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[健康与疾病的发育起源:一种以疾病为导向、具有开创性、起源于英国但扎根于匈牙利的理论]

[DOHaD: a disease-oriented, epoch-making, British-originated theory with Hungarian roots].

作者信息

Csaba György

机构信息

Általános Orvostudományi Kar, Genetikai, Sejt- és Immunbiológiai Intézet,Semmelweis EgyetemBudapest.

出版信息

Orv Hetil. 2020 Apr 1;161(16):603-609. doi: 10.1556/650.2020.31713.

Abstract

On the basis of comparative epidemiological statistical studies, the ’developmental origin of health and disease’ (DOHaD) theory was published in 1986, testifying the interrelation between certain perinatal events, like under- and overfeeding as well as infant mortality with cardiovascular lethality in adults (Barker DJ, Osmond C, Lancet, 1986; 137: 1077–1081) – and at present it is widely extended. The theory is rather similar to the hormonal imprinting concept, which had been published 6 years earlier (Csaba G, Biol Rev Cambr Philos Soc. 1980; 55: 47–63 and Horm Metab Res. 1984; 16: 329–335). This demonstrated the role of perinatal encounter with hormones or hormone-like molecules with adult’s endocrino-pathological events based on animal experiments. Barker hypothesized the role of hormonal imprinting in DOHaD (Phillips DI, Barker DJ, Osmond C, Acta Endocrinol (Copenh). 1993; 129: 134–138: „A possible explanation is that thyroid hormones present in the breast milk and absorbed by the suckling infant could, by the process of hormonal imprinting, permanently down-regulate the set point of thyroid homeostasis”, and this could have encouraged him to create the theory. Both theories suggest the relationship between the perinatal events and adult-age disease manifestation, however, in the case of faulty imprinting, perinatal disease does not have a role in the provocation by imprinters (only the encounter between the imprinter and the hormone receptor), but in the case of DOHaD, this seems to be involved in the process. The whole process points to the disturbance of epigenetic programming. On the basis of the present standpoint, DOHaD is valid in non-communicative diseases, however, considering the impact of faulty hormonal imprinting to the immune system, the extension to communicative diseases is expected and likely also the involvement of lifespan. Further critical developmental period is the adolescence (puberty), when similar reprogramming could be possible and also in certain cases (e.g., in the immune system) disease-causing reprogramming could occur during the whole life. The two concepts are not racing, but using different methods for verification supplement and support each other, by building up identical conclusions (faulty reprogramming) giving epigenetical explanation for numerous diseases. DOHaD and its antecedent, hormonal imprinting are not only theories, but realities, which are commendable to consider in diagnosis and therapy. Studying the tendencies of human creativeness, in all probability, the importance of DOHaD (and faulty imprinting) will be growing in the near and far future. Orv Hetil. 2020; 161(16): 603–609.

摘要

基于比较流行病学统计研究,“健康与疾病的发育起源”(DOHaD)理论于1986年发表,证实了某些围产期事件之间的相互关系,如喂养不足和过度喂养以及婴儿死亡率与成人心血管致死率之间的关系(Barker DJ,Osmond C,《柳叶刀》,1986年;137: 1077–1081),目前该理论已得到广泛扩展。该理论与6年前发表的激素印记概念颇为相似(Csaba G,《剑桥哲学学会生物学评论》,1980年;55: 47–63以及《激素与代谢研究》,1984年;16: 329–335)。基于动物实验,这证明了围产期接触激素或激素样分子与成人内分泌病理事件之间的作用。Barker假设了激素印记在DOHaD中的作用(Phillips DI,Barker DJ,Osmond C,《内分泌学学报(哥本哈根)》,1993年;129: 134–138:“一种可能的解释是,母乳中存在的甲状腺激素被哺乳婴儿吸收后,通过激素印记过程,可能会永久性地下调甲状腺内稳态的设定点”),这可能促使他创立了该理论。两种理论都表明了围产期事件与成年期疾病表现之间的关系,然而,在印记错误的情况下,围产期疾病在印记物引发疾病中不起作用(仅印记物与激素受体之间的接触起作用),但在DOHaD的情况下,这似乎参与了该过程。整个过程指向表观遗传编程的紊乱。基于当前观点,DOHaD在非传染性疾病中是有效的,然而,考虑到错误的激素印记对免疫系统的影响,预计它会扩展到传染性疾病,寿命可能也会受到影响。另一个关键的发育时期是青春期(青春期),此时可能会发生类似的重新编程,在某些情况下(例如在免疫系统中),一生中都可能发生致病的重新编程。这两个概念并非相互竞争,而是使用不同的验证方法相互补充和支持,通过得出相同的结论(错误的重新编程),为众多疾病提供表观遗传学解释。DOHaD及其前身激素印记不仅是理论,而且是现实,在诊断和治疗中值得考虑。研究人类创造力的趋势,很可能在不久的将来和遥远的未来,DOHaD(以及错误印记)的重要性将会不断增加。《匈牙利医学周报》,2020年;161(16): 603–609。

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