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Brain, Behavior, and Immunity

○ Elsevier BV

Preprints posted in the last 30 days, ranked by how well they match Brain, Behavior, and Immunity's content profile, based on 116 papers previously published here. The average preprint has a 0.10% match score for this journal, so anything above that is already an above-average fit.

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Cx3cr1-BAC-CRE-mediated knockout of toll-like receptor 4 alters mouse communicative behaviors, microglial morphology, and engulfment of synaptic material

Bankowski, I. M.; Bishnoi, I. R.; Shin, E. E.; Cashin, M. J.; Möhrle, D.; Norris, H. A.; Barry, D. T.; Slamin, M. M.; Bordt, E. A.

2026-09-23 neuroscience 10.64898/2026.09.17.752150 medRxiv
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Microglia, the tissue resident immune cells of the central nervous system, are critical regulators of postnatal neural circuit refinement. Innate immune receptors on microglia such as toll-like receptor 4 (TLR4) are best characterized in the context of inflammation, however, endogenous TLR4 ligands are generated during typical developmental processes. Here, we investigated whether TLR4 signaling in CX3CR1-expressing myeloid cells contributes to microglial morphology, synaptic engulfment, and behavioral development in mice under basal conditions. TLR4 conditional knockout altered maternal separation-induced ultrasonic vocalizations without impacting social preference or anxiety-like behaviors. Conditional TLR4 knockout in CX3CR1-expressing myeloid cells markedly increased microglial ramification and cell volume within the paraventricular nucleus (PVN) of the hypothalamus. TLR4 conditional knockout also reduced microglial engulfment of vGlut2-positive presynaptic material, while overall excitatory synapse numbers remained unchanged. Together, these findings demonstrate that TLR4 signaling in CX3CR1-expressing myeloid cells contributes to microglial morphology, presynaptic engulfment, and neonatal communicative behavior under basal conditions.

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Early-life adversity alters the adult blood proteome primarily in female mice

Garvin, M. M.; Kim, A. R.; Bolton, J. L.; Liang, Y.

2026-10-04 immunology 10.64898/2026.09.28.755115 medRxiv
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Background: Early-life adversity (ELA) is one of the strongest predictors of poor mental and physical health later in life, increasing an individual's risk for disorders ranging from depression to metabolic syndrome. However, whether and how ELA shapes immune memory through adulthood, subsequently affecting susceptibility to immune-associated diseases such as autoimmunity, remains elusive. Methods: To address this question, we employed a translationally and ethologically relevant mouse model of resource deprivation, the limited bedding and nesting model, to study the long-term effects of ELA on the immune system. ELA was induced by limited bedding and nesting material in the cage during postnatal days (P)2-9, which provokes fragmented and unpredictable maternal behavior in the dams, and results in chronic stress in the pups. Nucleic acid Linked ImmunoSandwich Assay (NULISA) was used to survey the proteome of adult (~P90) mice of both sexes that experienced ELA vs. control conditions. Results: Using a novel proteomic method, we detected significant upregulation in the levels of IL-17A in the adult blood, primarily in females. Within females, ELA also upregulated IL-13 and CCL3. Three proteins, HGF, PDGFA, and WNT16, were significantly downregulated in ELA mice of both sexes. Conclusions: Being a hallmark proinflammatory cytokine, IL-17A is found to increase in patients with systemic lupus erythematosus (SLE), as well as in animals with lupus-like diseases in virtually all reports. Importantly, autoimmune diseases like SLE have a higher prevalence in women than men, and our data support this sex bias. Together, our data suggest that ELA shapes long-term immune function in a way that may increase risk for autoimmune diseases, with promise for the development of more targeted and personalized therapies for autoimmunity.

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Dysfunctional Sleep Beliefs and Attitudes in Major Depressive Disorder: Dimensional Associations with Clinical Phenotypes and Gut-Neuroimmune-Metabolic-Oxidative Pathways

Wang, M.; Niu, M.; Luo, X.; Chen, X.; Liu, H.; Chen, T.; Almulla, A. F.; Zhang, Y.; Li, J.; Maes, M.

2026-10-20 psychiatry and clinical psychology 10.64898/2026.10.18.26365736 medRxiv
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Abstract Background: Insomnia is highly prevalent in major depressive disorder (MDD), yet the clinical and biological significance of dysfunctional beliefs and attitudes about sleep (DBAS) in MDD remains poorly understood. We examined whether distinct DBAS dimensions are associated with insomnia severity, depressive phenotypes, and neuroimmune-metabolic-oxidative (NIMETOX) biomarkers. Methods: DBAS-30 dimensions, clinical phenotypes, and NIMETOX biomarkers were assessed in 87 hospitalized patients with MDD and 31 healthy controls. Principal component analysis (PCA) was used to ascertain DBAS cognitive dimensions, and associations were examined using multivariable analyses. Results: Compared with controls, MDD patients showed lower scores on "perceived consequences of insomnia," "sleep-related worry and helplessness," and "medication-related beliefs," but higher "causal attributions to aging or biochemical imbalance" scores. A composite DBAS score reflecting these 4 MDD-associated cognitive dimensions was constructed, labeled DBAS dimensional index (DBAS-DI). This score was lower in MDD and inversely associated with Insomnia Severity Index (ISI) scores, overall MDD severity, physiosomatic symptoms, current suicidal ideation, and recurrence of illness. DBAS-DI and the expectations domain jointly explained 35.4% of the variance in ISI scores, with inverse and positive associations, respectively. The DBAS-DI score was inversely associated with indices of the acute-phase inflammatory response, oxidative stress, fecal branched-chain short-chain fatty acids (SCFAs) and positively associated with serum antioxidant capacity and protective SCFAs, such as acetate, propionate, and butyrate. Conclusions: DBAS abnormalities in MDD extend beyond insomnia-related cognitions and are associated with illness severity, suicidality, recurrence, and NIMETOX alterations. These findings suggest that dysfunctional sleep-related cognitions are embedded within broader immune-oxidative and gut microbial-metabolic processes that may contribute to the insomnia-depression interface.

