IgA/IgM responses to tryptophan and tryptophan catabolites (TRYCATs) are differently associated with prenatal depression, physio-somatic symptoms at the end of term and premenstrual syndrome

Abstract

There is some evidence that lowered tryptophan and an activated tryptophan catabolite (TRYCAT) pathway play a role in depression, somatoform disorder, and postpartum blues. The aim of this study is to delineate the associations between the TRYCAT pathway and premenstrual syndrome (PMS) and perinatal depressive and physio-somatic symptoms. We examine the associations between end of term serum IgM and IgA responses to tryptophan and 9 TRYCATs in relation to zinc, C-reactive protein (CRP), and haptoglobin and prenatal physio-somatic (previously known as psychosomatic) symptoms (fatigue, back pain, muscle pain, dyspepsia, obstipation) and prenatal and postnatal depression and anxiety symptoms as measured using the Edinburgh Postnatal Depression Scale (EPDS), Hamilton Depression Rating Scale (HAMD), and Spielberger's State Anxiety Inventory (STAI). We included pregnant females with (n = 24) and without depression (n = 25) and 24 non-pregnant females. There were no significant associations between the IgA/IgM responses to tryptophan and TRYCATs and prenatal and postnatal depression/anxiety symptoms, except for lowered IgA responses to anthranilic acid in prenatal depression. A large part of the variance in IgA responses to most TRYCATs was explained by PMS and haptoglobin (positively) and CRP (inversely) levels. The IgA responses to TRYCATs were significantly increased in PMS, in particular picolinic, anthranilic, xanthurenic and kynurenic acid, and 3OH-kynurenine. Variance (62.5%) in physio-somatic symptoms at the end of term was explained by PMS, previous depressions, zinc (inversely), CRP and haptoglobin (both positively), and the IgM responses to quinolinic acid (positively), anthranilic acid, and tryptophan (both negatively). The results suggest that mucosa-derived TRYCAT pathway activation is significantly associated with PMS, but not with perinatal depression/anxiety symptoms. Physio-somatic symptoms in pregnancy have an immune-inflammatory pathophysiology. Induction of the TRYCAT pathway appears to be more related to physio-somatic than to depression symptoms.

Natural regulatory IgM‐mediated autoimmune responses directed against malondialdehyde regulate oxidative and nitrosative pathways and coupled with IgM responses to nitroso adducts attenuate depressive and physiosomatic symptoms at the end of term pregnancy

“…68,69 PMS is comorbid with other immuno-inflammatory conditions, including major depression, bipolar disorder, as well as perinatal depression. 43,70 The fourth major finding of this study is that increased NOx levels are associated with IgM responses to NO adducts, but not NO 2 tyrosine, whilst the latter is associated with increased IgM responses to MDA. Different mechanisms may explain why increased NO production is associated with an index of nitrosylation (NO) but not nitration (NO 2 ).…”

Dexmedetomidine Alleviates Postpartum Depressive Symptoms following Cesarean Section in Chinese Women: A Randomized Placebo‐Controlled Study

“…By significantly reducing the incidence of PDS and postpartum blues, DEX would seem to be acting on the pathways primed by historical factors such as stress during pregnancy, life stress events, and domestic violence, which the data in the present study indicate to be risk factors for PDS. It is also of note that DEX decreased the risk of both postpartum blues and PDS, proposed by some researchers to have distinct pathophysiologies . Although DEX showed a trend to decrease PDS and postpartum blues in women reporting severe stress during pregnancy, only those reporting a moderate level of such pressure/stress showed a significant decrease in PDS and postpartum blues incidence.…”

“…It is also of note that DEX decreased the risk of both postpartum blues and PDS, proposed by some researchers to have distinct pathophysiologies. 47 Although DEX showed a trend to decrease PDS and postpartum blues in women reporting severe stress during pregnancy, only those reporting a moderate level of such pressure/stress showed a significant decrease in PDS and postpartum blues incidence. This requires further confirmation and investigation because it could suggest the existence of distinct physiologic processes that depend on the levels of reported stress.…”

Profiles and characteristics of clinical subtypes of perinatal depressive symptoms: A latent class analysis

“…Previous studies found that physio‐somatic symptoms of depression rather than primary mood symptoms per se may be related to alterations in TRYCATS (the tryptophan catabolite) pathways, which lead to increased activity of indoleamine 2,3‐dioxygenase disorders in kynurenine aminotransferase activity (Anderson, Berk, & Maes, ; Anderson, Maes, & Berk, ). However, Roomruangwong, Kanchanatawan, Sirivichayakul, Anderson, et al () indicated that increased TRYCATS activity cannot predict perinatal depression; in contrast, Maes et al () found a significant relationship between increased TRYCATS levels and postpartum blues (mild mood and physio‐somatic postpartum symptoms). Whether childbirth changes TRYCATS pathways activity or not, these contradictory or paradoxical results imply that the underlying biological mechanisms have not been substantially identified, regardless of the clinical phenotype subtypes.…”

“…Previous studies found that physio-somatic symptoms of depression rather than primary mood symptoms per se may be related to alterations in TRYCATS (the tryptophan catabolite) pathways, which lead to increased activity of indoleamine 2,3-dioxygenase disorders in kynurenine aminotransferase activity (Anderson, Berk, & Maes, 2014;Anderson, Maes, & Berk, 2012). However, Roomruangwong, Kanchanatawan, Sirivichayakul, Anderson, et al (2017) indicated that increased TRYCATS activity cannot predict perinatal depression; in contrast, Maes et al (2002) that underlie the different perinatal depressive-symptom subtypes at different pregnancy stages.…”