Editorial: Maternal Inflammation During Pregnancy: A Modifiable Pathway Toward Improving Offspring Socioemotional Outcomes in Childhood and Adolescence.
Editorial: Maternal Inflammation During Pregnancy: A Modifiable Pathway Toward Improving Offspring Socioemotional Outcomes in Childhood and Adolescence.
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社论：怀孕期间的母体炎症：改善后代童年和青春期社会情感结果的可修改途径。
DOI：
10.1016/j.jaac.2023.06.013
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发表时间：
2023
影响因子：
13.3
通讯作者：
Lean,RachelE
中科院分区：
文献类型：
--
作者：
Lean,RachelE
儿童精神病理学是成人生命历程不良结果的公认预测因素，包括受教育程度较低和家庭收入减少，美国的经济损失总额为 2.1 万亿美元。 1 鉴于个人和社会负担如此之高，人们投入了大量精力来确定可改变的危险因素，这些因素会导致幼儿期精神疾病的风险。事实上，早年逆境的许多方面，例如社会经济劣势、压力/创伤性生活事件以及亲子关系破裂，都表明与青春期的社会情感问题和精神疾病有很强的关联。 2 然而，对造成这种风险轨迹的潜在生物机制仍知之甚少。一种在发育精神病理学领域迅速发展的生物学机制涉及健康和疾病起源中的过度免疫系统激活和/或促炎症反应。 3 特别令人感兴趣的是产前时期，它是一个脆弱的时期，在此期间产前的暴露使胎儿为预期的产后环境做好准备或进行编程。 3-5 更具体地说，胎儿编程假设孕期母亲逆境的影响至少部分通过多种相关途径传递给胎儿，包括慢性母体炎症和/或下丘脑-垂体-肾上腺轴过度激活，导致母胎免疫/糖皮质激素系统异常以及发育中胎儿的下游表观遗传改变。这些因素共同作用，增加了后代对产后环境逆境的敏感性，进而增加了精神疾病的风险。 3-6 然而，现有文献大多基于临床前动物模型，临床研究相对较少。 3 因此，仍然缺乏大型、前瞻性设计的临床研究，检查妊娠期间母亲的促炎症状况与后代精神病理学的关系。 Frazier 等人的这项研究是美国国立卫生研究院资助的具有里程碑意义的 ECHO（环境对儿童健康结果的影响）联盟的一部分。图7代表了将围产期母亲促炎症状况与儿童和青少年同时发生的精神症状联系起来的最大规模的调查之一。
Childhood psychopathology is a well-established predictor of poor adult life-course outcomes including lower rates of educational attainment and reduced family income, with a total economic loss of $2.1 trillion in the United States. 1 Given this high level of individual and societal burden, much effort has been devoted to identifying the modifiable risk factors that confer risk for psychiatric disorders during early childhood. Indeed, numerous aspects of early life adversity, such as socioeconomic disadvantage, stressful/traumatic life events, and disrupted parent-child relationships, demonstrate strong associations with socioemotional problems and psychiatric disorders into adolescence. 2 However, the underlying biological mechanisms that also contribute to this risk trajectory remain less well understood. One proposed biological mechanism that is rapidly gaining momentum in the field of developmental psychopathology concerns excessive immune system activation and/or proinflammatory responses in the origins of health and disease. 3 Of particular interest is the prenatal period, representing a window of vulnerability in which prenatal exposures prepare or program the fetus for the expected postnatal environment. 3-5 More specifically, fetal programming posits that the effects of maternal adversity during pregnancy are, at least in part, transmitted to the fetus via multiple related pathways including chronic maternal inflammation and/or overactivation of the hypothalamic-pituitary-adrenal axis, resulting in aberrant maternal-fetal immune/glucocorticoid systems and downstream epigenetic alterations in the developing fetus. Together, these factors work to increase the susceptibility of offspring to adversity in the postnatal environment and, in turn, enhance risk for psychiatric disorders. 3-6 However, much of the existing literature is based on preclinical animal models with comparatively fewer clinical studies. 3 As such, there remains a paucity of large, prospectively designed clinical studies examining maternal proinflammatory conditions during pregnancy in relation to psychopathology in offspring. As part of the landmark National Institutes of Health-funded ECHO (Environmental influences on Child Health Outcomes) consortium, the study by Frazier et al. 7 represents one of the largest investigations linking perinatal maternal proinflammatory conditions with co-occurring psychiatric symptoms in children and adolescents.
影响因子：
5.4
作者：
Smith, James Patrick;Smith, Gillian C.
通讯作者：
Smith, Gillian C.