Harv Rev Psychiatry. 2022;30(1):24-39. doi: 10.1097/HRP.0000000000000325.
The overarching objective is to review how early exposure to adversity interacts with inflammation to alter brain maturation. Both adversity and inflammation are significant risk factors for psychopathology. Literature relevant to the effects of adversity in children and adolescents on brain development is reviewed. These studies are supported by research in animals exposed to species-relevant stressors during development. While it is known that exposure to adversity at any age increases inflammation, the effects of inflammation are exacerbated at developmental stages when the immature brain is uniquely sensitive to experiences. Microglia play a vital role in this process, as they scavenge cellular debris and prune synapses to optimize performance. In essence, microglia modify the synapse to match environmental demands, which is necessary for someone with a history of adversity. Overall, by piecing together clinical and preclinical research areas, what emerges is a picture of how adversity uniquely sculpts the brain. Microglia interactions with the inhibitory neurotransmitter GABA (specifically, the subtype expressing parvalbumin) are discussed within contexts of development and adversity. A review of inflammation markers in individuals with a history of abuse is combined with preclinical studies to describe their effects on maturation. Inconsistencies within the literature are discussed, with a call for standardizing methodologies relating to the age of assessing adversity effects, measures to quantify stress and inflammation, and more brain-based measures of biochemistry. Preclinical studies pave the way for interventions using anti-inflammation-based agents (COX-2 inhibitors, CB2 agonists, meditation/yoga) by identifying where, when, and how the developmental trajectory goes awry.
总体目标是回顾早期逆境暴露如何与炎症相互作用,改变大脑成熟。逆境和炎症都是精神病理学的重要危险因素。本文综述了儿童和青少年逆境对大脑发育影响的相关文献。这些研究得到了动物在发育过程中暴露于与物种相关应激源的研究的支持。虽然已知任何年龄暴露于逆境都会增加炎症,但在不成熟的大脑对经历特别敏感的发育阶段,炎症的影响会加剧。小胶质细胞在这个过程中起着至关重要的作用,因为它们清除细胞碎片并修剪突触以优化性能。从本质上讲,小胶质细胞改变突触以适应环境需求,这对于有逆境史的人来说是必要的。总的来说,通过整合临床和临床前研究领域,我们可以了解到逆境是如何独特地塑造大脑的。本文讨论了小胶质细胞与抑制性神经递质 GABA(特别是表达 parvalbumin 的亚型)在发育和逆境背景下的相互作用。结合临床前研究,对有虐待史个体的炎症标志物进行了综述,描述了它们对成熟的影响。本文还讨论了文献中的不一致之处,并呼吁标准化评估逆境影响的方法,包括评估应激和炎症的措施,以及更多基于大脑的生化测量方法。临床前研究为使用基于抗炎的干预措施(COX-2 抑制剂、CB2 激动剂、冥想/瑜伽)铺平了道路,这些措施确定了发育轨迹何时、何地以及如何出现偏差。