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成人疾病的胎儿编程迷人理论:对巴克假说基本原理的综述

The fascinating theory of fetal programming of adult diseases: A review of the fundamentals of the Barker hypothesis.

作者信息

Faa Gavino, Fanos Vassilios, Manchia Mirko, Van Eyken Peter, Suri Jasjit S, Saba Luca

机构信息

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA, USA.

出版信息

J Public Health Res. 2024 Mar 1;13(1):22799036241226817. doi: 10.1177/22799036241226817. eCollection 2024 Jan.

Abstract

The theory of fetal programming of adult diseases was first proposed by David J.P. Barker in the eighties of the previous century, to explain the higher susceptibility of some people toward the development of ischemic heart disease. According to his hypothesis, poor maternal living conditions during gestation represent an important risk factor for the onset of atherosclerotic heart disease later in life. The analysis of the early phases of fetal development is a fundamental tool for the risk stratification of children and adults, allowing the identification of susceptible or resistant subjects to multiple diseases later in life. Here, we provide a narrative summary of the most relevant evidence supporting the Barker hypothesis in multiple fields of medicine, including neuropsychiatric disorders, such as Parkinson disease and Alzheimer disease, kidney failure, atherosclerosis, coronary heart disease, stroke, diabetes, cancer onset and progression, metabolic syndrome, and infectious diseases including COVID-19. Given the consensus on the role of body weight at birth as a practical indicator of the fetal nutritional status during gestation, every subject with a low birth weight should be considered an "at risk" subject for the development of multiple diseases later in life. The hypothesis of the "physiological regenerative medicine," able to improve fetal organs' development in the perinatal period is discussed, in the light of recent experimental data indicating Thymosin Beta-4 as a powerful growth promoter when administered to pregnant mothers before birth.

摘要

成人疾病的胎儿编程理论最早由大卫·J·P·巴克于上世纪八十年代提出,用以解释一些人患缺血性心脏病的易感性较高的现象。根据他的假说,孕期母亲生活条件差是日后发生动脉粥样硬化性心脏病的一个重要危险因素。对胎儿发育早期阶段的分析是对儿童和成人进行风险分层的基本工具,有助于识别日后对多种疾病易感或有抵抗力的个体。在此,我们对多个医学领域中支持巴克假说的最相关证据进行了叙述性总结,这些领域包括神经精神疾病,如帕金森病和阿尔茨海默病、肾衰竭、动脉粥样硬化、冠心病、中风、糖尿病、癌症的发生和发展、代谢综合征以及包括新冠肺炎在内的传染病。鉴于出生体重作为孕期胎儿营养状况实际指标的作用已达成共识,每个低出生体重的个体都应被视为日后发生多种疾病的“高危”个体。鉴于最近的实验数据表明,在出生前给怀孕母亲注射胸腺素β-4时它是一种强大的生长促进剂,因此讨论了“生理性再生医学”这一能够在围产期改善胎儿器官发育的假说。

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