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首页> 外文期刊>Immunology and allergy clinics of North America >Epidemiology of stress and asthma: from constricting communities and fragile families to epigenetics.
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Epidemiology of stress and asthma: from constricting communities and fragile families to epigenetics.

机译：压力和哮喘的流行病学：从狭窄的社区和脆弱的家庭到表观遗传学。

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Several epidemiologic frameworks, exemplified through extant research examples, provide insight into the role of stress in the expression of asthma and other allergic disorders. Biologic, psychological, and social processes interact throughout the life course to influence disease expression. Studies exploiting a child development framework focus on critical periods of exposure, including the in utero environment, to examine the influence of stress on disease onset. Early stress effects that alter the normal course of morphogenesis and maturation that affect both structure and function of key organ systems (eg, immune, respiratory) may persist into adult life underscoring the importance of a life course perspective. Other evidence suggests that maternal stress influences programming of integrated physiologic systems in their offspring (eg, neuroendocrine, autonomic, immune function) starting in pregnancy; consequently stress effects may be transgenerational. A multilevel approach that includes an ecological perspective may help to explain heterogeneities in asthma expression across socioeconomic and geographic boundaries that to date remain largely unexplained. Evolving studies incorporating psychological, behavioral, and physiologic correlates of stress more specifically inform underlying mechanisms operating in these critical periods of development. The role of genetics, gene by environment interactions, and epigenetic mechanisms of gene expression have been sparsely examined in epidemiologic studies on stress and asthma although overlapping evidence provides proof of concept for such studies in the future.
机译：通过现有的研究实例来举例说明的几种流行病学框架，可以洞悉压力在哮喘和其他过敏性疾病表达中的作用。生物，心理和社会过程在整个生命过程中相互作用，从而影响疾病的表达。利用儿童发展框架的研究集中在暴露的关键时期，包括子宫内环境，以检验压力对疾病发作的影响。早期的应激影响会改变形态发生和成熟的正常过程，从而影响关键器官系统（例如免疫，呼吸）的结构和功能，这可能会延续到成年生活中，从而强调了生命过程观点的重要性。其他证据表明，从怀孕开始，母亲的压力会影响其后代的综合生理系统的编程（例如，神经内分泌，自主神经，免疫功能）。因此，压力影响可能是世代相传的。包括生态学观点的多层次方法可能有助于解释跨社会经济和地理边界的哮喘表达的异质性，迄今为止尚无法解释。涉及压力的心理，行为和生理相关性的不断发展的研究更具体地为在这些关键发展时期起作用的潜在机制提供了信息。在压力和哮喘的流行病学研究中，虽然稀疏的证据为将来进行此类研究提供了理论依据，但已经稀疏地检查了遗传学，基因与环境之间的相互作用以及基因表达的表观遗传机制的作用。

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