The Science of Early Life Toxic Stress for Pediatric Practice and Advocacy
The Science of Early Life Toxic Stress for Pediatric Practice and Advocacy
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DOI：
10.1542/peds.2012-0469
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发表时间：
2013-02-01
期刊：
影响因子：
8
通讯作者：
Riis, Jenna
中科院分区：
文献类型：
--
作者：
Johnson, Sara B.;Riley, Anne W.;Riis, Jenna
经历过有毒压力的幼儿在成年后面临许多健康问题的高风险，包括心血管疾病、癌症、哮喘和抑郁症。美国儿科学会（American Academy of Pediatrics）最近呼吁儿科医生根据分子生物学、基因组学、免疫学和神经科学的研究成果，成为以科学为基础的战略的领导者，为儿童的终身健康奠定坚实的基础。在本报告中，我们提供了有毒压力的科学概述。我们总结了神经内分泌免疫网络的发展，其功能如何被早期生活逆境改变，以及这些改变如何增加对疾病的易感性。早期环境在生命早期就塑造和校准了生物系统的功能，这一事实既是对忽视发育关键时期的警示，也是对干预前景持乐观态度的理由。即使在最极端的逆境中，及时改变儿童的环境也能改善结果。儿科医生处于一个独特的位置，通过解释看似与儿童健康无关的因素如何成为我们这一代一些最棘手的公共卫生问题的关键，为公众对健康和社会福利的讨论做出贡献。我们考虑的挑战和机遇，以防止有毒的压力在当代儿科实践的背景下。儿科2013;131:319 - 327
Young children who experience toxic stress are at high risk for a number of health outcomes in adulthood, including cardiovascular disease, cancers, asthma, and depression. The American Academy of Pediatrics has recently called on pediatricians, informed by research from molecular biology, genomics, immunology, and neuroscience, to become leaders in science-based strategies to build strong foundations for children's life-long health. In this report, we provide an overview of the science of toxic stress. We summarize the development of the neuroendocrine-immune network, how its function is altered by early life adversity, and how these alterations then increase vulnerability to disease. The fact that early environments shape and calibrate the functioning of biological systems very early in life is both a cautionary tale about overlooking critical periods in development and reason for optimism about the promise of intervention. Even in the most extreme cases of adversity, well-timed changes to children's environments can improve outcomes. Pediatricians are in a unique position to contribute to the public discourse on health and social welfare by explaining how factors that seem distal to child health may be the key to some of the most intractable public health problems of our generation. We consider the challenges and opportunities for preventing toxic stress in the context of contemporary pediatric practice. Pediatrics 2013;131:319-327