Department of Psychiatry, Division of Neurosciences, School of Medicine, Faculty of Medical Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Thessaloniki General Hospital "G. Papanicolaou", Psychiatric Hospital of Thessaloniki, Lagkada Str. 196, Stavroupoli, 56430, Thessaloniki, Greece.
Hormones (Athens). 2018 Dec;17(4):507-520. doi: 10.1007/s42000-018-0065-x. Epub 2018 Oct 2.
Experience of early life stress (ELS) and trauma is highly prevalent in the general population and has a high public health impact, as it can trigger a health-related risk cascade and lead to impaired homeostatic balance and elevated cacostatic load even decades later. The prolonged neuropsychobiological impact of ELS can, thus, be conceptualized as a common developmental risk factor for disease associated with increased physical and mental morbidity in later life. ELS during critical periods of brain development with elevated neuroplasticity could exert a programming effect on particular neuronal networks related to the stress response and lead to enduring neuroendocrine alterations, i.e., hyper- or hypoactivation of the stress system, associated with adult hypothalamic-pituitary-adrenal axis and glucocorticoid signaling dysregulation. This paper reviews the pathophysiology of the human stress response and provides evidence from human research on the most acknowledged stress axis-related neuroendocrine pathways exerting the enduring adverse effects of ELS and mediating the cumulative long-term risk of disease vulnerability in adulthood.
早期生活压力（ELS）和创伤在普通人群中非常普遍，具有很高的公共卫生影响，因为它可以引发与健康相关的风险级联反应，并导致内稳态平衡受损和慢性应激负荷增加，即使在几十年后也是如此。因此，ELS 的长期神经心理生物学影响可以被概念化为与晚年身体和精神发病率增加相关的疾病的共同发育风险因素。在神经可塑性增加的大脑发育关键时期经历 ELS 可能会对与应激反应相关的特定神经元网络产生编程效应，并导致持久的神经内分泌改变，即应激系统的过度或低度激活，与成人下丘脑-垂体-肾上腺轴和糖皮质激素信号转导失调有关。本文综述了人类应激反应的病理生理学，并提供了来自人类研究的证据，这些研究证实了与应激轴相关的神经内分泌途径，这些途径对 ELS 的持久不良影响，以及在成年期介导疾病易感性的累积长期风险。
