Zusammenfassung
Hintergrund
Das stetig wachsende Forschungsgebiet der „Frühe[n] Programmierung von Krankheit und Gesundheit“ untersucht, inwieweit die individuelle Vulnerabilität für die Entstehung verschiedenster Erkrankungen über die Lebensspanne bereits während der frühen Entwicklung beeinflusst wird.
Ziele der Arbeit
In der vorliegenden Übersichtsarbeit werden das Konzept der frühen Programmierung von Krankheitsvulnerabilität erläutert sowie Befunde zu den Folgen frühkindlicher Traumatisierung und pränataler Stressexposition zusammenfassend dargestellt. Es werden außerdem biologische Mechanismen diskutiert, die das erhöhte Krankheitsrisiko nach lebensgeschichtlich früher Stresserfahrungen vermitteln. Die Möglichkeit der transgenerationalen Transmission frühkindlicher Erfahrungen an die nächste Generation und die zugrundeliegenden Mechanismen dieser Übertragung werden ebenfalls vorgestellt.
Fazit
Die Befundlage zu Stresserfahrungen im frühen Leben und der Entstehung von psychischen und körperlichen Störungen über die Lebensspanne wächst stetig. Die Mechanismen werden derzeit weiter bis hin zur molekularbiologischen und epigenetischen Ebene erforscht. Hier ergeben sich ganz neue Perspektiven, welche die Präzision klinischer Diagnostik und den Erfolg von Interventionen erheblich verbessern könnten. Momentan existiert jedoch noch ein erheblicher Mangel an Translation zwischen diesen Forschungserkenntnissen und deren Anwendung in der klinischen Versorgung.
Abstract
Background
The rapidly growing research field of developmental programming of health and disease risk investigates the early life origins of individual vulnerability for common, complex disorders that confer a major burden of disease.
Objectives
The present article introduces the concept of developmental programming of disease vulnerability and summarizes studies on the mental and physical health consequences of exposure to childhood trauma and prenatal stress. Biological mechanisms that mediate disease risk after early life stress are discussed. The possibility of transgenerational transmission of effects of childhood trauma in exposed women to their children and potential mechanisms of this transmission are also presented.
Conclusion
A substantial number of studies show associations between early life stress and risk for mental and somatic diseases in later life. The underlying mechanisms are currently being studied at the molecular and epigenetic level. Potentially, these findings will allow unprecedented opportunities to improve the precision of current clinical diagnostic tools and the success of interventions. However, there is currently a lack of translation of research findings related to developmental programming to clinical applications.
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Danksagung
Teile dieser Arbeit wurden unterstützt durch das „Verbundprojekt Berlin LCS: Unmittelbare biologische Einbettung von Kindesmisshandlung: Berliner Longitudinale Kinderstudie (Charité – Universitätsmedizin Berlin) (Förderkennzeichen: 01KR1301A) sowie durch die NIH Grants R01 HD065825 und R01 MH091351“.
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S. Entringer, C. Buss und C. Heim geben an, dass kein Interessenkonflikt besteht.
Alle Studien der Autoren an Menschen, die in diesem Beitrag erwähnt sind, wurden unter Einhaltung ethischer Richtlinien durchgeführt. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben.
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Entringer, S., Buss, C. & Heim, C. Frühe Stresserfahrungen und Krankheitsvulnerabilität. Bundesgesundheitsbl 59, 1255–1261 (2016). https://doi.org/10.1007/s00103-016-2436-2
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DOI: https://doi.org/10.1007/s00103-016-2436-2
Schlüsselwörter
- Frühe Programmierung
- Frühkindliche Traumatisierung
- Pränataler Stress
- Transgenerationale Transmission
- Epigenetik