Title | Conventional and new immunotherapies for immune system dysregulation in postpartum mood disorders: comparisons to immune system dysregulations in bipolar disorder, major depression, and postpartum autoimmune thyroid disease. |
Publication Type | Journal Article |
Year of Publication | 2025 |
Authors | Drexhage HA, Bergink V, Poletti S, Benedetti F, Osborne LM |
Journal | Expert Rev Clin Immunol |
Volume | 21 |
Issue | 2 |
Pagination | 113-135 |
Date Published | 2025 Feb |
ISSN | 1744-8409 |
Keywords | Animals, Bipolar Disorder, Depression, Postpartum, Depressive Disorder, Major, Female, Humans, Immunotherapy, Mood Disorders, Postpartum Period, Pregnancy, Thyroiditis, Autoimmune |
Abstract | INTRODUCTION: Postpartum mood disorders are heterogenous disorders and comprise postpartum psychosis and postpartum depression. Evidence is accumulating that systemic monocyte/macrophage activation, low-grade inflammation and (premature senescence related) T cell defects increase the risk for mood disorders outside pregnancy by affecting the function of microglia and T cells in the emotional brain (the cortico-limbic system) leading to inadequate mood regulation upon stress. AREAS COVERED: The evidence in the literature that similar immune dysregulations are present in postpartum mood disorders. RESULTS: The physiological postpartum period is characterized by a rapid T cell surge and a mild activation of the monocyte/macrophage system. Postpartum mood disorder patients show a diminished T cell surge (including that of T regulatory cells) and an increase in low grade inflammation, that is, an increased inflammatory state of monocytes/macrophages and higher levels of serum pro-inflammatory cytokines. EXPERT OPINION: Anti-inflammatory agents (e.g. COX-2 inhibitors) and T cell boosting agents (e.g. low-dose IL-2 therapy) should be further investigated as treatment. The hypothesis should be investigated that postpartum mood disorders are active episodes (triggered by changes in the postpartum immuno-endocrine milieu) in ongoing, dynamically fluctuating aberrant neuro-immune-endocrine trajectories leading to mood disorders in women (inheritably) vulnerable to these disorders. |
DOI | 10.1080/1744666X.2024.2420053 |
Alternate Journal | Expert Rev Clin Immunol |
PubMed ID | 39441185 |
PubMed Central ID | PMC11786996 |
Grant List | R01 MH122869 / MH / NIMH NIH HHS / United States R01 MH124776 / MH / NIMH NIH HHS / United States |