Charles H. Lundquist College of Business, University of Oregon, Eugene, Oregon, United States of America
| | - Manami M Uptegrove
- Robert D. Clark Honors College, University of Oregon, Eugene, Oregon, United States of America
| | - Alex Vischer
- Robert D. Clark Honors College, University of Oregon, Eugene, Oregon, United States of America
| | - Hannah Wolf
- Robert D. Clark Honors College, University of Oregon, Eugene, Oregon, United States of America
| | - Fiona Smallman
- Robert D. Clark Honors College, University of Oregon, Eugene, Oregon, United States of America
| | - Houston Eymann
- Robert D. Clark Honors College, University of Oregon, Eugene, Oregon, United States of America.,School of Journalism and Communication, University of Oregon, Eugene, Oregon, United States of America
| | - Simon Narode
- Robert D. Clark Honors College, University of Oregon, Eugene, Oregon, United States of America
| | - Ellee Stapleton
- Department of Landscape Architecture, University of Oregon, Eugene, Oregon, United States of America
| | - Camille C Cioffi
- Counselling Psychology and Human Services, College of Education, University of Oregon, Eugene, Oregon, United States of America
| | - Hannah F Tavalire
- Institute of Ecology and Evolution, University of Oregon, Eugene, Eugene, Oregon, United States of America
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Zhou Y, Yu H, Guo Y, Chen C, Huang X, Gou Y, Du J, Zhuoxin Y. Efficacy of acupuncture versus sham acupuncture for postpartum depression disorder: Study protocol for a randomized controlled trial. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.100982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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36
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Bernabé BP, Tussing-Humphreys L, Rackers HS, Welke L, Mantha A, Kimmel MC. Improving Mental Health for the Mother-Infant Dyad by Nutrition and the Maternal Gut Microbiome. Gastroenterol Clin North Am 2019; 48:433-445. [PMID: 31383280 DOI: 10.1016/j.gtc.2019.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Perinatal mood and anxiety disorders (PMAD) have significant negative impacts on mother and child, yet treatments are limited. Adequate nutrition during the perinatal period is essential to maternal and infant health, including maternal mental health and the child's neurologic and neuropsychiatric development. Nutrition holds promise to improve prevention and treatment of PMAD. The ability to manipulate the gut microbiota composition and structure through host nutrition and to harness the gut microbes for improved individualized nutrition may be an important new direction for prevention and treatment of PMAD, thus improving the mental health of mother and child.
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Affiliation(s)
- Beatriz Peñalver Bernabé
- Department of Surgery, Microbiome Center, University of Chicago, 5841 S. Maryland Street, Chicago, IL 60637, USA; Division of Academic Internal Medicine, Department of Medicine, Institute for Health Research and Policy Cancer Center, University of Illinois at Chicago, 1747 W. Roosevelt Road, Chicago, IL 60608, USA
| | - Lisa Tussing-Humphreys
- Division of Academic Internal Medicine, Department of Medicine, Institute for Health Research and Policy Cancer Center, University of Illinois at Chicago, 1747 W. Roosevelt Road, Chicago, IL 60608, USA
| | - Hannah S Rackers
- Department of Psychiatry, UNC School of Medicine Campus Box 7160, Chapel Hill, NC 27599-7160, USA
| | - Lauren Welke
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor Street, Chicago, IL 60612, USA
| | - Alina Mantha
- Department of Maternal and Child Health, UNC Gillings School of Global Public Health, 401 Rosenau Hall, CB #7445, Chapel Hill, NC 27599-7445, USA
| | - Mary C Kimmel
- Department of Psychiatry, UNC School of Medicine Campus Box 7160, Chapel Hill, NC 27599-7160, USA.
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37
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Sun Y, Geng W, Pan Y, Wang J, Xiao P, Wang Y. Supplementation with Lactobacillus kefiranofaciens ZW3 from Tibetan Kefir improves depression-like behavior in stressed mice by modulating the gut microbiota. Food Funct 2019; 10:925-937. [PMID: 30698577 DOI: 10.1039/c8fo02096e] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Increasing evidence indicates that probiotics can effectively improve depression-like behavior. However, the underlying mechanism is still unclear. In this study, the antidepressant effect of Lactobacillus kefiranofaciens CGMCC2809 (ZW3) isolated from Tibetan Kefir grains was investigated using a mouse model of chronic unpredictable mild stress (CUMS). ZW3 improved depression-like behavior and independent exploration ability in the CUMS group. Moreover, ZW3 regulated biochemical disorders in the hypothalamic-pituitary-adrenal axis, immune system and tryptophan metabolism caused by stress. Furthermore, ZW3 could modulate the composition of the gut microbiota, and alleviate constipation by improving the fecal water content in stressed mice. We found that the probiotic strain was present in the whole intestine, even 7 days after its administration was stopped. These results suggest that L. kefiranofaciens ZW3 might improve depression by regulating the gut microbiota as a probiotic food.
