Soares Sara, Rocha Vânia, Kelly-Irving Michelle, Stringhini Silvia, Fraga Sílvia
EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.
Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
Front Public Health. 2021 Aug 19;9:649825. doi: 10.3389/fpubh.2021.649825. eCollection 2021.
This systematic review aimed to summarize evidence reporting epigenetic and/or neuro-immuno-endocrine embedding of adverse childhood events (ACEs) in children, with a particular focus on the short-term biological effect of those experiences. A search was conducted in PsycINFO®, PubMed®, Isi Web of Knowledge and Scopus, until July 2019, to identify papers reporting the short-term biological effects of exposure to ACEs. The search identified 58 studies, that were included in the review. Regarding exposure, the type of ACE more frequently reported was sexual abuse ( = 26), followed by life stressors ( = 20) and physical abuse ( = 19). The majority ( = 17) of studies showed a positive association between ACEs and biomarkers of the immune system. Regarding DNA methylation 18 studies showed more methylation in participants exposed to ACEs. Two studies presented the effect of ACEs on telomere length and showed that exposure was associated with shorter telomere length. Overall the associations observed across studies followed the hypothesis that ACEs are associated with biological risk already at early ages. This is supporting evidence that ACEs appear to get "under the skin" and induce physiological changes and these alterations might be strongly associated with later development of disease.
本系统评价旨在总结有关儿童期不良经历（ACEs）的表观遗传和/或神经免疫内分泌嵌入的证据，特别关注这些经历的短期生物学效应。截至2019年7月，在PsycINFO®、PubMed®、Isi Web of Knowledge和Scopus中进行了检索，以确定报告暴露于ACEs的短期生物学效应的论文。检索共识别出58项研究，并纳入本评价。关于暴露情况，报告频率较高的ACEs类型是性虐待（=26），其次是生活应激源（=20）和身体虐待（=19）。大多数研究（=17）表明ACEs与免疫系统生物标志物之间存在正相关。关于DNA甲基化，18项研究表明暴露于ACEs的参与者甲基化程度更高。两项研究呈现了ACEs对端粒长度的影响，结果显示暴露与较短的端粒长度相关。总体而言，各项研究中观察到的关联均符合以下假设：ACEs在儿童早期就与生物学风险相关。这支持了ACEs似乎会“深入肌肤”并诱发生理变化的证据，而且这些改变可能与疾病的后期发展密切相关。
