Department of Pediatrics, University of Cincinnati College of Medicine, Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
J Adolesc Health. 2013 May;52(5 Suppl):S15-20. doi: 10.1016/j.jadohealth.2012.09.019.
Early life exposures during times of rapid growth and development are recognized increasingly to impact later life. Epidemiologic studies document an association between exposures at critical windows of susceptibility with outcomes as diverse as childhood and adult obesity, timing of menarche, and risk for hypertension or breast cancer.
This article briefly reviews the concept of windows of susceptibility for providers who care for adolescent patients.
The theoretical bases for windows of susceptibility is examined, evaluating the relationship between pubertal change and breast cancer as a paradigm, and reviewing the underlying mechanisms, such as epigenetic modification.
The long-term sequela of responses to early exposures may impact other adult morbidities; addressing these exposures represents an important challenge for contemporary medicine.
越来越多的研究表明,生命早期在快速生长和发育时期的暴露会对后期生活产生影响。流行病学研究记录了在易感性关键窗口期暴露与多种结果之间的关联,例如儿童和成人肥胖、初潮时间以及高血压或乳腺癌风险。
本文简要回顾了易感性窗口期的概念,为照顾青少年患者的提供者提供了参考。
检查了易感性窗口期的理论基础,以青春期变化与乳腺癌的关系为范例进行了评估,并回顾了潜在的机制,如表观遗传修饰。
对早期暴露的反应的长期后果可能会影响其他成年疾病;解决这些暴露问题是当代医学的重要挑战。