Tumour necrosis factor a and bipolar affective puerperal psychosis: PDF OnlyTumour necrosis factor α and bipolar affective puerperal psychosisMiddle, Fiona; Jones, Ian; Robertson, Emma; Lendon, Corinne; Craddock, NickAuthor Information Division of Neurosciences, Department of Psychiatry, University of Birmingham, Queen Elizabeth Psychiatric Hospital, Birmingham B15 2QZ, UK Correspondence to Professor N. Craddock, Division of Neurosciences, Department of Psychiatry, University of Birmingham, Queen Elizabeth Psychiatric Hospital, Birmingham B15 2QZ, UK. E-mail:[email protected] Received 8 January 2001; accepted 8 January 2001 Psychiatric Genetics: December 2000 - Volume 10 - Issue 4 - p 195-198 Buy Abstract The macrophage theory of depression proposes that an excessive secretion of monocyte / macrophage cytokines causes symptoms of depression. It has been suggested that changes in immune function that accompany pregnancy and childbirth could contribute to the affective symptoms suffered by many puerperal women. Tumour necrosis factor α (TNFα) is a pro-inflammatory cytokine that has been implicated in inflammatory infections and immune diseases. Production of TNFα has been shown to be regulated by oestrogen, which suggests it as a potential candidate for susceptibility to post-partum mood disorders. Several polymorphisms have been identified in the TNFα gene. The -308 promoter polymorphism has been associated with elevated production of TNFα and has been found to influence the neurological outcome of various infections. In a case-control association study, we have examined the frequency of this polymorphism in groups of parous DSM-IV Bipolar females with (N= 116) and without (N= 56) puerperal psychosis, and a female non-psychiatric comparison group (N= 72). We provided no support for the hypothesis that this polymorphism influences susceptibility to bipolar disorder, or acts as a trigger for puerperal psychosis. However, variation at other polymorphisms within TNFα or in other oestrogen-regulated genes involved in immune function remain interesting candidates for study in post-partum mood disorders. © 2000 Lippincott Williams & Wilkins, Inc.