Center on the Developing Child, Harvard University, Cambridge, MA 02138, United States.
Brain Behav Immun. 2012 Feb;26(2):239-50. doi: 10.1016/j.bbi.2011.11.003. Epub 2011 Nov 25.
Research suggests that adverse experiences in childhood affect the development of cardiovascular disease (CVD), and immune and inflammation dysregulation has been postulated to play role. However, it is unclear whether the effects of social adversity on immune-related biomarkers are evident in early life, and if these biomarkers may provide an early risk marker for targeting prevention and intervention. The purpose of this review is to evaluate research on the relationship between adversity and CVD-relevant immune biomarkers in youth, assess the consistency of the findings, and consider what additional research is needed.
PubMed and PsycINFO searches were conducted through September 2011. Studies were selected using criteria related to the childhood exposure, biomarker outcome, age range, and sample selection. Twenty articles were identified, examining associations between childhood adversity and immune biomarkers (assessed during childhood) that are potential risk markers for CVD later in life.
Although childhood adversity was not consistently related to youth levels of inflammatory and other immune markers relevant to CVD, a trend toward positive findings was observed. No detectable patterns were evident based on measure of adversity, biomarker, study design, or sample size.
Overall, our findings suggest this avenue of research is worth continued investigation. We offer recommendations for future research related to (1) study design and sample, (2) definition and measurement of adversity, (3) statistical analysis, and (4) outcomes that will help distinguish whether there are immunologic alterations related to adversity and subsequent CVD risk that can be reliably detected in childhood.
研究表明,儿童时期的不良经历会影响心血管疾病(CVD)的发展,免疫和炎症失调被认为在此过程中发挥了作用。但是,目前尚不清楚社会逆境对免疫相关生物标志物的影响是否在早期生命中表现明显,以及这些生物标志物是否可以作为针对预防和干预的早期风险标志物。本综述的目的是评估有关逆境与青少年 CVD 相关免疫生物标志物之间关系的研究,评估研究结果的一致性,并考虑需要进行哪些额外的研究。
通过 2011 年 9 月在 PubMed 和 PsycINFO 上进行了检索。研究采用与儿童期暴露、生物标志物结果、年龄范围和样本选择相关的标准进行选择。共确定了 20 篇文章,研究了儿童期逆境与免疫生物标志物(在儿童期评估)之间的关系,这些生物标志物是日后 CVD 的潜在风险标志物。
尽管儿童期逆境与青少年时期与 CVD 相关的炎症和其他免疫标志物水平之间没有一致的相关性,但观察到了正向的趋势。但是,根据逆境、生物标志物、研究设计或样本量的测量,没有发现明显的模式。
总的来说,我们的研究结果表明,该研究方向值得进一步研究。我们为未来的研究提供了建议,涉及:(1)研究设计和样本;(2)逆境的定义和测量;(3)统计分析;(4)研究结果,这些建议将有助于区分是否存在与逆境和随后的 CVD 风险相关的免疫改变,并且这些改变在儿童期可以被可靠地检测到。