Blood T-helper 17 cells and interleukin-17A correlate with the elevated risk of postpartum depression and anxiety

Abstract

Background: T-helper (Th) cells regulate inflammation and immunity, which is implicated in psychological disorders. The current study aimed to explore the clinical role of blood Th1, Th2, and Th17 cells and their main secreted cytokines in postpartum depression (PPD) and postpartum anxiety (PPA).

Methods: A total of 226 postpartum women were included. At 6 weeks postpartum, Edinburgh Postnatal Depression Scale (EPDS) and State Trait Anxiety Inventory 6 item version (STAI6) scores were assessed; meanwhile, blood Th1, Th2, and Th17 cells were detected by flow cytometry, serum interferon-gamma (IFN-γ), interleukin-4 (IL-4), and IL-17A were detected by enzyme-linked immunosorbent assay.

Results: The incidence of PPD and PPA were 24.3% and 27.9%, respectively. Th17 cells and IL-17A were positively correlated with EPDS score and STAI6 score (all p < 0.001). Besides, Th17 cells (p < 0.001) and IL-17A (p = 0.002) were increased in PPD cases vs. non-PPD cases, and they were also elevated in PPA cases vs. non-PPA cases (both p < 0.05). However, Th1 cells, Th2 cells, IFN-γ, and IL-4 were not linked with EPDS score or STAI6 score (all p > 0.05); besides, they did not vary in PPD cases vs. non-PPD cases or in PPA cases vs. non-PPA cases (all p > 0.05). Multivariate logistic regression model analysis showed that Th17 cells were independently associated with an elevated risk of PPD (odds ratio [OR] = 1.600, p = 0.001) and PPA (OR = 1.371, p = 0.022).

Conclusion: Blood Th17 cells and IL-17A are positively linked with the risk of PPD and PPA, indicating which may be involved in the development of PPD and PPA.

Keywords: T-helper cells; cytokines; postpartum anxiety; postpartum depression; risk factors.

FIGURE 1

Study flow chart

FIGURE 2

Incidence of PPD and PPA. Frequency of different EPDS score (A), rate of PPD (B), frequency of different STAI6 score (C) and rate of PPA (D)

FIGURE 3

Th17 cells and IL‐17A were positively correlated with EPDS score. Correlation of Th1 cells (A), Th2 cells (B), Th17 cells (C), IFN‐γ (D), IL‐4 (E), and IL‐17A (F) with EPDS score

FIGURE 4

Th17 cells and IL‐17A were elevated in PPD women vs. non‐PPD women. Comparison of Th1 cells (A), Th2 cells (B), Th17 cells (C), IFN‐γ (D), IL‐4 (E), and IL‐17A (F) in PPD women vs. non‐PPD women

FIGURE 5

Th17 cells and IL‐17A were positively correlated with STAI6 score. Correlation of Th1 cells (A), Th2 cells (B), Th17 cells (C), IFN‐γ (D), IL‐4 (E), and IL‐17A (F) with STAI6 score

FIGURE 6

Th17 cells and IL‐17A were increased in PPA women vs. non‐PPA women. Comparison of Th1 cells (A), Th2 cells (B), Th17 cells (C), IFN‐γ (D), IL‐4 (E), and IL‐17A (F) in PPA women vs. non‐PPA women