Do Defective Immune System-Mediated Myelination Processes Increase Postpartum Psychosis Risk?

Trends Mol Med. 2018 Nov;24(11):942-949. doi: 10.1016/j.molmed.2018.09.002. Epub 2018 Oct 19.


Postpartum (or puerperal) psychosis (PP) is a rare, severe psychiatric disorder that affects women shortly after childbirth; risk is particularly high in individuals with a history of bipolar disorder or PP, but the underlying pathophysiology remains poorly understood. Emerging evidence suggests that immune system (dys)function plays an important role in disorder onset. On the basis of new findings from clinical and animal model studies, we hypothesise that the abundance and/or activity of regulatory T cells, and the efficacy of consequent (re)myelination processes in the brain mediated by CCN proteins, is perturbed in PP; this pathway may be modulated by risk and protective/treatment factors for the disorder, and identifying abnormalities within it could signpost novel predictive biomarkers and therapeutic targets.

Keywords: CCN3; bipolar disorder; mouse model; multiple sclerosis; oligodendrocyte; regulatory T cell.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Biomarkers
  • Disease Susceptibility
  • Humans
  • Immune System / immunology*
  • Immune System / metabolism*
  • Myelin Sheath / metabolism*
  • Nephroblastoma Overexpressed Protein / metabolism
  • Oligodendroglia / immunology
  • Oligodendroglia / metabolism
  • Phenotype
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / etiology*
  • Psychotic Disorders / metabolism*
  • Psychotic Disorders / psychology
  • Puerperal Disorders / diagnosis
  • Puerperal Disorders / etiology*
  • Puerperal Disorders / metabolism*
  • Puerperal Disorders / psychology
  • Symptom Assessment
  • T-Lymphocytes, Regulatory / immunology
  • T-Lymphocytes, Regulatory / metabolism


  • Biomarkers
  • Nephroblastoma Overexpressed Protein