Peripartum mood disturbances pathophysiology: Difference between revisions

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===Pathogenesis===
===Pathogenesis===
*The exact pathogenesis of [disease name] is not completely understood.
*[[Genetics]] of postpartum depression: <ref name="pmid30552910">{{cite journal |vauthors=Payne JL, Maguire J |title=Pathophysiological mechanisms implicated in postpartum depression |journal=Front Neuroendocrinol |volume=52 |issue= |pages=165–180 |date=January 2019 |pmid=30552910 |pmc=6370514 |doi=10.1016/j.yfrne.2018.12.001 |url=}}</ref>
OR
<br>[[Estrogen receptor]] alpha gene, polymorphisms in the [[serotonin transporter]] gene, 5-HTT, and the gene encoding for MAOA and the gene encoding for [[Catechol-O-methyltransferase]] (COMT), Genetic variants for the TPH2 gene, a SNP in OXT was predictive of both variation in breastfeeding duration and postpartum depression scores, an interaction between a SNP in the OXTR gene and methylation state was detected in association with postpartum depression. In a genome-wide linkage and association study, the Hemicentin 1 gene (HMNC1) had the strongest association with postpartum depression.  
*It is understood that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
*[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
*Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
*[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
*The progression to [disease name] usually involves the [molecular pathway].
*The pathophysiology of [disease/malignancy] depends on the histological subtype.


*Epigenetic]] mechanisms of postpartum depression<br>In women with [[postpartum depression]], there was a substantial interaction between OXTR [[DNA methylation]], [[estradiol]], and the ratio of [[allopregnanolone]] to [[progesterone]]. Alterations in DNA methylation of the OXTR gene are adversely linked with blood [[estradiol]] levels in women with [[postpartum depression]]. As a result, [[epigenetic]] alterations can affect [[metabolic]] processes linked to [[postpartum depression]].


Many [[pathological]] mechanisms are involved in [[postpartum]] [[depression]] which interact with one another.<ref name="pmid30552910">{{cite journal |vauthors=Payne JL, Maguire J |title=Pathophysiological mechanisms implicated in postpartum depression |journal=Front Neuroendocrinol |volume=52 |issue= |pages=165–180 |date=January 2019 |pmid=30552910 |pmc=6370514 |doi=10.1016/j.yfrne.2018.12.001 |url=}}</ref>
*[[Neuroendocrine]] mechanisms of postpartum depression: <br>In [[postpartum depression]], there is an interaction between the [[Hypothalamus]]-[[pituitary]]-[[gonadal]] (HPG) and [[Hypothalamus]]-[[Pituitary]]-[[Adrenal]]([[HPA]]) axis. [[HPA axis]] function has been found to be influenced by reproductive hormones and vice versa. As a result, any change in reproductive hormones may cause [[stress hormone]] levels to fluctuate, resulting in [[postpartum depression]]. Alterations of the [[HPA axis]]' function may also affect reproductive hormone levels, contributing to [[postpartum depression]].


* '''[[Genetics]] of postpartum depression'''<br>[[Estrogen receptor]] alpha gene, polymorphisms in the [[serotonin transporter]] gene, 5-HTT, and the gene encoding for MAOA and the gene encoding for [[Catechol-O-methyltransferase]] (COMT), Genetic variants for the TPH2 gene, a SNP in OXT was predictive of both variation in breastfeeding duration and postpartum depression scores, an interaction between a SNP in the OXTR gene and methylation state was detected in association with postpartum depression. In a genome-wide linkage and association study, the Hemicentin 1 gene (HMNC1) had the strongest association with postpartum depression.
*[[Neurotransmitters]] and postpartum depression :<br>'''GABA'''-GABA which is an inhibitory [[neurotransmitter]] in the brain, its level is inversely related with the depression symptoms in  the [[postpartum]] period.<br>
 
* '''[[Epigenetic]] mechanisms of postpartum depression'''<br>In women with [[postpartum depression]], there was a substantial interaction between OXTR [[DNA methylation]], [[estradiol]], and the ratio of [[allopregnanolone]] to [[progesterone]]. Alterations in DNA methylation of the OXTR gene are adversely linked with blood [[estradiol]] levels in women with [[postpartum depression]]. As a result, [[epigenetic]] alterations can affect [[metabolic]] processes linked to [[postpartum depression]].
 
* '''[[Neuroendocrine]] mechanisms of postpartum depression'''<br>In [[postpartum depression]], there is an interaction between the [[Hypothalamus]]-[[pituitary]]-[[gonadal]] (HPG) and [[Hypothalamus]]-[[Pituitary]]-[[Adrenal]]([[HPA]]) axis. [[HPA axis]] function has been found to be influenced by reproductive hormones and vice versa. As a result, any change in reproductive hormones may cause [[stress hormone]] levels to fluctuate, resulting in [[postpartum depression]].  Alterations of the [[HPA axis]]' function may also affect reproductive hormone levels, contributing to [[postpartum depression]].
 