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Attenuated GlycoRNA-microglial transcriptional coupling in the dorsolateral prefrontal cortex of patients with major depressive disorder: an exploratory interaction-based in-silico analysis

Xu, R.; Zhang, Y.; Maes, M.

2026-10-15 psychiatry and clinical psychology 10.64898/2026.10.12.26365369 medRxiv
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Abstract Background: Glycosylated RNAs (GlycoRNAs) participate in immune recognition and intercellular communication, but their relationship with brain cell-type transcriptional signatures in major depressive disorder (MDD) remains unclear. We examined GlycoRNA-related transcriptional coupling with microglial and other cellular signatures in the dorsolateral prefrontal cortex (DLPFC). Method: Postmortem DLPFC transcriptomic data from 22 controls and 26 MDD patients (GSE102556) were analyzed. GlycoRNA-related pathway enrichment was quantified using gene set variation analysis (GSVA), whereas microglial, neuronal, astrocytic, and oligodendrocytic signatures were derived using single-sample gene set enrichment analysis (ssGSEA). Pearson correlations, linear regression, and generalized estimating equations (GEE) evaluated cell-type-specific associations and diagnostic interactions. Exploratory GEE results underwent false discovery rate (FDR) correction. Results: No differentially expressed genes survived FDR correction, and GlycoRNA-related and cell-type signatures did not differ significantly between groups. In controls, GlycoRNA enrichment was positively associated with the microglial signature (beta = 0.447, FDR-adjusted P = 0.006), with significantly weaker associations for neurons, astrocytes, and oligodendrocytes (all FDR-adjusted P < 0.05). The two-way GlycoRNA x is_microglia interaction was nominally significant (beta = 0.210, P = 0.048), confirming that GlycoRNA transcriptional coupling is substantially stronger for microglia than for the other three cell types combined. The microglial association was numerically attenuated in MDD (beta difference = -0.273, P = 0.167), but diagnostic interactions were nonsignificant. Conclusions: GlycoRNA pathway transcriptional enrichment exhibits preferential microglial association in control DLPFC. Its possible attenuation in MDD remains to be validated. keyword: Major depressive disorder; GlycoRNA; microglia; dorsolateral prefrontal cortex; generalized estimating equation; ssGSEA; bioinformatics

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The Gut Microbiome-Amino Acid Pathway to Emotional Lability: A Multi-Step Mendelian Randomization Study

Chen, Z.; Jiang, T.; yang, Y.; wang, r.; li, h.

2026-10-08 epidemiology 10.64898/2026.10.06.26364911 medRxiv
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Emotional lability (EL) is a prevalent cross-diagnostic symptom with unclear etiology. Given the potential role of the gut-brain axis in linking gut microbiota to EL, we adopted a multi-step Mendelian randomization (MR) framework to investigate the causal effects of gut microbiota on EL and the mediating role of blood metabolites. Bidirectional two-sample MR was first implemented to determine the causal relationship and direction between gut microbiota and EL, followed by multivariable MR (MVMR) to assess the direct contributions of individual microbial taxa. We then applied a multistep MR approach to identify gut microbiota specifically associated with EL-related psychopathology. Finally, the mediation effects of blood metabolites were quantified via the coefficient of variation method, and pathway analysis was conducted to verify the biological plausibility of the enriched metabolic pathways. Bidirectional MR detected 16 gut microbiota species associated with EL risk. MVMR identified three causally associated bacteria: RUG013 sp001486445 exerted the strongest positive effect (odds ratio [OR] = 1.500, 95\% confidence interval [CI]: 1.029-2.187, P = 0.034), followed by CAG-485 sp002362485 (OR = 1.398, 95\% CI: 1.118-1.749, P = 0.003). Each standard deviation (SD) increment in CAG-485 sp002362485 was linked to a 39.8\% higher risk of EL. This bacterium was specific to EL and correlated with glycine/serine/threonine metabolites. Reverse MR analyses ruled out reverse causality .

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T-cell dysregulation is implicated in the encephalopathy of prematurity

Smikle-Bernard, R.; Blesa Cabez, M.; Vaher, K.; Amir, R.; Mckinnon, K.; Murphy, L.; Thrippleton, M. J.; Quigley, A. J.; Bastin, M. E.; Reynolds, R. M.; Whalley, H. C.; Marioni, R. E.; Cox, S. R.; Boardman, J. P.

