Immune system aberrations in postpartum psychosis: An immunophenotyping study from a tertiary care neuropsychiatric hospital in India

•Increased activated CD8 T cells in postpartum psychosis reflects impaired T cell compartment in postpartum psychosis•Increased memory regulatory T cells do not appear to have a protective role in postpartum psychosis•Altered innate immune system with decrease in myeloid dendritic cells and non-classical monocytes in postpartum psychosis•Decreased cytotoxic NK and increased regulatory NK cells is suggestive of immune dysfunction in postpartum psychosis•Widespread immune system dysregulation is a hallmark of postpartum psychosis

Postpartum psychosis (PP) is associated with significant morbidity to both mother and infant. Immune system dysregulation during PP is reported in recent studies. This study attempted to determine immune signatures associated with first-onset PP by flow cytometry.Peripheral blood showed decreased naive CD4 and CD8 T cells, while activated CD8 and memory regulatory T cells (Tregs) were increased in women with PP as against healthy controls. The CD14− CD16+ non-classical monocytes, CD11c + myeloid DCs and cytotoxic CD56dimCD16+ were reduced, while CD56brtCD16+/− regulatory NK cells were elevated in women with PP. The variations in immune cell subsets highlight the generalized immune dysregulation in PP.

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