Nobile Stefano, Di Sipio Morgia Chiara, Vento Giovanni
Department of Woman, Child and Public Health, Division of Neonatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
J Pers Med. 2022 Jan 25;12(2):157. doi: 10.3390/jpm12020157.
The "developmental origins of health and disease" (DOHaD) hypothesis refers to the influence of early developmental exposures and fetal growth on the risk of chronic diseases in later periods. During fetal and early postnatal life, cell differentiation and tissue formation are influenced by several factors. The interaction between genes and environment in prenatal and early postnatal periods appears to be critical for the onset of multiple diseases in adulthood. Important factors influencing this interaction include genetic predisposition, regulation of gene expression, and changes in microbiota. Premature birth and intrauterine growth restriction (IUGR) are other important factors considered by the DOHaD hypothesis. Preterm birth is associated with impaired or arrested structural or functional development of key organs/systems, making preterm infants vulnerable to cardiovascular, respiratory, and chronic renal diseases during adulthood. Growth restriction, defined as impaired fetal growth compared to expected biological potential in utero, is an additional negative factor increasing the risk of subsequent diseases. Environmental factors implicated in the developmental programming of diseases include exposure to pollution, stress, drugs, toxic agents, nutrition, and exercise. The DOHaD may explain numerous conditions, including cardiovascular, metabolic, respiratory, neuropsychiatric, and renal diseases. Potential antenatal and postnatal preventive measures, interventions, and future directions are discussed.
“健康与疾病的发育起源”（DOHaD）假说指的是早期发育暴露和胎儿生长对后期慢性病风险的影响。在胎儿期和出生后早期，细胞分化和组织形成受多种因素影响。产前和产后早期基因与环境之间的相互作用似乎对成年期多种疾病的发病至关重要。影响这种相互作用的重要因素包括遗传易感性、基因表达调控以及微生物群的变化。早产和宫内生长受限（IUGR）是DOHaD假说考虑的其他重要因素。早产与关键器官/系统的结构或功能发育受损或停滞有关，这使得早产儿在成年期易患心血管、呼吸和慢性肾脏疾病。生长受限定义为与子宫内预期生物学潜力相比胎儿生长受损，是增加后续疾病风险的另一个负面因素。与疾病发育编程相关的环境因素包括接触污染、压力、药物、有毒物质、营养和运动。DOHaD可以解释众多病症，包括心血管、代谢、呼吸、神经精神和肾脏疾病。本文还讨论了潜在的产前和产后预防措施、干预措施及未来方向。