2026-10-16 neurology 10.64898/2026.10.15.26365621 medRxiv
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Preterm birth is strongly linked to systemic inflammation and encephalopathy of prematurity, which underlies subsequent cognitive impairment. T-cell immunity contributes to brain-immune crosstalk across the life course but its role in the pathogenesis of encephalopathy of prematurity is unknown. Protein epigenetic scores are DNA methylation (DNAm)-based proxies of circulating proteins. We tested the hypothesis that T-cell dysregulation has a specific role in child neurodevelopment following preterm birth. Multimodal data were collected from 144 preterm infants (median gestational age at birth 29+5 weeks [range 23+3 to 32+6]) recruited to a prospective cohort study: saliva DNAm for protein epigenetic score derivation and brain MRI, both at term-equivalent age, and the Mullen Scales of Early Learning Composite score at 5 years from a subset. We investigated associations of the epigenetic scores for cytotoxic and regulatory T cell-associated molecule (DNAm CRTAM) and C-reactive protein (DNAm CRP; a non-specific marker of inflammation) with MRI metrics of encephalopathy of prematurity: global and regional brain volumes, and general factors of diffusion tensor imaging and neurite orientation dispersion and density imaging metrics averaged across 42 white matter tracts. We tested whether DNAm CRTAM explains more variance than DNAm CRP in MRI metrics of the encephalopathy of prematurity and cognitive scores in childhood. Higher neonatal DNAm CRTAM was associated with lower general factor of fractional anisotropy ({beta} = -0.252, q = 0.011) and higher general factors of radial diffusivity ({beta} = 0.215, q = 0.039), mean diffusivity ({beta} = 0.198, q = 0.047) and orientation dispersion index ({beta} = 0.201, q = 0.048), independent of inflammatory morbidities and other biological covariates after false discovery rate correction. DNAm CRTAM explained more variance than DNAm CRP (maximum incremental R2 = 4.2% vs 1.5%) in diffusion MRI metrics. Higher neonatal DNAm CRTAM was associated with lower cognitive scores at 5 years, independent of DNAm CRP and other covariates ({beta} = -0.332, P = 0.008), and explained more variance in cognitive scores than DNAm CRP (incremental R2 = 9.4% vs 1.2%). An epigenetic proxy of CRTAM in preterm infants is associated with both encephalopathy of prematurity in the neonatal period and lower cognitive performance at 5 years, explaining greater incremental variance than a non-specific marker of inflammation. The data implicate T-cell dysregulation in the pathophysiology of atypical neurodevelopment following preterm birth.

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From Gut to Brain: A Longitudinal Assessment of Intestinal Permeability and Immune Activation Markers in Early-Stage Schizophrenia Spectrum Disorders

Jakob, L.; Mahayri, T. M.; Koutrouli, I. R. A.; Kekrtova, K.; Novakova, D.; Totkova, T.; Spaniel, F.

2026-10-19 psychiatry and clinical psychology 10.64898/2026.10.16.26364494 medRxiv
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Schizophrenia spectrum disorders (SSD) have been linked to immune dysregulation and altered intestinal barrier function, although findings across studies remain inconsistent. The present study investigated circulating markers of intestinal permeability and immune activation in individuals with early-stage SSD and healthy controls and examined their associations with clinical outcomes. Serum concentrations of intestinal fatty acid-binding protein (iFABP), zonulin, soluble CD14 (sCD14), bactericidal/permeability-increasing protein (BPI), and lipopolysaccharide-binding protein (LBP) were measured in 36 patients with SSD at baseline and one-year follow-up and in 36 matched healthy controls. Linear mixed-effects models adjusted for age, sex, and body mass index (BMI) were used to evaluate group differences and longitudinal changes. No biomarker differences between patients and controls, and no longitudinal changes within patients, remained statistically significant after correction for multiple testing. Similarly, biomarker concentrations were not associated with symptom severity, global functioning, or neutrophil-to-lymphocyte ratio (NLR). Exploratory analyses identified a robust positive association between BMI and zonulin concentrations and additional associations among iFABP, LBP, and sCD14. Exploratory mixed-effects models identified a negative non-significant association between iFABP and sCD14 after adjustment for age, sex, and BMI. Overall, the findings do not support a generalized alteration of gut permeability or immune activation markers in SSD. Instead, they suggest that variation in gut-related biomarkers may be more strongly influenced by metabolic and individual factors than by diagnosis or current symptom severity.

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Preconceptional social isolation alters inflammatory and transcriptional signalling across the placenta-fetal brain axis

Iachizzi, M.; Rodriguez, J. R.; Herrero, F.; Schär, R.; Cattaneo, A.; Richetto, J.

