Pilot validation of blood-based biomarkers during pregnancy and postpartum in women with prior or current depression

Postpartum Depression: Interacting Biological Pathways and the Promising Validation of Blood-Based Biomarkers

Background/Objectives: Postpartum depression (PPD), the most common and prevalent psychiatric disorder after birth, is a prevalent yet underdiagnosed psychiatric condition that remains insufficiently understood, particularly in terms of its biological basis. While epidemiological data are extensive, few studies have systematically investigated their underlying biological mechanisms. The purpose of this study was to explore the potential links between blood biomarker levels and postpartum depressive symptoms, contributing to the development of a unified biological model of PPD. Methods: We conducted a cross-sectional study between 2023 and 2025 at a tertiary academic hospital in Timisoara, Romania, involving 860 postpartum women recruited at hospital discharge (1-2 weeks after childbirth). The participants completed the Edinburgh Postnatal Depression Scale (EPDS) and provided peripheral blood samples, which were analyzed using standardized protocols. The blood levels of pregnancy-related hormones (estrogen and progesterone), vitamin D, biochemical markers of inflammatory response (white blood cell count, C-reactive protein, fibrinogen, neutrophil count, lymphocyte count, and ferritin), anemia indicators (hemoglobin, red blood cell count, hematocrit, and ferritin), thyroid hormones (TSH, FT3, and FT4) and markers of coagulation abnormalities (D-dimer, platelets, fibrinogen, APTT, and INR) were evaluated. The data were analyzed with JASP v0.19.3. The statistical methods included multivariate linear regression, the Kruskal-Wallis and Mann-Whitney U tests, and Spearman correlation, with significance set at p < 0.05. Results: The analysis revealed that postpartum depression (PPD) is associated with distinct biological profiles, reflecting the unique hormonal and physiological changes in the peripartum period. Significant associations were identified between EPDS scores and the levels of estrogen, progesterone, thyroid hormones (TSH, FT3, and FT4), inflammatory markers (CRP and ferritin), vitamin D, and coagulation parameters (APTT and INR). These findings support the notion that PPD has a multifactorial biological basis and highlight the potential of these biomarkers as early predictors of risk. Conclusions: Integrating biochemical assessments into postpartum care may enhance early identification and inform targeted preventive interventions, such as hormone monitoring, vitamin D and iron supplementation, or thyroid function correction.

Using transcriptome analysis to investigate the induction of vitellogenesis in female Japanese eels (Anguilla japonica)

Oogenesis, encompassing folliculogenesis, development, and maturation, is a complex physiological process that is not solely regulated by gonadotropins but is also actively influenced by multiple growth factors produced by the oocyte and its surrounding follicular cells. The Japanese eel (Anguilla japonica) has a complex life history, resulting in many uncertainties regarding its growth, development, and reproduction. Under artificial culture conditions, oocyte development in the Japanese eel is arrested and can only progress to the vitellogenic stage through artificial induction. In the present study, we observed that, despite receiving the same hormone treatment as normally developing individuals, a small proportion of female eels exhibited oocytes arrested at the perinucleolar stage. Transcriptome analysis revealed that differentially expressed genes are involved in multiple reproductive-related physiological processes and functional pathways, such as tachykinin system, MAPK signaling pathway, steroid-related pathways, oocyte meiosis, Wnt signaling pathway and GnRH signaling pathway. The abnormal expression of the two follicle-stimulating hormone (FSH) subunit genes may be a key factor contributing to this phenomenon. This study reveals the underlying causes of ovarian developmental arrest in hormonally induced female Japanese eels from the perspective of the brain-pituitary-gonad (BPG) axis, providing a research foundation for the artificial reproduction of Japanese eels.

A mutation in the transmembrane domain of Adenylate cyclase 3 impairs enzymatic function to cause sex-specific depression- and anxiety-like behaviors and food seeking in a rat model