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Affiliation(s)
- Ye Sun
- State Key Laboratory of Food Nutrition and Safety, Faculty of Food Engineering and Biotechnology, Tianjin University of Science and Technology, Tianjin, 300457, China.
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38
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Abstract
The developmental period constitutes a critical window of sensitivity to stress. Indeed, early-life adversity increases the risk to develop psychiatric diseases, but also gastrointestinal disorders such as the irritable bowel syndrome at adulthood. In the past decade, there has been huge interest in the gut-brain axis, especially as regards stress-related emotional behaviours. Animal models of early-life adversity, in particular, maternal separation (MS) in rodents, demonstrate lasting deleterious effects on both the gut and the brain. Here, we review the effects of MS on both systems with a focus on stress-related behaviours. In addition, we discuss more recent findings showing the impact of gut-directed interventions, including nutrition with pre- and probiotics, illustrating the role played by gut microbiota in mediating the long-term effects of MS. Overall, preclinical studies suggest that nutritional approaches with pro- and prebiotics may constitute safe and efficient strategies to attenuate the effects of early-life stress on the gut-brain axis. Further research is required to understand the complex mechanisms underlying gut-brain interaction dysfunctions after early-life stress as well as to determine the beneficial impact of gut-directed strategies in a context of early-life adversity in human subjects.
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Hao Z, Wang W, Guo R, Liu H. Faecalibacterium prausnitzii (ATCC 27766) has preventive and therapeutic effects on chronic unpredictable mild stress-induced depression-like and anxiety-like behavior in rats. Psychoneuroendocrinology 2019; 104:132-142. [PMID: 30844607 DOI: 10.1016/j.psyneuen.2019.02.025] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 02/23/2019] [Accepted: 02/25/2019] [Indexed: 01/19/2023]
Abstract
The realization that the microbiota-gut-brain axis plays a critical role in health and disease,including neuropsychiatric disorders, is rapidly advancing.An abundance of preclinical studies have shown that psychobiotics acting via the brain-gut-axis can affect brain development, function and behavior. Here we tested whether potential psychobiotics Faecalibacterium prausnitzii (ATCC 27766) has anxiolytic and antidepressant-like effects and reverse the impact of chronic unpredictable mild stress (CUMS) in rats. The experiment was divided into two phases, the first stage was CUMS procedure period and the second stage was convalescence period. SD male rats were administered Faecalibacterium prausnitzii for 4 weeks prior to testing during each period. Behavior, growth status, SCFAs produced, plasma cytokine, endocrinology and bone mineral density (BMD) were assessed. Our findings indicate that the administration of F. prausnitzii had preventive and therapeutic effects on CUMS-induced depression-like and anxiety-like behavior. In addition, F. prausnitzii administration could significantly prevent the reduction of the whole-body, femur and tibia BMD during the recovery phase. Moreover, the growth status of rats fed the F. prausnitzii was better than the rats by CUMS. And F. prausnitzii administration led to higher levels of SCFAs in the cecum and higher levels of cytokines interleukin-10 (IL-10) in the plasma, prevented the effects on corticosterone, C-reaction protein and cytokines interleukin-6 (IL-6) release induced by CUMS, changes that were associated with the effects seen on behavior. These results provide further evidence that gut microflora play a role in anxiety and depression. Subject to the confirmation of these results, probiotics might offer a useful novel therapeutic approach to neuropathological disorders and/or as adjunct therapies in psychiatric disorders and support the recent broadening of the definition of psychobiotic. Finally, this study supports F. prausnitzii has significant potential as a psychobiotic.
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Affiliation(s)
- Zikai Hao
- Institute of Environmental Biology and Life Support Technology, School of Biological Science and Medical Engineering, Beihang University, Room 516, YiFu Building, 37# XueYuan, Haidian District, Beijing, 100083, China; Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Room 516, YiFu Building, 37# XueYuan, Haidian District, Beijing, 102402, China
| | - Wei Wang
- Institute of Environmental Biology and Life Support Technology, School of Biological Science and Medical Engineering, Beihang University, Room 516, YiFu Building, 37# XueYuan, Haidian District, Beijing, 100083, China; Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Room 516, YiFu Building, 37# XueYuan, Haidian District, Beijing, 102402, China
| | - Rong Guo
- Institute of Environmental Biology and Life Support Technology, School of Biological Science and Medical Engineering, Beihang University, Room 516, YiFu Building, 37# XueYuan, Haidian District, Beijing, 100083, China; Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Room 516, YiFu Building, 37# XueYuan, Haidian District, Beijing, 102402, China
| | - Hong Liu
- Institute of Environmental Biology and Life Support Technology, School of Biological Science and Medical Engineering, Beihang University, Room 516, YiFu Building, 37# XueYuan, Haidian District, Beijing, 100083, China; Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Room 516, YiFu Building, 37# XueYuan, Haidian District, Beijing, 102402, China; State Key Laboratory of Virtual Reality Technology and Systems, School of Computer Science and Engineering, Beihang University, Room 516, YiFu Building, 37# XueYuan, Haidian District, Beijing, 100083, China; International Joint Research Center of Aerospace Biotechnology & Medical Engineering, Beihang University, Room 516, YiFu Building, 37# XueYuan, Haidian District, Beijing, 100083, China.