2026-10-08 neuroscience 10.64898/2026.10.01.755920 medRxiv
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Maternal depression and psychosocial adversity during pregnancy are associated with altered offspring neurodevelopment, yet the molecular processes linking maternal state to the developing fetus remain incompletely understood. The placenta is positioned to sense and respond to maternal physiological signals, but how placental molecular responses relate to those in the developing brain is unclear. Here, we used a mouse model of prolonged social isolation initiated before conception and maintained throughout pregnancy to investigate inflammatory and transcriptional alterations across matched placenta and fetal-brain samples at gestational day 18. Maternal social isolation altered cytokine profiles in both tissues and induced extensive transcriptional changes in the placenta, with a more restricted response in the fetal brain. Functional analyses identified alterations in placental immune, metabolic and transport-related programmes and fetal-brain immune, neuronal and proliferative processes. Although sex-stratified analyses revealed different transcriptional profiles in male and female tissues, formal maternal housing x fetal-sex interaction testing did not identify significant gene-level interaction effects. Cross-tissue co-expression analysis initially identified extensive covariation between social-isolation-responsive placental and fetal-brain modules; however, most associations were attenuated after accounting for their shared relationship with maternal housing. An exposure-independent network analysis nevertheless identified an inverse pregnancy-level association between a placental module enriched for immune and interferon-related signalling and a fetal-brain module enriched for cell-cycle and proliferative processes. Together, these findings show that prolonged maternal social adversity is associated with coordinated but tissue-distinct molecular alterations across the placenta-fetal brain axis and demonstrate the importance of distinguishing parallel responses to a common maternal environment from direct cross-tissue molecular coupling.

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Persistent gut microbiota alterations after ischemic stroke are modifiable by probiotic intervention

Melton, P.; Sorbie, A.; Aho, V. T. E.; Haslinger, C.; Zimmermann, M.; Marut, W.; Jaeger, C.; Wilmes, P.; Benakis, C.; Liesz, A.

2026-10-20 neurology 10.64898/2026.10.15.26365107 medRxiv
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The gut-brain axis has emerged as a critical modulator in neurological diseases, including stroke. While acute post-stroke dysbiosis is well established, it remains unclear whether these alterations persist long-term and can be therapeutically modulated. This study addresses this gap through integrated metagenomic and metabolomic profiling in two independent clinical stroke cohorts, complemented by experimental models. Experimental stroke induced persistent changes in gut microbiota composition and altered short-chain fatty acid profiles. In patients, microbiota composition remained distinct from controls up to three months after ischemic stroke or transient ischemic attack (TIA), accompanied by persistent reductions in propionic and valeric acid and reduced abundance of Prevotella-associated microbial signatures. We performed a randomized, double-blind interventional trial (PRISE) testing a multispecies probiotic versus placebo, using household members as additional controls. Probiotic intervention led to microbiome compositional changes with increased abundance of beneficial taxa and significantly improved functional recovery. The tested probiotic strains showed anti-inflammatory and antioxidant effects in vitro. These findings suggest that targeted modulation of the microbiome represents a promising therapeutic avenue to improve chronic stroke recovery, warranting validation in larger Phase III clinical trials.

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Spinal microglia are dispensable for the development of opioid-induced hyperalgesia

Nickols, J. E. R.; Wilson, T.; Lee, K. V.; Clark, J. M.; Wass, A. C.; Baaklini, C. S.; Faig, C. A.; Ho, M. F. S.; Souter, K. M.; Szulc, B.; Traetta, M. E.; Plemel, J. R.; Taylor, A. M. W.

2026-09-30 neuroscience 10.64898/2026.09.24.753592 medRxiv
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Adverse side effects of chronic opioid use, including analgesic tolerance, opioid-induced hyperalgesia, and addiction, are serious clinical challenges for pain management and opioid deprescribing. Microglia have been implicated in the development of these adverse effects, but the extent to which opioids alter microglia and the mechanisms behind opioid effects on microglia are poorly understood. We performed morphological and single-cell transcriptomic analysis on spinal microglia from opioid-withdrawn and saline-treated mice, and found that while morphological changes recapitulated prior reports, transcriptomic changes in these cells were modest. Furthermore, peripherally, but not centrally, restricted opioid administration was sufficient to induce both hyperalgesia and microglial morphological changes in mice. Finally, complete loss of microglia in Csf1r{Delta}{Delta}FIRE mice did not prevent the development of opioid-induced hyperalgesia, analgesic tolerance, and somatic withdrawal symptoms. These data argue against any microglial involvement in the development of these phenomena.

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Milk-derived extracellular vesicles are functional mediators of postnatal neuroimmune rescue

De Albuquerque Silva Braga, G.; Pando, P.; Hazzard, H.; Vuong, H.; Le, T. T. Q.; Ates, Y.; Gumusoglu, S. B.; Kentner, A. C.

2026-10-11 neuroscience 10.64898/2026.10.03.756449 medRxiv
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Early parental experiences can be translated into biological signals that are transmitted to offspring. These signals influence developmental trajectories to both increase offspring vulnerability following adverse experiences or promote resilience when environments are supported and enriched. Among the potential routes of parental-offspring communication, milk-derived extracellular vesicles (EVs) transferred through nursing are particularly interesting because they carry bioactive molecular cargos capable of influencing recipient cells. Previously, we found that milk-derived EV cargo is remodeled by both adverse and positive experiences and that environmental enrichment (EE) can rescue adversity-associated effects, including EV-miRNA cargo changes. Environmental programming of EVs during lactation may therefore have functional consequences on offspring development and adaptability. Here, we tested whether milk-derived EVs from our rat EE model are sufficient to rescue offspring outcomes following maternal immune activation (MIA). Milk-derived EVs isolated from donor EE dams were administered directly to MIA-exposed pups, mitigating MIA-associated reductions in social behavior. EE-EV administration also promoted social behavior in non-MIA exposed male offspring. To investigate microglia as a cellular target, EE-EVs were administered to LPS-activated BV2 microglial cells. EE-EV exposure attenuated LPS-associated transcriptional alterations across inflammatory pathways, including cytokine, chemokine, and NF-B signaling, while modulating genes associated with cellular homeostasis and metabolic responses. Together, these results 1) support milk-derived EVs as a biologically active interface through which environmental experience may be communicated to offspring, and 2) identify microglial transcriptional responses as a potential cellular pathway underlying these effects.