We have previously demonstrated that a transmembrane domain mutation in Adenylate cyclase 3 ( Adcy3 ) causes increased adiposity and negative emotion-like behaviors in a rat model. We set out to replicate and expand upon our previous study by conducting comprehensive behavioral testing, and we also investigated the molecular changes that result from this mutation. Rats with a mutation in the second transmembrane helix of ADCY3 (Adcy3 mut/mut ) and wild-type rats were fed a high-fat diet for 12 weeks. We measured body weight, body composition, and depression-like and anxiety-like behaviors using the following tests: sucrose splash test, sucrose preference test, forced swim test, open field test, elevated plus maze, successive alleys test, and novelty-suppressed feeding. We also measured serum leptin levels, hypothalamic cyclic AMP (cAMP) production, and membrane fraction ADCY3 content. Adcy3 mut/mut male and female rats had increased adiposity. Adcy3 mut/mut males showed increased despair- and anxiety-like behaviors, food seeking, and higher leptin levels relative to wild-type males. Adcy3 mut/mut females showed only mildly increased anxiety-like behaviors relative to wild-type females. Adcy3 mut/mut rats of both sexes had decreased cAMP production in the hypothalamus, with no changes in ADCY3 content in the membrane fraction. We conclude that the transmembrane domain of ADCY3 plays a critical role regulating adiposity and behavior, as well as cAMP production. There were key differences between males and females for the observed phenotypes. This study supports the idea that Adcy3 contributes to emotion-like behaviors and potentially mental health disorders, and that the transmembrane domain of ADCY3 is important for protein function.

Identification of Specific Plasma miRNAs as Potential Biomarkers for Major Depressive Disorder

BACKROUND

Depression is a significant concern in clinical and preclinical psychoneurobiological sciences due to its high prevalence and its individual and collective consequences. Identifying efficient biomarkers for accurate diagnosis is crucial, with ideal biomarkers having detectable serum levels and conformational and thermal stability. This study aims to identify stable plasma biomarkers for the diagnosis and prognosis of major depressive disorder, as the pathogenesis of the disorder remains incompletely understood, affecting diagnosis accuracy.

METHODS

Thus, this study included ten MDD patients and eight healthy controls. The present work analyzed miRNAs in patients with major depressive disorder compared to healthy controls.

RESULTS

Eleven specific miRNAs, particularly hsa-miR-874-3p; hsa-let-7d-5p; and hsa-miR-93-3p showed upregulation-type plasma variations in the group of patients with major depressive disorder. miRNA functionality is linked to depressive pathophysiology.

CONCLUSIONS

This study identifies a "bouquet" of miRNAs with significant upregulation variations in patients with major depressive disorder, suggesting further research to determine their suitability for personalization and evaluation, ultimately becoming integral components of major depression serological evaluations.

Role of Enzymes Capable of Transporting Phosphatidylserine in Brain Development and Brain Diseases

Phosphatidylserine (PS) is a common type of phospholipid, typically located in the inner leaflet of the cell membrane, especially abundant in the nervous system. It is an important component of the neuronal membrane and is considered to play a regulatory role in various brain functions, including memory and emotional stability, because its exposure to the outer leaflet of the neuronal membrane can result in abnormalities in various neurobiological processes such as synaptic transmission and neuronal apoptosis. Recently, research on two types of membrane proteins that synergistically mediate the transmembrane transport of phospholipid molecules in eukaryotic cells has become more in-depth and detailed. This review mainly explores the regulation of the expression of phosphatidylserine transporters and their impact on brain development and diseases.

Adenylate cyclase 3: a potential genetic link between obesity and major depressive disorder

Obesity and major depressive disorder (MDD) are both significant health issues that have been increasing in prevalence and are associated with multiple comorbidities. Obesity and MDD have been shown to be bidirectionally associated, and they are both influenced by genetics and environmental factors. However, the molecular mechanisms that link these two diseases are not yet fully understood. It is possible that these diseases are connected through the actions of the cAMP/protein kinase A (PKA) pathway. Within this pathway, adenylate cyclase 3 (Adcy3) has emerged as a key player in both obesity and MDD. Numerous genetic variants in Adcy3 have been identified in humans in association with obesity. Rodent knockout studies have also validated the importance of this gene for energy homeostasis. Furthermore, Adcy3 has been identified as a top candidate gene and even a potential blood biomarker for MDD. Adcy3 and the cAMP/PKA pathway may therefore serve as an important genetic and functional link between these two diseases. In this mini-review, we discuss the role of both Adcy3 and the cAMP/PKA pathway, including specific genetic mutations, in both diseases. Understanding the role that Adcy3 mutations play in obesity and MDD could open the door for precision medicine approaches and treatments for both diseases that target this gene.

Biomarkers in psychiatric disorders

Psychiatric disorders represent a significant socioeconomic and healthcare burden worldwide. Of these, schizophrenia, bipolar disorder, major depressive disorder and anxiety are among the most prevalent. Unfortunately, diagnosis remains problematic and largely complicated by the lack of disease specific biomarkers. Accordingly, much research has focused on elucidating these conditions to more fully understand underlying pathophysiology and potentially identify biomarkers, especially those of early stage disease. In this chapter, we review current status of this endeavor as well as the potential development of novel biomarkers for clinical applications and future research study.

