Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, 90095-1772, USA.
Am J Epidemiol. 2012 Jun 1;175(11):1191-9. doi: 10.1093/aje/kwr393. Epub 2012 Apr 16.
Although cytokines play a dual role in the developing neurologic system and in prenatal immune reactions, relations between fetal cytokine levels and child intellectual development remain unknown. The authors investigated associations between umbilical cord serum cytokine concentrations and intellectual outcomes in 369 children within a prospective cohort study, the Eunice Kennedy Shriver National Institute of Child Health and Human Development-University of Alabama Infant Growth Study (1985-1988). Concentrations of interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), and interleukins 4, 10, and 12p70 were determined. The Wechsler Preschool and Primary Scale of Intelligence-Revised was administered at age 5 years, producing verbal and performance intelligence quotients (VIQ and PIQ); associations with each cytokine were evaluated using linear and logistic regression. Log-unit increases in IFN-γ (adjusted odds ratio (aOR) = 0.67, 95% confidence interval (CI): 0.46, 0.98) and interleukin-12p70 (aOR = 0.43, 95% CI: 0.21, 0.87) were inversely associated with low PIQ (score <70). One log-unit increase in TNF-α was associated with a reduced odds ratio for low VIQ (score <70) among preterm children (aOR = 0.11, 95% CI: 0.01, 0.94) and an elevated odds ratio for low VIQ among small-for-gestational-age children (aOR = 3.96, 95% CI: 0.99, 15.9). IFN-γ, which is involved in neurogenesis and perinatal adaptive immunity, may be related to fetal neurologic development overall, while TNF-α may be a marker of intellectual development in vulnerable subgroups.
虽然细胞因子在发育中的神经系统和产前免疫反应中发挥双重作用，但胎儿细胞因子水平与儿童智力发育之间的关系尚不清楚。作者在一项前瞻性队列研究中，即 Eunice Kennedy Shriver 国立儿童健康与人类发育研究所-阿拉巴马大学婴儿生长研究（1985-1988 年）中，调查了 369 名儿童脐带血清细胞因子浓度与智力结果之间的关系。测定了干扰素-γ（IFN-γ）、肿瘤坏死因子-α（TNF-α）以及白细胞介素 4、10 和 12p70 的浓度。在 5 岁时使用韦氏学前和初级智力量表修订版（Wechsler Preschool and Primary Scale of Intelligence-Revised）进行评估，得出言语和表现智商（VIQ 和 PIQ）；使用线性和逻辑回归评估每种细胞因子的相关性。IFN-γ（调整后的优势比（aOR）=0.67，95%置信区间（CI）：0.46，0.98）和白细胞介素 12p70（aOR=0.43，95%CI：0.21，0.87）的对数单位增加与低 PIQ（得分<70）呈负相关。TNF-α 的一个对数单位增加与早产儿低 VIQ（得分<70）的比值比降低相关（aOR=0.11，95%CI：0.01，0.94），与小于胎龄儿低 VIQ（aOR=3.96，95%CI：0.99，15.9）的比值比升高相关。IFN-γ 参与神经发生和围产期适应性免疫，可能与胎儿神经系统发育总体相关，而 TNF-α 可能是脆弱亚组智力发育的标志物。
