Department of Epidemiology, Mailman School of Public Health, Columbia University New York, NY, USA ; Institute of Human Nutrition, Columbia University New York, NY, USA.
Front Neurosci. 2013 Jul 31;7:120. doi: 10.3389/fnins.2013.00120. eCollection 2013.
The developing immune system and central nervous system in the fetus and child are extremely sensitive to both exogenous and endogenous signals. Early immune system programming, leading to changes that can persist over the life course, has been suggested, and other evidence suggests that immune dysregulation in the early developing brain may play a role in neurodevelopmental disorders such as autism spectrum disorder and schizophrenia. The timing of immune dysregulation with respect to gestational age and neurologic development of the fetus may shape the elicited response. This creates a possible sensitive window of programming or vulnerability. This review will explore the effects of maternal prenatal and infant nutritional status (from conception until early childhood) as well as maternal prenatal stress and anxiety on early programming of immune function, and how this might influence neurodevelopment. We will describe fetal immune system development and maternal-fetal immune interactions to provide a better context for understanding the influence of nutrition and stress on the immune system. Finally, we will discuss the implications for prevention of neurodevelopmental disorders, with a focus on nutrition. Although certain micronutrient supplements have shown to both reduce the risk of neurodevelopmental disorders and enhance fetal immune development, we do not know whether their impact on immune development contributes to the preventive effect on neurodevelopmental disorders. Future studies are needed to elucidate this relationship, which may contribute to a better understanding of preventative mechanisms. Integrating studies of neurodevelopmental disorders and prenatal exposures with the simultaneous evaluation of neural and immune systems will shed light on mechanisms that underlie individual vulnerability or resilience to neurodevelopmental disorders and ultimately contribute to the development of primary preventions and early interventions.
胎儿和儿童正在发育的免疫系统和中枢神经系统对外源和内源性信号都极其敏感。有人提出,早期免疫系统编程会导致可长期持续的变化,而其他证据表明,早期发育大脑中的免疫失调可能在自闭症谱系障碍和精神分裂症等神经发育障碍中发挥作用。免疫失调与胎儿的胎龄和神经发育的时间关系可能会影响所引发的反应。这就产生了一个可能的编程或脆弱敏感窗口。这篇综述将探讨母体产前和婴儿营养状况(从受孕到幼儿期)以及母体产前压力和焦虑对免疫功能早期编程的影响,以及这如何影响神经发育。我们将描述胎儿免疫系统的发育和母婴免疫相互作用,以更好地理解营养和压力对免疫系统的影响。最后,我们将讨论预防神经发育障碍的意义,重点是营养。虽然某些微量营养素补充剂已被证明既能降低神经发育障碍的风险,又能增强胎儿的免疫发育,但我们不知道它们对免疫发育的影响是否有助于预防神经发育障碍。需要进一步的研究来阐明这种关系,这可能有助于更好地理解预防机制。将神经发育障碍和产前暴露的研究与同时评估神经和免疫系统相结合,将揭示导致个体对神经发育障碍易感性或弹性的机制,并最终有助于制定初级预防和早期干预措施。