Selective serotonin-reuptake inhibitors and persistent pulmonary hypertension of the newborn

Uppsala University Hospital, Uppsala, Uppsala, Sweden
New England Journal of Medicine (Impact Factor: 55.87). 06/2006; 354(20):2188-90; author reply 2188-90.
Source: PubMed


ABSTRACT Background Persistent pulmonary,hypertension of the newborn,(PPHN) is associated with sub- stantial infant mortality and morbidity. A previous cohort study suggested a pos- sible association between maternal use of the selective serotonin-reuptake inhibitor (SSRI) fluoxetine late in the third trimester of pregnancy and the risk of PPHN in the infant. Weperformed,a case–control study to assess whether PPHN is associated with exposure to SSRIs during late pregnancy. Methods

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    • "In contrast, PNEC/NEB are not only strategically located near peripheral resistance vessels but also exhibit serotonergic and O2 sensor phenotype [55] [79]. The potential link between PNEC/ NEB, 5-HT and PH has been strengthened by a recent finding of increased incidence of persistent pulmonary hypertension of the neonate (PPHN) in infants born to mothers taking selective serotonin reuptake inhibitors (SSRIs), particularly during the second half of pregnancy [114], when PNEC/NEB are most prominent [17] [18]. The principal action of SSRIs is an inhibition of 5-HT transporter (5-HTT), an integral membrane protein that is responsible for terminating the action of 5-HT released from serotonergic neurons. "
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    ABSTRACT: Pulmonary neuroendocrine cell (PNEC) system consists of solitary cells and innervated clusters, neuroepithe-lial bodies (NEB), widely distributed throughout the airway mucosa of mammalian lungs. These cells are numerous in fe-tal/neonatal lungs and produce amine (serotonin, 5-HT) as well as a variety of neuropeptides (e.g. bombesin). The poten-tial role and significance of these highly specialized lung cells in normal and diseased lung is only now beginning to be appreciated. The multifaceted role(s) of PNEC system include lung development, neonatal adaptation and during postnatal airway homeostasis as guardians of stem cell niche. Recent advances in cellular and molecular biology of PNEC system particularly their ontogeny and mechanisms of neuroendocrine differentiation in developing lung are reviewed. The evidence for the role of NEB as hypoxia-sensitive airway chemoreceptors is presented including identification and characterization of O2 sensor molecular complex that is activated by hypoxia leading to release of amine and peptide me-diators acting locally or via NEB neural connections. Thus NEB are postulated to function as O2 sensitive airway sensors involved in respiratory control, especially during adaptation to extrauterine life. Hyperplasia of PNEC/NEB cells, suggest-ing altered function, has been identified in a number of perinatal/pediatric lung disorders including bronchopulmonary dysplasia, central hypoventilation syndrome, Sudden Infant Death Syndrome and Neuroendocrine Hyperplasia of Infancy as well as Cystic Fibrosis and pediatric asthma. In the adults, PNEC/NEB may be involved in the pathogenesis of tobacco induced airway disease, pulmonary fibrosis and lung carcinogenesis.
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    ABSTRACT: The treatment of major depressive disorder during pregnancy is an important but complex clinical topic. Medications, electroconvulsive therapy, and psychotherapy are all reasonable choices, but each has its limitations. In this article, we propose that a novel device technology known as repetitive transcranial magnetic stimulation should be systematically studied as a potential treatment option for women with major depressive disorder during pregnancy.
    Current Psychiatry Reports 12/2009; 11(6):443-446. DOI:10.1007/s11920-009-0067-0 · 3.24 Impact Factor
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