* '''[[Neurotransmitters]] and postpartum depression'''<br>'''GABA'''-GABA which is an inhibitory [[neurotransmitter]] in the brain, its level is inversely related with the depression symptoms in  the [[postpartum]] period.<br>
'''Glutamate'''-Glutamate is the excitatory neurotransmitter in the brain. In women with postpartum depression its level are increased in the medial prefrontal cortex and decreased in the dorsolateral prefrontal cortex.<br>
'''Glutamate'''-Glutamate is the excitatory neurotransmitter in the brain. In women with postpartum depression its level are increased in the medial prefrontal cortex and decreased in the dorsolateral prefrontal cortex.<br>
'''Serotonin'''-The binding of [[Serotonin]] to 5HT1A receptors is decreased in the mesiotemporal and  anterior cingulate cortices.<br>
'''Serotonin'''-The binding of [[Serotonin]] to 5HT1A receptors is decreased in the mesiotemporal and  anterior cingulate cortices.<br>
'''Dopamine'''-[[Mutations]] in DR1 is related to the behaviour of mother paying less attention to the baby.<br>
'''Dopamine'''-[[Mutations]] in DR1 is related to the behaviour of mother paying less attention to the baby.<br>


* '''Neuroinflammatory mechanisms in postpartum depression'''<br>There is a negative relationship between [[T-cell]] number and [[postpartum depression]] symptoms, whereas [[IL-6]] and IL-1β have a significant positive relationship with it.
Neuroinflammatory mechanisms in postpartum depression: <br>There is a negative relationship between [[T-cell]] number and [[postpartum depression]] symptoms, whereas [[IL-6]] and IL-1β have a significant positive relationship with it.


It is thought that in postpartum psychosis, immunoneuroendocrine set point is dysregulated with overactivation of the [[immune system]]'s [[macrophage]] and [[monocyte]] arm. <ref name="pmid28713685">{{cite journal |vauthors=Davies W |title=Understanding the pathophysiology of postpartum psychosis: Challenges and new approaches |journal=World J Psychiatry |volume=7 |issue=2 |pages=77–88 |date=June 2017 |pmid=28713685 |pmc=5491479 |doi=10.5498/wjp.v7.i2.77 |url=}}</ref>
It is thought that in postpartum psychosis, immunoneuroendocrine set point is dysregulated with overactivation of the [[immune system]]'s [[macrophage]] and [[monocyte]] arm. <ref name="pmid28713685">{{cite journal |vauthors=Davies W |title=Understanding the pathophysiology of postpartum psychosis: Challenges and new approaches |journal=World J Psychiatry |volume=7 |issue=2 |pages=77–88 |date=June 2017 |pmid=28713685 |pmc=5491479 |doi=10.5498/wjp.v7.i2.77 |url=}}</ref>

Revision as of 16:53, 2 August 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sunita Kumawat, M.B.B.S[2]

Overview

Many pathological mechanisms are involved in postpartum depression which interact with one another.

Pathophysiology

Physiology

The normal physiology of [name of process] can be understood as follows:

Pathogenesis


Estrogen receptor alpha gene, polymorphisms in the serotonin transporter gene, 5-HTT, and the gene encoding for MAOA and the gene encoding for Catechol-O-methyltransferase (COMT), Genetic variants for the TPH2 gene, a SNP in OXT was predictive of both variation in breastfeeding duration and postpartum depression scores, an interaction between a SNP in the OXTR gene and methylation state was detected in association with postpartum depression. In a genome-wide linkage and association study, the Hemicentin 1 gene (HMNC1) had the strongest association with postpartum depression.

Glutamate-Glutamate is the excitatory neurotransmitter in the brain. In women with postpartum depression its level are increased in the medial prefrontal cortex and decreased in the dorsolateral prefrontal cortex.
Serotonin-The binding of Serotonin to 5HT1A receptors is decreased in the mesiotemporal and anterior cingulate cortices.
Dopamine-Mutations in DR1 is related to the behaviour of mother paying less attention to the baby.

Neuroinflammatory mechanisms in postpartum depression:
There is a negative relationship between T-cell number and postpartum depression symptoms, whereas IL-6 and IL-1β have a significant positive relationship with it.

It is thought that in postpartum psychosis, immunoneuroendocrine set point is dysregulated with overactivation of the immune system's macrophage and monocyte arm. [2]

Genetics

[Disease name] is transmitted in [mode of genetic transmission] pattern.

OR

Genes involved in the pathogenesis of [disease name] include:

  • [Gene1]
  • [Gene2]
  • [Gene3]

OR

The development of [disease name] is the result of multiple genetic mutations such as:

  • [Mutation 1]
  • [Mutation 2]
  • [Mutation 3]

Associated Conditions

Conditions associated with [disease name] include:

  • [Condition 1]
  • [Condition 2]
  • [Condition 3]

Gross Pathology

On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Microscopic Pathology

On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

References

  1. Payne JL, Maguire J (January 2019). "Pathophysiological mechanisms implicated in postpartum depression". Front Neuroendocrinol. 52: 165–180. doi:10.1016/j.yfrne.2018.12.001. PMC 6370514. PMID 30552910.
  2. Davies W (June 2017). "Understanding the pathophysiology of postpartum psychosis: Challenges and new approaches". World J Psychiatry. 7 (2): 77–88. doi:10.5498/wjp.v7.i2.77. PMC 5491479. PMID 28713685.