Brain-derived estrogen: a critical player in maintaining cognitive health of aged female rats, possibly involving GPR30

Brain-derived estrogen is an endogenous neuroprotective agent, whether and how might this protective function with aging, especially postmenopausal drops in circulating estrogen, remain unclear. We herein subjected 6, 14, and 18 Mon female rats to mimic natural aging, and found that estrogen synthesis is more active in the healthy aged brain, as evidenced by the highest levels of mRNA and protein expression of aromatase, the key enzyme of E2 biosynthesis, among the three groups. Aromatase knockout in forebrain neurons (FBN-Aro-/-) impaired hippocampal and cortical neurons, and cognitive function in 18 Mon rats, compared to wild-type controls. Furthermore, estrogen nuclear receptors (ERα/β) displayed opposite changes, with a significant ERα decrease and ERβ increase, while membrane receptor GPR30 expressed stably in hippocampus during aging. Intriguingly, GPR30, but not ERα and ERβ, was decreased by FBN-Aro-/-. The results indicate that GPR30 is more sensitive to brain local E2 synthesis. Our findings provide evidence of a critical role for brain-derived estrogen in maintaining healthy brain function in older individuals, possibly involving GPR30.

LRFN5 and OLFM4 as novel potential biomarkers for major depressive disorder: a pilot study

Evidences have shown that both LRFN5 and OLFM4 can regulate neural development and synaptic function. Recent genome-wide association studies on major depressive disorder (MDD) have implicated LRFN5 and OLFM4, but their expressions and roles in MDD are still completely unclear. Here, we examined serum concentrations of LRFN5 and OLFM4 in 99 drug-naive MDD patients, 90 drug-treatment MDD patients, and 81 healthy controls (HCs) using ELISA methods. The results showed that both LRFN5 and OLFM4 levels were considerably higher in MDD patients compared to HCs, and were significantly lower in drug-treatment MDD patients than in drug-naive MDD patients. However, there were no significant differences between MDD patients who received a single antidepressant and a combination of antidepressants. Pearson correlation analysis showed that they were associated with the clinical data, including Hamilton Depression Scale score, age, duration of illness, fasting blood glucose, serum lipids, and hepatic, renal, or thyroid function. Moreover, these two molecules both yielded fairly excellent diagnostic performance in diagnosing MDD. In addition, a combination of LRFN5 and OLFM4 demonstrated a better diagnostic effectiveness, with an area under curve of 0.974 in the training set and 0.975 in the testing set. Taken together, our data suggest that LRFN5 and OLFM4 may be implicated in the pathophysiology of MDD and the combination of LRFN5 and OLFM4 may offer a diagnostic biomarker panel for MDD.

The Wistar Kyoto Rat: A Model of Depression Traits

There is an ongoing debate about the value of animal research in psychiatry with valid lines of reasoning stating the limits of individual animal models compared to human psychiatric illnesses. Human depression is not a homogenous disorder; therefore, one cannot expect a single animal model to reflect depression heterogeneity. This limited review presents arguments that the Wistar Kyoto (WKY) rats show intrinsic depression traits. The phenotypes of WKY do not completely mirror those of human depression but clearly indicate characteristics that are common with it. WKYs present despair- like behavior, passive coping with stress, comorbid anxiety, and enhanced drug use compared to other routinely used inbred or outbred strains of rats. The commonly used tests identifying these phenotypes reflect exploratory, escape-oriented, and withdrawal-like behaviors. The WKYs consistently choose withdrawal or avoidance in novel environments and freezing behaviors in response to a challenge in these tests. The physiological response to a stressful environment is exaggerated in WKYs. Selective breeding generated two WKY substrains that are nearly isogenic but show clear behavioral differences, including that of depression-like behavior. WKY and its substrains may share characteristics of subgroups of depressed individuals with social withdrawal, low energy, weight loss, sleep disturbances, and specific cognitive dysfunction. The genomes of the WKY and WKY substrains contain variations that impact the function of many genes identified in recent human genetic studies of depression. Thus, these strains of rats share characteristics of human depression at both phenotypic and genetic levels, making them a model of depression traits.

