Measurement of tryptophan, kynurenine and neopterin in women with and without postpartum blues.
BACKGROUND
Activation of the tryptophan-degrading enzyme indoleamine (2,3)-dioxygenase was demonstrated to be critically involved in tolerance induction to prevent fetal rejection. Our study was designed to examine alterations of tryptophan and its catabolic product kynurenine in the postpartum period and to compare them to neopterin as an immunological marker.


METHODS
95 healthy women delivering without complications provided blood during labour, and 2 and 4 days after birth. The blood samples were analysed for concentrations of tryptophan, kynurenine and neopterin. Women were asked to perform the Edinburgh Postnatal Depression Scale (EPDS) on days 2 and 4.


RESULTS
In women without blues symptoms (n=86) tryptophan concentrations increased within 2 days after birth, whereas they did not change in women with postpartum blues (n=9; 9.5%). The group difference reached statistical significance (p<0.05). The change of the kynurenine to tryptophan ratio (kyn/trp), which estimates the degree of tryptophan degradation, was also different between the two groups at days 0 and 2 (p<0.05). Neopterin concentrations decreased between days 2 and 4 (p<0.05), but there were no differences between the two groups.


CONCLUSIONS
Our study population had a low prevalence of postpartum blues symptoms.


CONCLUSIONS
Low postpartal mood is associated with continuously low serum tryptophan after delivery due to an increased degradation to kynurenine, but is independent of the postpartal course of neopterin.
Kohl
Claudia
C
Department of Psychiatry, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria. Claudia.Kohl@uibk.ac.at
Walch
Thomas
T
Huber
Regina
R
Kemmler
Georg
G
Neurauter
Gabriele
G
Fuchs
Dietmar
D
Sölder
Elisabeth
E
Schröcksnadel
Hans
H
Sperner-Unterweger
Barbara
B
D000328:Adult; D001317:Austria / Q000453:epidemiology; D019052:Depression, Postpartum / Q000097:blood* / Q000453:epidemiology / Q000378:metabolism; D005260:Female; D006801:Humans; D007737:Kynurenine / Q000097:blood* / Q000378:metabolism; D007743:Labor, Obstetric / Q000097:blood / Q000378:metabolism; D019798:Neopterin / Q000097:blood* / Q000378:metabolism; D049590:Postpartum Period / Q000097:blood* / Q000378:metabolism; D011247:Pregnancy; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D013997:Time Factors; D014364:Tryptophan / Q000097:blood* / Q000378:metabolism; D014366:Tryptophan Oxygenase / Q000378:metabolism
D007737:Kynurenine; D019798:Neopterin; D014364:Tryptophan; D014366:Tryptophan Oxygenase