Department of Anthropology, Yale University, New Haven, USA.
Department of Anthropology, Yale University, New Haven, USA.
Brain Behav Immun. 2020 Jul;87:207-217. doi: 10.1016/j.bbi.2019.02.015. Epub 2019 Feb 20.
Experiencing childhood adversity has been associated with significant changes in inflammation, cell-mediated immunocompetence, and cortisol secretion. Relatively few studies have examined, longitudinally, alterations to inflammatory processes during adolescence, especially outside Western contexts; none have evaluated biomarker trajectories for at-risk youth in response to a structured behavioral intervention. We conducted a randomized controlled trial evaluating the efficacy of a humanitarian intervention targeting stress-alleviation, with 12-18 year-old Syrian refugees (n = 446) and Jordanian non-refugees (n = 371) living side-by-side in war-affected communities in Jordan. We measured C-reactive protein (CRP), Epstein-Barr virus antibodies (EBV), and hair cortisol concentration (HCC) at three timepoints (pre/post intervention and 11 month follow-up), and assessed three main outcomes (psychosocial stress, mental health, and cognitive function). Using growth mixture models, regressions, and growth curve models, we identified three distinct trajectories for CRP, two for EBV, and three for HCC, and examined their associations with age, gender, BMI, poverty, and trauma. We found associations with BMI for CRP, refugee status for EBV, and BMI and gender with HCC trajectory. In terms of health outcomes, we found associations between rising CRP levels and perceived stress (B = -2.92, p = .007), and between HCC hypersecretion and insecurity (B = 7.21, p = .017). In terms of responses to the intervention, we observed no differential impacts by CRP or EBV trajectories, unlike HCC. These results suggest that commonly-assayed biomarkers do not associate with health outcomes and respond to targeted interventions in straightforward ways. Our study is the first to examine multiple biomarker trajectories in war-affected adolescents, in order to better evaluate the extent, timing, and malleability of the biological signatures of poverty, conflict, and forced displacement.
经历儿童期逆境与炎症、细胞介导免疫功能和皮质醇分泌的显著变化有关。相对较少的研究从纵向角度研究了青春期炎症过程的变化，特别是在西方背景之外；也没有研究评估针对有风险的青年的生物标志物轨迹对结构化行为干预的反应。我们进行了一项随机对照试验，评估了一项针对缓解压力的人道主义干预的疗效，该干预针对的是生活在约旦受战争影响社区中的 12-18 岁叙利亚难民（n=446）和非难民（n=371）。我们在三个时间点（干预前后和 11 个月随访）测量了 C 反应蛋白（CRP）、爱泼斯坦-巴尔病毒抗体（EBV）和头发皮质醇浓度（HCC），并评估了三个主要结果（心理社会压力、心理健康和认知功能）。使用增长混合物模型、回归和增长曲线模型，我们确定了 CRP 的三种不同轨迹、EBV 的两种轨迹和 HCC 的三种轨迹，并研究了它们与年龄、性别、BMI、贫困和创伤的关联。我们发现 CRP 与 BMI 有关，EBV 与难民身份有关，HCC 轨迹与 BMI 和性别有关。在健康结果方面，我们发现 CRP 水平升高与感知压力之间存在关联（B=-2.92，p=0.007），HCC 分泌过多与不安全感之间存在关联（B=7.21，p=0.017）。就干预措施的反应而言，我们没有观察到 CRP 或 EBV 轨迹的差异影响，而 HCC 则有差异影响。这些结果表明，常见的测定生物标志物与健康结果没有关联，也不以简单的方式对靶向干预措施做出反应。我们的研究首次在受战争影响的青少年中检查了多种生物标志物轨迹，以更好地评估贫困、冲突和被迫流离失所的生物学特征的程度、时间和可塑。