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Postnatal maternal separation alters caregiving patterns but fails to promote anxiety- and depressive-like behaviour in C57BL/6N mouse dams

Mordvinova, V.; Trowsse, T.; Audet, M.-C.

2026-09-25 animal behavior and cognition 10.64898/2026.09.22.753354 medRxiv
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Stressors experienced during the postnatal period may increase vulnerability to mental health disorders, including postpartum depression and anxiety. In rodents, maternal separation (MS) has been shown to alter behaviours in dams, but these observations have been made almost exclusively in rats and thus robust mouse models of postpartum mental health disorders using this stressor remain limited. Here we first examined, in mice, the effects of MS on maternal caregiving and on anxiety- and depressive-like behaviours. As stress-induced inflammatory activation in the gut-brain axis has been associated with behavioural alterations in non-postpartum contexts, changes in pro-inflammatory cytokines and tight junction proteins in the brain and intestinal tract were also examined. Female C57BL/6N mice were assigned to a No Separation (NS) or a MS condition that consisted of 3-hour daily separation sessions from postnatal days (P) 2 to 14. Maternal care behaviours were assessed on P3 and P7, followed by anxiety- and depressive-like behaviours on P22 and P23, and the collection of the medial prefrontal cortex (mPFC) and colon on P24 to determine the expression of selected genes. Caregiving patterns in MS dams fluctuated throughout the early postnatal period. Although behaviours and gene expression outcomes remained unchanged by MS, grooming time in the splash test was correlated with the expression of different genes in the mPFC. These findings suggest that C57BL/6 mouse dams may be less sensitive to the actions of MS on behaviour and on brain and intestinal markers of inflammation and barrier permeability, at least when examined shortly after weaning.

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Methadone Triggers Fetal Membrane Sterile Inflammation Through Innate Immune and Opioid Receptor Signaling

Kelleher, M. E.; Georges, H. M.; Salmeron, L. C.; Logan, R.; Yonkers, K.; Abrahams, V. M.

2026-10-01 immunology 10.64898/2026.09.25.754438 medRxiv
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Introduction: Preterm birth is often associated with fetal membrane (FM) inflammation. Opioid-use disorder during pregnancy is a major public health issue as all opioids carry a risk for preterm birth. While maintenance therapy with methadone improves maternal outcomes, it also elevates the risk of preterm birth. We previously reported that the opioid, buprenorphine, induced human FM sterile inflammation. The goal of this study was to investigate if methadone also induced FM inflammation and to determine the mechanisms involved. Methods: Human FM explants were treated with or without methadone in the presence or absence of inhibitors to TLR4/MD2, TLR7, TLR8, NLRP3, the -opioid receptor, p65 NF{kappa}B, p38 MAPK, ERK or JNK. Supernatants were measured for cytokines/chemokines by ELISA. Tissues were analyzed by Western blot for NF{kappa}B and MAPK activity, and by RT-qPCR for the TLR7/8-activating miRs: miR-21a, miR-29a, miR-146a-3p, Let-7b. Pregnant C57BL/6 mice were injected with PBS or methadone on E15.5 and 6hrs later FMs were analyzed by RT-qPCR. Results: Methadone elevated human FM explant secretion of IL-1{beta}, TNF, MIP-1, GM-CSF, and PGE2, and expression of miR-21a. In vivo, methadone elevated mouse FM expression of MIP1A, KC, and COX2. TLR4/MD2 inhibition had no effect on human FM inflammation in response to methadone. NLRP3 inhibition reduced methadone-induced FM IL-1{beta}, TLR7 inhibition reduced methadone-induced FM TNF, and inhibition of either TLR8 or the -opioid receptor reduced methadone-induced secretion of TNF, MIP-1, GM-CSF, and PGE2, but not IL-1{beta} Methadone increased human FM activity of p65 NF{kappa}B, p38 MAPK, JNK, and ERK and inhibition of these signaling pathways collectively reduced methadone-triggered FM inflammation. Finally, naloxone reduced most of the methadone-induced FM inflammatory response. Conclusion: Methadone induces sterile inflammation in human and mouse FMs. In human FMs this inflammation is mediated through activation of innate immune TLR7, TLR8, and NLRP3; the -opioid receptor; and NF{kappa}B/MAPK signaling. These findings provide further insight into the mechanisms underlying the association between opioid use during pregnancy and preterm birth.

