Dietert Rodney R, Dietert Janice M, Dewitt Jamie C
Department of Microbiology and Immunology, Cornell University, Ithaca, NY, USA;
Emerg Health Threats J. 2011 Apr 20;4:7111. doi: 10.3402/ehtj.v4i0.7111.
Autism is a devastating childhood condition that has emerged as an increasing social concern just as it has increased in prevalence in recent decades. Autism and the broader category of autism spectrum disorders are among the increasingly seen examples in which there is a fetal basis for later disease or disorder. Environmental, genetic, and epigenetic factors all play a role in determining the risk of autism and some of these effects appear to be transgenerational. Identification of the most critical windows of developmental vulnerability is paramount to understanding when and under what circumstances a child is at elevated risk for autism. No single environmental factor explains the increased prevalence of autism. While a handful of environmental risk factors have been suggested based on data from human studies and animal research, it is clear that many more, and perhaps the most significant risk factors, remain to be identified. The most promising risk factors identified to date fall within the categories of drugs, environmental chemicals, infectious agents, dietary factors, and other physical/psychological stressors. However, the rate at which environmental risk factors for autism have been identified via research and safety testing has not kept pace with the emerging health threat posed by this condition. For the way forward, it seems clear that additional focused research is needed. But more importantly, successful risk reduction strategies for autism will require more extensive and relevant developmental safety testing of drugs and chemicals.
自闭症是一种严重的儿童疾病,近几十年来其发病率不断上升,同时也日益成为社会关注的焦点。自闭症及更广泛的自闭症谱系障碍类别,是越来越多有胎儿期基础的后期疾病或障碍的例子。环境、遗传和表观遗传因素都在决定自闭症风险方面发挥作用,其中一些影响似乎具有跨代性。确定发育易损性的最关键窗口期对于理解儿童在何时以及何种情况下患自闭症的风险升高至关重要。没有单一的环境因素能解释自闭症发病率的上升。虽然根据人体研究和动物研究的数据提出了一些环境风险因素,但显然还有更多,也许是最重要的风险因素有待确定。迄今为止确定的最有希望的风险因素包括药物、环境化学物质、传染因子、饮食因素以及其他身体/心理应激源。然而,通过研究和安全测试确定自闭症环境风险因素的速度,未能跟上这种疾病所带来的新出现的健康威胁。展望未来,显然需要进行更多有针对性的研究。但更重要的是,成功的自闭症风险降低策略将需要对药物和化学品进行更广泛且相关的发育安全测试。