Exploring the Risk Factors for Sudden Infant Deaths and Their Role in Inflammatory Responses to Infection
Exploring the Risk Factors for Sudden Infant Deaths and Their Role in Inflammatory Responses to Infection
复制标题
探讨婴儿猝死的危险因素及其在感染炎症反应中的作用
作者：
C. Blackwell;Sophia M. Moscovis;S. Hall;C. Burns;R. Scott
婴儿猝死综合症 (SIDS) 的危险因素与传染病的易感性或严重程度相似。没有证据表明单一传染源与婴儿猝死综合症有关；共同点似乎是诱导对感染的炎症反应。在这篇综述中，根据以下假设评估了 SIDS 的遗传和环境危险因素之间的相互作用，即许多婴儿死亡是由于对“轻微”感染的炎症反应失调所致。风险因素的评估与感染的三个重要阶段相关：（1）细菌定植（频率或密度）； (2)诱导温度依赖性毒素； (3)诱导或控制炎症反应。在本文中，我们回顾了 SIDS 危险因素之间的相互作用，以及它们对诱导或控制炎症反应的影响。研究的危险因素有遗传因素（性别、SIDS高风险或低风险种族群体中细胞因子基因多态性）；发育阶段（与 2 至 4 个月年龄范围相关的皮质醇和睾酮水平的变化）；环境因素（病毒感染、接触香烟烟雾）。这些相互作用有助于解释在减少婴儿死亡的公共卫生运动之前观察到的种族群体之间 SIDS 发病率的差异。
The risk factors for sudden infant death syndrome (SIDS) parallel those associated with susceptibility to or severity of infectious diseases. There is no evidence that a single infectious agent is associated with SIDS; the common thread appears to be induction of inflammatory responses to infections. In this review, interactions between genetic and environmental risk factors for SIDS are assessed in relation to the hypothesis that many infant deaths result from dysregulation of inflammatory responses to “minor” infections. Risk factors are assessed in relation to three important stages of infection: (1) bacterial colonization (frequency or density); (2) induction of temperature-dependent toxins; (3) induction or control of inflammatory responses. In this article, we review the interactions among risk factors for SIDS for their effects on induction or control of inflammatory responses. The risk factors studied are genetic factors (sex, cytokine gene polymorphisms among ethnic groups at high or low risk of SIDS); developmental stage (changes in cortisol and testosterone levels associated with 2- to 4-month age range); environmental factors (virus infection, exposure to cigarette smoke). These interactions help to explain differences in the incidences of SIDS observed between ethnic groups prior to public health campaigns to reduce these infant deaths.