Heindel Jerrold J, Vandenberg Laura N
aDivision of Extramural Research and Training, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina bDivision of Environmental Health Sciences, School of Public Health, University of Massachusetts, Amherst, Massachusetts, USA.
Curr Opin Pediatr. 2015 Apr;27(2):248-53. doi: 10.1097/MOP.0000000000000191.
Although diseases may appear clinically throughout the lifespan, it is clear that many diseases have origins during development. Altered nutrition, as well as exposure to environmental chemicals, drugs, infections, or stress during specific times of development, can lead to functional changes in tissues, predisposing those tissues to diseases that manifest later in life. This review will focus on the role of altered nutrition and exposures to environmental chemicals during development in the role of disease and dysfunction.
The effects of altered nutrition or exposure to environmental chemicals during development are likely because of altered programming of epigenetic marks, which persist across the lifespan. Indeed some changes can be transmitted to future generations.
The evidence in support of the developmental origins of the health and disease paradigm is sufficiently robust and repeatable across species, including humans, to suggest a need for greater emphasis in the clinical area. As a result of these data, obesity, diabetes, cardiovascular morbidity, and neuropsychiatric diseases can all be considered pediatric diseases. Disease prevention must start with improved nutrition and reduced exposure to environmental chemicals during development.
尽管疾病可能在整个生命周期中临床显现，但许多疾病显然起源于发育过程。在特定发育时期，营养改变以及接触环境化学物质、药物、感染或应激，可导致组织功能变化，使这些组织易患在生命后期表现出的疾病。本综述将聚焦于发育过程中营养改变和接触环境化学物质在疾病及功能障碍中的作用。
发育过程中营养改变或接触环境化学物质的影响可能是由于表观遗传标记的编程改变，这种改变会贯穿一生。事实上，一些变化可以传递给后代。
支持健康与疾病发育起源范式的证据在包括人类在内的跨物种研究中足够有力且可重复，表明在临床领域需要更加强调这一点。基于这些数据，肥胖、糖尿病、心血管疾病和神经精神疾病都可被视为儿科疾病。疾病预防必须从发育过程中改善营养和减少接触环境化学物质开始。