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40
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The year of immunopsychiatry: A special issue that foresaw the future. Psychoneuroendocrinology 2019; 103:49-51. [PMID: 30640037 DOI: 10.1016/j.psyneuen.2019.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 01/03/2019] [Indexed: 12/12/2022]
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41
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Sanders A, Rackers H, Kimmel M. A role for the microbiome in mother-infant interaction and perinatal depression. Int Rev Psychiatry 2019; 31:280-294. [PMID: 30784334 DOI: 10.1080/09540261.2018.1548431] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Perinatal depression is a significant public health problem, due to its negative impact on maternal well-being and long-term adverse effects for children. Mother-infant interaction and maternal responsiveness and sensitivity are a hypothesized mechanism by which perinatal depression effects child development, and increasing research in the microbiota-gut-brain axis may provide a new avenue of investigation. There is limited efficacy for treatment of perinatal depression for improving the mother-infant relationship and child outcomes. The maternal microbiota may be the basis of child outcomes through foetal programming and sharing of microbes between mother and infant. There is evidence that less diversity of the intestinal microbial community is associated with neuropsychiatric disorders, including depression and anxiety in mothers and offspring. Assessing the maternal and child's microbial communities may be an important missing component in mother-infant attachment-based therapies during treatment of perinatal depression. Probiotics and prebiotics require further research as additions to mother-infant interventions. Further research may enable identification of bacterial genes that indicate specific pathways that could be targeted to improve outcomes for mother and child.
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Affiliation(s)
- Amanda Sanders
- a Department of Psychiatry , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Hannah Rackers
- a Department of Psychiatry , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Mary Kimmel
- a Department of Psychiatry , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
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42
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Kimmel MC, Bauer A, Meltzer-Brody S. Toward a framework for best practices and research guidelines for perinatal depression research. J Neurosci Res 2019; 98:1255-1267. [PMID: 30924191 PMCID: PMC10127524 DOI: 10.1002/jnr.24425] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 10/09/2018] [Accepted: 10/26/2018] [Indexed: 02/06/2023]
Abstract
This review article highlights the current state of perinatal depression (PND) research including established standards of care and innovative research in progress. PND can have a significant adverse impact on mother, child, and family; however, to date, wide-scale identification, prevention, and treatment have been limited. PND is heterogenous in presentation with likely multifactorial etiologies for each woman. Challenges in PND research are discussed including a need for universal tools, standardized measures, benchmarks, and best practices. Current examples are reviewed that highlight approaches to novel treatment paradigms and interventions. This includes reviewing epidemiologic studies in PND research, examining the biological underpinnings of PND, and discussing examples from this field and other fields currently developing translational research that spans from bench to bedside. Current and future challenges and opportunities in developing best practices for the treatment of PND are outlined. We also discuss the use of the NIMH Research Domain Criteria approach for PND research and provide recommendations for future directions in PND research collaboration. In conclusion, greater precision in perinatal psychiatry can be possible in the future with the development of guidelines and best practices that build on current work and apply innovative and collaborative approaches of scientists, providers, patients, community members, and government officials.
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Affiliation(s)
- Mary C Kimmel
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Anna Bauer
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Samantha Meltzer-Brody
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
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Christian LM. At the forefront of psychoneuroimmunology in pregnancy: Implications for racial disparities in birth outcomes: PART 2: Biological mechanisms. Neurosci Biobehav Rev 2019; 117:327-333. [PMID: 30885813 DOI: 10.1016/j.neubiorev.2019.03.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 02/26/2019] [Accepted: 03/14/2019] [Indexed: 10/27/2022]
Abstract
As reviewed in Part 1 of this two part review, birth prior to full term is a substantial public health issue. In the US, ˜400,000 babies per year are born preterm (< 37 weeks), while>1 million are early term (37-386/7 weeks) and remarkable racial disparities in shortened gestation are observed among African Americans as compared to Whites. Biomechanisms linking stressor exposures with birth outcomes are increasingly being explicated. The current paper reviews the mechanistic role of maternal biological functioning in the link between behavioral exposures and birth outcomes. These include the inter-related roles of neuroendocrine function, inflammatory regulation, biological aging, and the microbiome. An integrative approach which addresses both behavioral and biological factors within the same study, carefully considers the role of race/ethnicity, and rigorously defines birth outcomes (e.g., spontaneous versus medically-indicated and inclusive of early term birth) is needed to move research in this field toward better mechanistic understanding and clinical application.