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Late-pregnancy immune and kynurenine signatures predict postpartum depression and brain morphology

Harrington, Y. A.; Shin, H. K.; Milano, C.; Mauri, M. C.; Marano, A.; Maggioni, E.; Squarcina, L.; Tassi, E.; Enrico, P.; Persico, N.; Conte, G.; Melloni, E. M. T.; Agnoletto, E.; Spadini, S.; Lorenzi, C.; Nasini, S.; DallAcqua, S.; Comai, S.; Poletti, S.; Origoni, M.; Brambilla, P.; Benedetti, F.; Milano PPDINFLAME Study Group,

2026-10-06 psychiatry and clinical psychology 10.64898/2026.10.02.26364495 medRxiv
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Background: Pregnancy involves profound immune adaptations that may contribute to the development of postpartum depression (PPD); however, the relevant biomarkers and critical time window remain unclear. Therefore, we investigated whether third-trimester and postpartum cytokines and kynurenine pathway (KP) metabolites predict PPD and whether these biological signatures are related to postpartum brain morphology. Methods: Circulating cytokines and KP metabolites were assessed in 140 pregnant women during the third trimester and postpartum. Partial least squares (PLS) regression models were used to identify multivariate biological profiles predictive of PPD, followed by classification and regression tree (CART) analyses to evaluate predictive performance. In a neuroimaging subsample (n=61), voxel-based morphometry examined associations among PPD status, significant PLS-derived components, selected individual biomarkers, and postpartum grey matter volume. Results: A third-trimester cytokine signature including 21 cytokines significantly predicted PPD with high specificity. A third-trimester KP profile, driven primarily by the kynurenic acid/quinolinic acid ratio, also predicted PPD, and the combination of cytokine and KP components improved overall predictive performance to 93.3%. Postpartum biomarkers showed substantially weaker associations with PPD. The cytokine component was differentially associated with postpartum grey matter volume according to PPD status, with opposite associations observed in occipital regions between women who did and did not develop PPD. KP measures also showed distinct associations within sensorimotor regions based on PPD status Conclusions: Late pregnancy immune-inflammatory alterations are associated with subsequent PPD and postpartum brain morphology, supporting the potential utility of pregnancy-derived biological signatures for identifying women at increased risk for PPD.

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Comparative Meta-Analysis of the Gut Microbiome Between ADHD and Healthy Human Cohorts

Chauhan, A.; Singh, S.; Bokey, A.; Pathak, A.

2026-10-01 psychiatry and clinical psychology 10.64898/2026.09.29.26364326 medRxiv
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Attention deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition characterized by inattention, impulsivity, and hyperactivity, and is believed to involve altered dopamine signaling. Growing evidence suggests that the gut microbiome may contribute to neurobehavioral conditions, including ADHD. In this study, we examined differences in gut microbiome composition, measured using metagenomics, between healthy and ADHD-affected individuals, and evaluated age- and gender-related variation within the ADHD population. We analyzed publicly available gut microbiome datasets from the American Gut Project, NCBI, and MGnify, and retrieved data from 496 ADHD and 419 healthy individuals. Further, metadata and taxonomic abundance were processed using RStudio, normalized to sequencing depth, and analyzed at the genus level. Both groups shared several gut bacteria, including Blautia, Bacteroides, Faecalibacterium, Roseburia, and Alistipes, indicating a broadly similar core microbiome. However, individuals with ADHD showed differences in the stability and persistence of certain core taxa, such as Proteobacteria and the unclassified genus Prevotellaceae, which were uniquely present in the ADHD group. Further, PERMANOVA showed that age and gender explained a small yet significant difference in microbial variation (Rsquare = 0.0437, p = 0.001), with greater variability observed between males and females than across age groups. Dispersion analysis revealed significant microbial variability between males and females (p = 0.001), whereas age groups showed no significant variation (p = 0.792). Overall, these results suggest that differences in the gut microbiome between individuals with ADHD and healthy individuals are subtle. Clinically, this highlights the need to consider broader biological, environmental, and lifestyle influences- such as diet, medication use, and comorbidities- when evaluating the potential role of the gut microbiomes in ADHD.

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The Th17/IL-17 Axis and Systemic Inflammatory Biomarkers in Sepsis-Associated Encephalopathy and Delirium: A Systematic Review and Meta-Analysis

Chaves Filho, A. M.; Nascimento, E. F.; Goncalves, L. D. C.; Dias Filho, F. J.; Oliveira, T. Q.; Macedo, D. S.; Dal-Pizzol, F.; de Moraes, M. E. A.; Barichello, T.

