Kumsta Robert
Department of Behavioural and Cognitive Sciences, Faculty of Humanities, Education and Social Sciences, Laboratory for Stress and Gene-Environment Interplay, University of Luxemburg, Esch-sur-Alzette, Luxemburg; Faculty of Psychology, Institute for Health and Development, Ruhr University Bochum, Bochum, Germany; German Center for Mental Health (DZPG), partner site Bochum/Marburg, Germany.
Psychoneuroendocrinology. 2023 Oct;156:106364. doi: 10.1016/j.psyneuen.2023.106364. Epub 2023 Aug 11.
Exposure to early adversity is one of the most important and pervasive risk factors for the development of nearly all major mental disorders across the lifespan. In the search for the mediating mechanisms and processes that underlie long-term stability of these effects, changes to stress-associated hormonal and cellular signalling have emerged as prime candidates. This review summarises evidence showing that experience of early adversity in the form of childhood abuse or neglect and exposure to severe institutional deprivation influences multiple interconnected bio-behavioural, physiological and cellular processes. This paper focusses on dysregulations of hormonal stress regulation, altered DNA methylation pattern, changes to transcriptomic profiles in the context of stress-immune interplay, and mitochondrial biology. Consistent findings that have emerged include a relative cortisol hypoactivity and hyporeactivity in response to challenge, increased activity of pro-inflammatory genes, and altered mitochondrial function. The majority of investigations have focussed on single outcomes, but there is a clear rationale of conceiving the implicated physiological processes as interconnected parts of a wider stress-associated regulatory network, which in turn is connected to behaviour and mental disorders. This calls for integrated and longitudinal investigations to come to a more comprehensive understanding of the role of stress in the biological embedding of experience. The review concludes with considerations of how stress research can contribute to translational efforts through characterising subtypes of mental disorders which arise as a function of early adversity, and have distinct features of behavioral and biological stress processing.
暴露于早期逆境是一生中几乎所有主要精神障碍发展的最重要且最普遍的风险因素之一。在探寻这些影响长期稳定性背后的中介机制和过程时,与应激相关的激素和细胞信号传导变化已成为主要候选因素。本综述总结了证据,表明童年期虐待或忽视形式的早期逆境经历以及暴露于严重的机构剥夺会影响多个相互关联的生物行为、生理和细胞过程。本文重点关注激素应激调节失调、DNA甲基化模式改变、应激 - 免疫相互作用背景下转录组图谱的变化以及线粒体生物学。已出现的一致发现包括对挑战的相对皮质醇低活性和低反应性、促炎基因活性增加以及线粒体功能改变。大多数研究都集中在单一结果上,但将所涉及的生理过程视为更广泛的应激相关调节网络的相互关联部分是有明确依据的,而这个网络又与行为和精神障碍相关。这就需要进行综合和纵向研究,以便更全面地理解应激在经历的生物嵌入中的作用。综述最后考虑了应激研究如何通过表征因早期逆境而产生且具有行为和生物应激处理独特特征的精神障碍亚型,为转化研究做出贡献。