Giovannini Niccolò, Lattuada Debora, Danusso Roberta, Ferrazzi Enrico
Department of women-child-newborn Obstetrics and Gynaecology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
J Matern Fetal Neonatal Med. 2023 Dec;36(1):2183738. doi: 10.1080/14767058.2023.2183738.
SARS-CoV2 is the latest pandemic that have plagued the socio-health system as an epiphenomenon resulting from planetary resources abuse, crucial for biodiversity. The Anthropocene best defines the present epoch in which human activity irreversibly manipulates intricate and delicate geological and biological balances established over eons. The devastating ecological and socio-economic implications of COVID-19, underline the importance of updating the present pandemic framework to a syndemic. This paper stems from the need to suggest to scientists, doctors, and patients a mission that integrates responsibility from individual to collective health, from present to trans-generational, from human to the entire biotic network. Today's choices are crucial for the perspective on all levels: political, economic, and health as well as cultural. Research on PubMed and other specific web-sites journal was performed on the topic "Microbiota", "Covid-19", "Pandemic", "Zoonosis", "SARS-CoV-2", "Environmental Pollutants", "Epigenetics", "Fetal Programming", "Human Extinction". Data collected were analysed for an integrative model of interconnection between environment, pregnancy, SARS-CoV-2 infection, and microbiota. Moreover, systematic literature review allowed to summarise in a table information about the worst pandemics that afflicted the human species recently. This paper offers a broad view of the current pandemic starting with pregnancy, the moment when a new life begins and the health trajectories of the unborn child are defined, which will inevitably have repercussions on his well-being. The fundamental role of the biodiversity-rich microbiota in avoiding the development of severe infectious diseases, is therefore highlighted. It is imperative to adjust the current reductionist paradigm based on mostly immediate symptom management towards a broader understanding of the spatial interconnection of ecological niches with human health and the impacts of today's choices on the future. Health and healthcare are elitist rather than egalitarian, therefore focusing on environmental health forces us to make a concerted and systemic effort that challenges political and economic barriers, which are biologically senseless. A healthy microbiota is essential to well-being, both by preventing chronic degenerative conditions, the infectiousness and pathogenicity of bacterial and viral diseases. SARS-CoV-2 should not be an exception. The human microbiota, forged by the first 1,000 days of life, is fundamental in shaping the health-disease trajectories, and by the everlasting exposome that is dramatically affected by the ecological disaster. Individual health is one world health whereas single and global well-being are interdependent in a space-time perspective. Is it not a convenient reductionism not to consider the COVID-19 emergency as a bio-social epiphenomenon of a far more devastating and multi-faceted crisis whose common denominator is the global biotic network loss of which humans are still part?
严重急性呼吸综合征冠状病毒2(SARS-CoV-2)是最新的一场大流行病,它作为地球资源滥用导致的一种附带现象,给社会卫生系统带来了困扰,而地球资源滥用对生物多样性至关重要。人类世最恰当地定义了当前这个时代,在这个时代,人类活动不可逆转地操纵着历经漫长岁月建立起来的复杂而微妙的地质和生物平衡。2019冠状病毒病(COVID-19)造成的毁灭性生态和社会经济影响,突显了将当前的大流行框架更新为共病流行的重要性。本文源于一种需求,即向科学家、医生和患者提出一项使命,该使命整合了从个人健康到集体健康、从当下到跨代、从人类到整个生物网络的责任。当今的选择在各个层面都至关重要:政治、经济、健康以及文化层面。我们在PubMed和其他特定网站期刊上就“微生物群”“COVID-19”“大流行”“人畜共患病”“SARS-CoV-2”“环境污染物”“表观遗传学”“胎儿编程”“人类灭绝”等主题进行了研究。对收集到的数据进行了分析,以建立一个环境、妊娠、SARS-CoV-2感染和微生物群之间相互联系的综合模型。此外,系统的文献综述使我们能够在一个表格中总结有关最近困扰人类的最严重大流行病的信息。本文从妊娠开始,对当前的大流行进行了全面审视,妊娠是新生命开始的时刻,未出生婴儿的健康轨迹由此确定,这将不可避免地对其福祉产生影响。因此,强调了富含生物多样性的微生物群在避免严重传染病发生方面的基本作用。必须摒弃当前主要基于即时症状管理的还原论范式,转而更广泛地理解生态位与人类健康的空间相互联系以及当今选择对未来的影响。健康和医疗保健是精英化而非平等化的,因此关注环境健康迫使我们做出协调一致的系统性努力,以挑战那些在生物学上毫无意义的政治和经济障碍。健康的微生物群对于福祉至关重要,它既能预防慢性退行性疾病,又能预防细菌和病毒疾病的传染性和致病性。SARS-CoV-2不应成为例外。在生命的最初1000天形成的人类微生物群,对于塑造健康与疾病轨迹至关重要,并且受到生态灾难严重影响的永恒暴露组也起着重要作用。个人健康就是全球健康,而个体和全球福祉在时空视角下是相互依存的。不将COVID-19紧急情况视为一场更具毁灭性和多面性危机的生物社会附带现象,难道不是一种便利的还原论吗?这场危机的共同特征是全球生物网络的丧失,而人类仍是其中一部分。