Hansen Anne Sofie, Rask Charlotte Ulrikka, Kallesøe Karen Hansen
Department of Child and Adolescent Psychiatry, Aalborg University Hospital, 9000 Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark.
Children (Basel). 2024 May 3;11(5):549. doi: 10.3390/children11050549.
Functional somatic disorders (FSDs) are common in children and adolescents. Recent findings suggest that low-grade inflammation has a role in the development and maintenance of pediatric FSDs. This systematic review included studies with original data on systemic inflammatory markers in children and adolescents with an FSD compared to individuals without an FSD. The literature search identified 1374 articles. After assessment, a total of 15 studies met the inclusion criteria. In total, 41 serum or plasma cytokines were assayed in a population of 696 children and adolescents. Altered cytokine levels in patients with FSDs were reported in 12 studies, whereas three studies found no significant differences when comparing patients with FSDs and controls. The cytokine levels were significantly elevated in nine studies (i.e., IL-2, IL-6, IL-8, IL-12 (p70), CRP, hsCRP, IP-10, MCP-1, sTIM-3, sCD25 and TNF-α). The findings indicate that inflammatory response may have a role in the pathophysiology of pediatric FSDs. However, the included studies showed limited quality with potential risk of bias, small study populations and a narrow spectrum of included FSDs, which limits the generalizability of the results. To further explore the potential link between inflammatory markers and pediatric FSDs, future research using a longitudinal study design is recommended.
功能性躯体障碍（FSDs）在儿童和青少年中很常见。最近的研究结果表明，低度炎症在儿童FSDs的发生和维持中起作用。本系统评价纳入了有关患有FSDs的儿童和青少年与未患FSDs的个体相比全身炎症标志物原始数据的研究。文献检索共识别出1374篇文章。经过评估，共有15项研究符合纳入标准。总共对696名儿童和青少年的群体检测了41种血清或血浆细胞因子。12项研究报告了FSDs患者细胞因子水平的改变，而3项研究在比较FSDs患者和对照组时未发现显著差异。9项研究中细胞（即白细胞介素-2、白细胞介素-6、白细胞介素-8、白细胞介素-12（p70）、C反应蛋白、超敏C反应蛋白、干扰素诱导蛋白-10、单核细胞趋化蛋白-1、可溶性T细胞免疫球蛋白黏蛋白分子-3、可溶性白细胞介素-2受体α链和肿瘤坏死因子-α）细胞因子水平显著升高。这些发现表明炎症反应可能在儿童FSDs的病理生理学中起作用。然而，纳入的研究显示质量有限，存在潜在的偏倚风险、研究人群规模小以及纳入的FSDs范围狭窄，这限制了结果的普遍性。为了进一步探索炎症标志物与儿童FSDs之间的潜在联系，建议未来采用纵向研究设计进行研究。