2026-10-21 intensive care and critical care medicine 10.64898/2026.10.16.26365073 medRxiv
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OBJECTIVE: Sepsis-associated encephalopathy (SAE) and sepsis-associated delirium (SAD) lack confirmatory laboratory tests or biomarkers. We evaluated whether the Th17/interleukin (IL)-17 axis or neuroglial-injury biomarkers reflect acute brain dysfunction beyond systemic inflammation and whether biomarker profiles differ between these phenotypes. DATA SOURCES: EMBASE, MEDLINE/PubMed, and the Cochrane Library from inception to August 1, 2026, supplemented by backward and forward citation searching, following PRISMA 2020. STUDY SELECTION: Observational studies of adults with sepsis classified by SAE or SAD status and reporting circulating biomarker concentrations by neurological group or biomarker-outcome associations. Eighteen studies (2,388 participants; 1,863 with sepsis) were included. DATA EXTRACTION: Two reviewers independently extracted study, phenotype, assay, and outcome data. Risk of bias was assessed with the Newcastle-Ottawa Scale and certainty with GRADE. DATA SYNTHESIS: Random-effects models pooled standardized mean differences (SMDs) separately against non-septic and septic controls and odds ratios (ORs) for biomarker-outcome associations. IL-6 was the only mediator elevated in both comparative frameworks and associated with outcomes (non-septic controls: SMD, 0.54 [0.25-0.82]; septic controls: SMD, 1.05 [0.51-1.59]; OR, 1.85 [1.50-2.29]). S100B, neuron-specific enolase, IL-10, tumor necrosis factor; and interferon-gamma; were elevated versus septic controls, whereas IL-17 was modestly elevated only versus non-septic controls (SMD, 0.37 [0.01-0.73]). The IL-6 septic-control effect was concentrated in SAE (p<0.0001) and remained robust in leave-one-out and risk-of-bias sensitivity analyses. Certainty was low to very low, and all 14 computable prediction intervals included the null. CONCLUSIONS: IL-6 emerges as the leading circulating candidate biomarker of sepsis-associated brain dysfunction, while S100B and NSE capture neuroglial injury beyond sepsis. Current evidence does not establish a discriminating role for the Th17 axis. Future studies require standardized neurological phenotyping and appropriately matched septic controls to establish diagnostic value.

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Exacerbation of neurodegeneration by a metabolically engineered bacterium in a mouse model of tauopathy

Self, W. K.; Sharma, P.; Gent, G.; Bosch, M. E.; Zhu, Y.; Powell, N.; Agca, C.; Ulrich, J. D.; Song, J.; de Figueiredo, P.; Holtzman, D. M.

2026-10-08 neuroscience 10.64898/2026.09.28.755025 medRxiv
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BackgroundTherapeutics that modulate peripheral and central immune responses are emerging as promising approaches for neurodegenerative disease. However, the biological context in which these interventions are deployed may critically influence therapeutic outcomes. An attenuated Brucella melitensis 16M strain and a similar strain engineered to express the metabolite indole have previously demonstrated therapeutic efficacy in preclinical models of cancer and autoimmunity through immune system modulation. Here, we tested whether repeated administration of these bacterial strains could modify pathological outcomes in a mouse model of tauopathy. MethodsAttenuated Brucella strains were administered to transgenic mice overexpressing mutant tau protein on a human APOE4 knock-in background via intraperitoneal injection every 5 weeks starting at 6 months of age. Mice were analyzed at 9.5 months of age for tau pathology, neurodegeneration, and changes in innate and adaptive immune responses. ResultsBrucella strains distributed predominantly in the periphery following repeated intraperitoneal treatment in transgenic mice, with minimal detection in the brain and no detection in the dural meninges. Repeated administration of either bacterial strain was well tolerated, with no evidence of adverse safety events. Surprisingly, repeated treatment with the engineered Brucella strain exacerbated neurodegenerative pathology, resulting in reduced hippocampal volume and increased phosphorylated tau pathology compared with control- and non-engineered Brucella strain -treated animals. Immunohistochemical analyses revealed increased numbers of hippocampal CD4+ T cells following treatment with either Brucella strain relative to PBS controls. However, only treatment with the engineered Brucella increased microglial reactivity within the hippocampus. ConclusionThese findings demonstrate that peripheral administration of an engineered bacterial therapeutic can differentially influence neuroimmune responses and disease progression. These results underscore the importance of disease context when developing bacteria-based immunomodulatory therapies for neurodegenerative disorders.

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Reduced Systemic Homeostatic and Endothelial Protective Capacity in Adolescent Major Depression: Associations with Early-Life Adversity and Clinical Phenotypes

Almulla, A. F.; Wang, P.; Mao, H.; Zhang, Y.; Li, J.; Chen, J.; Huang, Y.; Zhang, Y.; Maes, M.

2026-10-13 psychiatry and clinical psychology 10.64898/2026.10.11.26365268 medRxiv
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Background: Major depressive disorder (MDD) is a heterogeneous condition characterized by neuro-immune-metabolic-oxidative stress (NIMETOX) pathways. A systems-biology approach may help elucidate how these interconnected NIMETOX disturbances relate to early-life adversity and multidimensional clinical phenomes in adolescent MDD. Objectives: This study aimed to define the peripheral metabolic, vascular, and acute-phase, oxidative, and lipid biomarker profiles of adolescent MDD and to investigate associations with ACEs and clinical phenotypes. Methods: This cross-sectional study recruited 80 adolescents with MDD and 53 matched healthy controls and assessed C-peptide and insulin, vascular tone markers, the acute-phase inflammatory axis, oxidative stress, and lipid profiles. Results: MDD adolescents exhibited significant reductions in C-peptide, NO, ApoE, ApoA1, HDL-C, albumin, and transferrin, together with increased ApoB/ApoA1 ratio. These biomarkers correlated significantly with family dysfunction, childhood trauma, bullying exposure, and maladaptive parenting. These biomarkers and stressors accounted for 46.2% to 61.2% of the variance in psychological resilience, and major affective, physiosomatic, self-injurious, suicidal, and self-regulation phenomes. ACEs and bullying exposure, together with relevant socio-demographic data, explained 10.5% to 28.4% of the variance in selected metabolic, vascular, and acute-phase biomarkers. Multivariable classification models showed adequate discrimination between MDD and healthy controls, achieving up to 88.5% classification accuracy and an AUC of 0.948. Conclusion: Adolescent MDD is characterized by coordinated reductions in negative acute-phase proteins, metabolic and lipoprotein protective factors, and endothelial NO, without overt CRP-defined inflammation or conventional dyslipidemia. These findings support a systems-biology model of impaired peripheral homeostatic protection associated with developmental adversity and multidimensional depressive phenomes.