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Affiliation(s)
- Lisa M Christian
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA; Department of Psychology, The Ohio State University, Columbus, OH, 43210, USA; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA.
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44
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Redpath N, Rackers HS, Kimmel MC. The Relationship Between Perinatal Mental Health and Stress: a Review of the Microbiome. Curr Psychiatry Rep 2019; 21:18. [PMID: 30826885 DOI: 10.1007/s11920-019-0998-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE OF REVIEW Our current understanding of the underlying mechanisms and etiologies of perinatal mood and anxiety disorders (PMADs) is not clearly identified. The relationship of stress-induced adaptations (i.e., the hypothalamic-pituitary-adrenal (HPA) axis, the autonomic nervous system (ANS), the immune system) and the microbiota are potential contributors to psychopathology exhibited in women during pregnancy and postpartum and should be investigated. RECENT FINDINGS The stress response activates the HPA axis and dysregulates the ANS, leading to the inhibition of the parasympathetic system. Sustained high levels of cortisol, reduced heart variability, and modulated immune responses increase the vulnerability to PMAD. Bidirectional communication between the nervous system and the microbiota is an important factor to alter host homeostasis and development of PMAD. Future research in the relationship between the psychoneuroimmune system, the gut microbiota, and PMAD has the potential to be integrated in clinical practice to improve screening, diagnosis, and treatment.
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Affiliation(s)
- Nusiebeh Redpath
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hannah S Rackers
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mary C Kimmel
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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45
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Dickens MJ, Pawluski JL. The HPA Axis During the Perinatal Period: Implications for Perinatal Depression. Endocrinology 2018; 159:3737-3746. [PMID: 30256957 DOI: 10.1210/en.2018-00677] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 09/19/2018] [Indexed: 12/19/2022]
Abstract
The transition to motherhood is characterized by some of the most pronounced endocrine changes a woman will experience in her lifetime. Unfortunately, matrescence is also a time in a woman's life when she is most susceptible to mental illness such as perinatal depression. A growing body of research has aimed to determine how key endocrine systems, such as the hypothalamic-pituitary-adrenal (HPA) axis, are involved in the dysregulation of perinatal mental health. However, very little research has consistently linked perinatal changes in the HPA axis with maternal mental illness. Therefore, the aims of this mini review are to: (i) clearly summarize the normative changes in the HPA axis that occur during pregnancy and the postpartum period; (ii) summarize what we know about the HPA axis in perinatal depression, and (iii) propose key areas for future research. Understanding physiological biomarkers that can predict which women are at risk for perinatal mood disorders will lead to better tools for treating, and ultimately preventing, these debilitating disorders, improving the health of mother, child, and family.
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Affiliation(s)
| | - Jodi L Pawluski
- Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, Rennes, France
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46
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Jouda J, Wöhr M, Del Rey A. Immunity and ultrasonic vocalization in rodents. Ann N Y Acad Sci 2018; 1437:68-82. [PMID: 30062701 DOI: 10.1111/nyas.13931] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 06/20/2018] [Accepted: 06/21/2018] [Indexed: 12/14/2022]
Abstract
Ultrasonic vocalizations (USVs) serve important communicative functions in rodents. Different types of USVs can be triggered in the sender, for example, by maternal separation, social interactions, or exposure to predators, and they evoke affiliative or alarming behaviors in recipients. This review focusses on studies evaluating possible links between immunity and USVs. Most studies have been performed in a murine model of maternal immune activation and subsequent evaluation of effects in the offspring. This model has received large attention in recent years because it mimics behavioral abnormalities observed in certain human neuropsychiatric disorders, including autism spectrum disorder. Although there is still some controversy, the results indicate that stimulation of the immune system of mice and rats during pregnancy affects ultrasonic calling in pups. Few studies are available on immunization during adulthood and USVs. In most cases, immune stimulation led to disease, complicating conclusions about a possible direct link between vocalization and immunity. Although much work is still needed, this is certainly a rather new and promising aspect of interactions between the immune system and behavior.
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Affiliation(s)
- Jamela Jouda
- Department of Biology, College of Science, Al-Mustansiriyah University, Baghdad, Iraq
| | - Markus Wöhr
- Behavioral Neuroscience, Experimental and Biological Psychology, Philipps-University of Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, Philipps-University of Marburg, Marburg, Germany
| | - Adriana Del Rey
- Immunophysiology, Division of Neurophysiology, Institute of Physiology and Pathophysiology, Philipps-University of Marburg, Marburg, Germany
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