Clinical Utility of Fluid Biomarker in Depressive Disorder

Major depressive disorders are ranked as the single largest contributor to non-fatal health loss and biomarkers could largely improve our routine clinical activity by predicting disease course and guiding treatment. However there is still a dearth of valid biomarkers in the field of psychiatry. The initial assumption that a single biomarker can capture the myriad of complex processes proved to be naive. The purpose of this paper is to critically review the field and to illustrate the possible practical application for routine clinical care. Biomarkers derived from DNA analysis are the ones that have received the most attention. Other potential candidates include circulating transcription products, proteins, and inflammatory markers. DNA polygenic risk scores proved to be useful in other fields of medicine and preliminary results suggest that they could be useful both as risk and diagnostic biomarkers also in depression and for the choice of treatment. A number of other possible fluid biomarkers are currently under investigation for diagnosis, outcome prediction, staging, and stratification of interventions, however research is still needed before they can be used for routine clinical care. When available, clinicians may be able to receive a lab report with detailed information about disease risk, outcome prediction, and specific indications about preferred treatments.

Reduced Hippocampal and Anterior Cingulate Expression of Antioxidant Enzymes and Membrane Progesterone Receptors in Alzheimer's Disease with Depression

BACKGROUND

Major depressive disorder (MDD) is a risk factor for dementia including that caused by Alzheimer's disease (AD). Both MDD and AD have a higher prevalence in women than men, and estrogen-related processes have been implicated in this sex difference.

OBJECTIVE

To identify if enhanced oxidative stress and decreased expression of the memory enhancer insulin-like growth factor 2 (IGF2), each implicated separately in MDD and AD, are exaggerated in individuals with both AD and MDD compared to those with AD.

METHODS

Expression of target genes are determined by qPCR in postmortem hippocampus (Hip) and anterior cingulate cortex (ACC) of individuals with dementia and autopsy confirmed AD and those of AD+MDD.

RESULTS

Transcript levels of the antioxidant enzymes catalase (CAT) and superoxide dismutase 1 (SOD1), as well as IGF2 and its receptor (IGF2R) were significantly lower in the Hip and ACC of individuals with both AD and MDD compared to those with AD and no MDD. Expressions of Progestin and AdipoQ Receptor Family Member 7 (PAQR7, alias progesterone receptor alpha, mPRa) and PAQR8 (mPRβ), receptors that bind neurosteroids, were also lower in the Hip and ACC of AD+MDD samples compared to those of AD without MDD. Correlations among these transcripts revealed that estrogen receptor 2 (ESR2) and mPR β are direct or indirect regulators of the expression of the antioxidant enzymes and IGF2R.

CONCLUSION

Reduced levels of antioxidant enzymes, decreased IGF2 expression, and diminished estrogen or membrane progesterone receptor-dependent processes might be more pronounced in the subpopulation of individuals with AD and MDD than without MDD.

Genetic variation in satiety signaling and hypothalamic inflammation: merging fields for the study of obesity

Although obesity has been a longstanding health crisis, the genetic architecture of the disease remains poorly understood. Genome-wide association studies have identified many genomic loci associated with obesity, with genes being enriched in the brain, particularly in the hypothalamus. This points to the role of the central nervous system (CNS) in predisposition to obesity, and we emphasize here several key genes along the satiety signaling pathway involved in genetic susceptibility. Interest has also risen regarding the chronic, low-grade obesity-associated inflammation, with a growing concern toward inflammation in the hypothalamus as a precursor to obesity. Recent studies have found that genetic variation in inflammatory genes play a role in obesity susceptibility, and we highlight here several key genes. Despite the interest in the genetic variants of these pathways individually, there is a lack of research that investigates the relationship between the two. Understanding the interplay between genetic variation in obesity genes enriched in the CNS and inflammation genes will advance our understanding of obesity etiology and heterogeneity, improve genetic risk prediction analyses, and highlight new drug targets for the treatment of obesity. Additionally, this increased knowledge will assist in physician's ability to develop personalized nutrition and medication strategies for combating the obesity epidemic. Though it often seems to present universally, obesity is a highly individual disease, and there remains a need in the field to develop methods to treat at the individual level.

Circulating circular RNA profiles associated with celiac disease seropositivity in children with type 1 diabetes

INTRODUCTION

The frequency of celiac disease autoantibody (CDAb) positivity in type 1 diabetes (T1D) has increased due to unclear mechanisms, including autoimmune injury. Circular ribonucleic acids (circRNAs) participate in autoimmune diseases, but the roles of circRNAs in T1D with CDAbs are currently unknown. This study aimed to determine the frequency of CDAbs in Chinese children with T1D and describe the relationship between CDAbs and circRNAs.

MATERIALS AND METHODS

Eighty patients diagnosed with T1D were screened for CDAbs and CD-predisposing genes, and circRNAs in peripheral blood mononuclear cells (PBMCs) were collected from 47 patients. The Gene Expression Omnibus (GEO) database was searched for candidate circRNAs in related studies on T1D PBMCs. Data on clinical characteristics (i.e., blood glucose control, residual islet function, and daily insulin dosage) and immunophenotypes (i.e., islet autoantibodies and immune cell subsets) were collected.