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Microglia sculpt dopamine receptor-mediated adolescent behaviors in a social experience dependent manner

Clark, M.; Gershowitz, E.; Devlin, B.; Amin, R.; Dziabis, J.; Staley, H.; Shamberger, O.; Kellam, J.; Bilbo, S.

2026-09-30 neuroscience 10.64898/2026.09.29.755379 medRxiv
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Adverse childhood experiences like social isolation (SI) contribute to long term negative health outcomes and the development of severe psychiatric disorder. Adolescence is a unique period of coordinated social and motivational system development driven by dopamine (DA) signaling. Microglia, immune cells of the brain, may play a unique role in regulating SI-induced DA system changes and associated behavioral dysfunction. Male microglia refine dopamine D1 receptors (D1rs) in the nucleus accumbens (NAc) of adolescent male rats shaping play behavior. Here we characterized the molecular developmental impacts of postweaning SI from P21-P38, with a resocialization period to P54. We tested the role of microglial engulfment of D1rs in mediating behavioral consequences of SI using neutrophil inhibitory factor (NIF) to block complement-mediated engulfment required for D1r pruning. We found sex specific impacts of SI on brain development and the DA system. In SI males, microglia engulf more NAc D1rs than group housed (GH) controls. Within GH animals, NAc D1r density is positively correlated to play and allogrooming. In SI animals, NAc D1r density is negatively correlated to biting behavior, and is not correlated to play or allogrooming. Pharmacologically inhibiting microglial engulfment of D1r via bilateral NAc NIF injection prevents observed D1r:behavior correlations in GH and SI animals. NIF treatment interacts with SI, exaggerating aggressive-like behavior, showing a role for microglia in regulating aggressive-like behavior via complement pruning in adolescence. Microglia may play a unique role in regulating behavior that drive negative health outcomes in the face of developmental stress, including SI.

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Cortical hemodynamic dysregulation is linked to peripheral NIMETOX pathways in major depressive disorder: an 89-channel fNIRS systems-biology study.

Luo, Y.; Deng, X.; Niu, M.; Carvalho, A. F.; Almulla, A. F.; Wu, H.; Wang, X.; Li, J.; Zhang, Y.; Maes, M.

2026-09-29 psychiatry and clinical psychology 10.64898/2026.09.28.26364187 medRxiv
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Background: Major depressive disorder (MDD) is clinically heterogeneous, but relationships among cortical hemodynamic abnormalities, peripheral neuroimmune, metabolic, and oxidative stress (NIMETOX) processes, and clinical phenome features remain unclear. We applied a systems-biology approach integrating functional near-infrared spectroscopy (fNIRS), peripheral NIMETOX biomarkers, and multidimensional clinical phenomes. Methods: Patients with MDD (n = 86) and demographically matched healthy controls (HC, n = 40) underwent 89-channel high-density fNIRS during resting-state and verbal fluency task (VFT) conditions. Temporal hemodynamic variability (Difference) and area under the concentration-time curve (AUC) were derived from oxygenated hemoglobin (HbO), deoxygenated hemoglobin (HbR), and total hemoglobin (HbT) signals. NIMETOX assessments included inflammatory biomarkers, generalized and lipophilic antioxidant defenses, oxidized lipids, lipidomics, and 16S rRNA amplicon sequencing of the stool microbiome. Results: MDD showed reduced VFT Difference and AUC across HbO, HbR, and HbT. Difference reductions were widespread across prefrontal, frontal eye field, language-related, and sensorimotor cortices, whereas AUC abnormalities were more restricted and resting-state alterations were limited. VFT differences significantly differentiated MDD from HC, with further improvement after integrating NIMETOX biomarkers. Lower antioxidants, carnitines/acetylcarnitines, polyunsaturated and even-chain saturated fatty acids, inflammation, indices of gut dysbiosis and leaky gut, and adverse childhood experiences explained substantial variance in HbO, HbR, and HbT Difference. Integrated fNIRS-NIMETOX profiles explained substantial variance in overall illness severity (cross-validated R2= 0.62) and physiosomatic symptoms (cross-validated R2= 0.48). Conclusions: Systems-biology integration identified a multilevel MDD phenotype linking peripheral NIMETOX dysregulation with task-evoked cortical hemodynamic abnormalities and clinical phenome heterogeneity, supporting an interconnected gut-NIMETOX-brain pathophysiology. Key words: major depressive disorder, biomarkers, redox mechanisms, lipophilic antioxidants, oxidized lipids