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Review
. 2021 Jun;24(3):391-401.
doi: 10.1007/s00737-020-01093-1. Epub 2020 Nov 20.

A new molecular risk pathway for postpartum mood disorders: clues from steroid sulfatase-deficient individuals

Affiliations
Review

A new molecular risk pathway for postpartum mood disorders: clues from steroid sulfatase-deficient individuals

Harish Thippeswamy et al. Arch Womens Ment Health. 2021 Jun.

Abstract

Postpartum mood disorders develop shortly after childbirth in a significant proportion of women. These conditions are associated with a range of symptoms including abnormally high or low mood, irritability, cognitive disorganisation, disrupted sleep, hallucinations/delusions, and occasionally suicidal or infanticidal ideation; if not treated promptly, they can substantially impact upon the mother's health, mother-infant bonding, and family dynamics. The biological precipitants of such disorders remain unclear, although large changes in maternal immune and hormonal physiology following childbirth are likely to play a role. Pharmacological therapies for postpartum mood disorders can be effective, but may be associated with side effects, concerns relating to breastfeeding, and teratogenicity risks when used prophylactically. Furthermore, most of the drugs that are used to treat postpartum mood disorders are the same ones that are used to treat mood episodes during non-postpartum periods. A better understanding of the biological factors predisposing to postpartum mood disorders would allow for rational drug development, and the identification of predictive biomarkers to ensure that 'at risk' mothers receive earlier and more effective clinical management. We describe new findings relating to the role of the enzyme steroid sulfatase in maternal postpartum behavioural processes, and discuss how these point to a novel molecular risk pathway underlying postpartum mood disorders. Specifically, we suggest that aberrant steroid hormone-dependent regulation of neuronal calcium influx via extracellular matrix proteins and membrane receptors involved in responding to the cell's microenvironment might be important. Testing of this hypothesis might identify novel therapeutic targets and predictive biomarkers.

Keywords: Calcium signalling; Cellular Communication Network Factor; Oestrogen; Phosphodiesterase 10A; Psychosis; Transient Receptor Potential Cation Channel Subfamily M Member 3 (TRPM3).

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
External environmental cues can stimulate neuronal calcium (Ca2+) influx via effects on extracellular matrix components (notably CCN proteins and hemicentin (HMCN1)), a variety of transmembrane receptors, and intracellular signalling cascades; the expression/activity of many of these proteins is differentially sensitive to sulfated and free steroids, and/or is affected by steroid sulfatase (STS) deficiency (indicated with an asterisk symbol)

References

    1. Babalola PA, Fitz NF, Gibbs RB, Flaherty PT, Li PK, Johnson DA. The effect of the steroid sulfatase inhibitor (p-O-sulfamoyl)-tetradecanoyl tyramine (DU-14) on learning and memory in rats with selective lesion of septal-hippocampal cholinergic tract. Neurobiol Learn Mem. 2012;98:303–310. doi: 10.1016/j.nlm.2012.09.003. - DOI - PMC - PubMed
    1. Bauer J (2019) Investigation of the genetic components of maternal infanticide in Sus scrofa. Ph.D thesis, University of Cambridge. 10.17863/CAM.40257
    1. Bergink V, Kushner SA, Pop V, Kuijpens H, Lambregtse-van den Berg MP, Drexhage RC, Wiersinga W, Nolen WA, Drexhage HA. Prevalence of autoimmune thyroid dysfunction in postpartum psychosis. Br J Psychiatry. 2011;198:264–268. doi: 10.1192/bjp.bp.110.082990. - DOI - PubMed
    1. Bergink V, Burgerhout KM, Weigelt K, Pop VJ, de Wit H, Drexhage RC, Kushner SA, Drexhage HA. Immune system dysregulation in first-onset postpartum psychosis. Biol Psychiatry. 2013;73:1000–1007. doi: 10.1016/j.biopsych.2012.11.006. - DOI - PubMed
    1. Bergink V, Laursen TM, Johannsen BMW, et al. Pre-eclampsia and first-onset postpartum psychiatric episodes: a Danish population-based cohort study. Psychol Med. 2015;45:1–9. doi: 10.1017/S0033291715001385. - DOI - PMC - PubMed

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