RESULTS

In total, 35.0% of patients were positive for CDAbs. CD-predisposing genes accounted for 52.5% of the genes, and no significant difference in frequency was found between the CDAb-positive (CDAb⁺) and CDAb-negative (CDAb^-) groups. In addition, among the differentially expressed circRNAs from the GEO database, five highly conserved circRNAs homologous to humans and mice were screened, and only the expression of hsa_circ_0004564 in the CDAb⁺ group significantly decreased (CDAb⁺ vs. CDAb^-:1.72 ± 1.92 vs. 11.12 ± 8.59, p = 6.0 × 10^-6), while the expression of hsa_circ_0004564 was upregulated in the general T1D population. Moreover, its parental gene RAPH1 was significantly upregulated (CDAb⁺ vs. CDAb^-:1.26 ± 0.99 vs. 0.61 ± 0.46, p = 0.011). Importantly, the positive correlation between hsa_circ_0004564 and CD3⁺ cells was validated in children with T1D after adjustments for CDAbs (p = 0.029), while there were no correlations between hsa_circ_0004564 and clinical characteristics or other immune cell subsets (i.e., CD4⁺ T cells, CD8⁺ T cells, and natural killer cells).

CONCLUSION

This study highlights the importance of screening for CD in Chinese children with T1D, considering the high prevalence of CDAb positivity and CD-predisposing genes. The profile of candidate circRNAs in children with T1D with CDAbs was different from that in previous reports on general T1D patients from the GEO database. Moreover, hsa_circ_0004564 and its parental gene RAPH1 may be new targets for studying immune mechanisms in children with T1D and CD.

Immediate stress alters social and object interaction and recognition memory in nearly isogenic rat strains with differing stress reactivity

Stress prior to learning and recall is known to affect both processes depending on the learning paradigm, the sex of the animal, and their reactivity to stress. Male and female animals of the inbred Wistar-Kyoto More Immobile (WMI) and Less Immobile (WLI) strains were tested in the modified novel object and spatial recognition paradigm and in the social interaction-recognition paradigm immediately after a 30 min restraint stress. The WMI strain shows enhanced stress reactivity compared to its near isogenic WLI control and thus, represents a genetically stress-susceptible rodent model. Without stress, there were no strain differences in social or object recognition, but there were sex differences in both types of investigation. Immediate stress generally increased object investigation, but decreased social interaction in all groups, except the WMI males, who exhibited increased aggression toward the juveniles. While stress increased plasma corticosterone and decreased testosterone levels in WLI males as expected, it increased testosterone in the aggressive WMI males, despite elevated levels of corticosterone. Stress generally decreased recognition, except the spatial recognition of WMI females, which paradoxically improved after stress. The strain-specific effects of immediate stress indicate that stress unlocks the vulnerability encoded by the stable genetic differences between WLIs and WMIs to result in the observed phenotypes.

Whole genome sequencing of nearly isogenic WMI and WLI inbred rats identifies genes potentially involved in depression and stress reactivity

The WMI and WLI inbred rats were generated from the stress-prone, and not yet fully inbred, Wistar Kyoto (WKY) strain. These were selected using bi-directional selection for immobility in the forced swim test and were then sib-mated for over 38 generations. Despite the low level of genetic diversity among WKY progenitors, the WMI substrain is significantly more vulnerable to stress relative to the counter-selected WLI strain. Here we quantify numbers and classes of genomic sequence variants distinguishing these substrains with the long term goal of uncovering functional and behavioral polymorphism that modulate sensitivity to stress and depression-like phenotypes. DNA from WLI and WMI was sequenced using Illumina xTen, IonTorrent, and 10X Chromium linked-read platforms to obtain a combined coverage of ~ 100X for each strain. We identified 4,296 high quality homozygous SNPs and indels between the WMI and WLI. We detected high impact variants in genes previously implicated in depression (e.g. Gnat2), depression-like behavior (e.g. Prlr, Nlrp1a), other psychiatric disease (e.g. Pou6f2, Kdm5a, Reep3, Wdfy3), and responses to psychological stressors (e.g. Pigr). High coverage sequencing data confirm that the two substrains are nearly coisogenic. Nonetheless, the small number of sequence variants contributes to numerous well characterized differences including depression-like behavior, stress reactivity, and addiction related phenotypes. These selected substrains are an ideal resource for forward and reverse genetic studies using a reduced complexity cross.