Department of Medicine and Surgery, University of Parma, Parma, Italy.
Unit of Paediatrics, P. Barilla Children's Hospital, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy.
Front Endocrinol (Lausanne). 2023 May 2;14:1149417. doi: 10.3389/fendo.2023.1149417. eCollection 2023.
Neuro-biological variations in the timing of sexual maturation within a species are part of an evolved strategy that depend on internal and external environmental conditions. An increased incidence of central precocious puberty (CPP) has been described in both adopted and "covid-19 pandemic" children. Until recently, it was hypothesised that the triggers for CPP in internationally adopted children were likely to be better nutrition, greater environmental stability, and improved psychological wellbeing. However, following data collected during and after the coronavirus (COVID-19) global pandemic, other possibilities must be considered. In a society with high levels of child wellbeing, the threat to life presented by an unknown and potentially serious disease and the stressful environment created by lockdowns and other public health measures could trigger earlier pubertal maturation as an evolutionary response to favour early reproduction. The main driver for increased rates of precocious and rapidly progressive puberty during the pandemic could have been the environment of "fear and stress" in schools and households. In many children, CPP may have been triggered by the psychological effects of living without normal social contact, using PPE, being near adults concerned about financial and other issues and the fear of getting ill. The features and time of progression of CPP in children during the pandemic are similar to those observed in adopted children. This review considers the mechanisms regulating puberty with a focus on neurobiological and evolutionary mechanisms, and analyses precocious puberty both during the pandemic and in internationally adopted children searching for common yet unconsidered factors in an attempt to identify the factors which may have acted as triggers. In particular, we focus on stress as a potential factor in the early activation of the hypothalamic-pituitary-gonadal axis and its correlation with rapid sexual maturation.
物种内部性成熟时间的神经生物学变化是一种进化策略的一部分，这种策略取决于内部和外部环境条件。在被收养的儿童和“covid-19 大流行”的儿童中，都已经描述了中枢性性早熟（CPP）发病率的增加。直到最近，人们假设国际收养儿童中 CPP 的触发因素可能是更好的营养、更稳定的环境和改善的心理健康。然而，在冠状病毒（COVID-19）大流行期间和之后收集的数据表明，还必须考虑其他可能性。在一个儿童福利水平较高的社会中，未知的、潜在严重的疾病所带来的生命威胁，以及封锁和其他公共卫生措施所造成的紧张环境，可能会引发更早的青春期成熟，作为一种有利于早期繁殖的进化反应。大流行期间青春期提前和快速进展的主要驱动因素可能是学校和家庭中“恐惧和压力”的环境。在许多儿童中，CPP 可能是由于没有正常社会接触、使用个人防护设备、接近担心财务和其他问题的成年人以及担心生病而产生的心理影响而引发的。大流行期间儿童 CPP 的特征和进展时间与收养儿童中观察到的相似。这篇综述考虑了调节青春期的机制，重点是神经生物学和进化机制，并分析了大流行期间和国际收养儿童中 CPP 的发生，寻找共同但未被考虑的因素，以确定可能作为触发因素的因素。特别是，我们关注压力作为下丘脑-垂体-性腺轴早期激活的潜在因素，以及它与快速性成熟的相关性。
