童年逆境是自身免疫性疾病的危险因素：一项对精神病学影响的系统回顾和荟萃分析

IF 8.8 2区医学 Q1 IMMUNOLOGY

Brain, Behavior, and Immunity Pub Date : 2025-05-02 DOI:10.1016/j.bbi.2025.04.036

Jehanita Jesuthasan , Cameron J. Watson , Danish Hafeez , Katharine Lynch-Kelly , Andrea Danese , Thomas A. Pollak

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引用次数: 0

摘要

自身免疫性疾病是由遗传和环境因素相互作用引起的异质疾病，导致免疫反应失调。童年逆境是一种对免疫系统具有持久影响的环境风险因素，因此可能与自身免疫性疾病的病因有关。本系统综述和荟萃分析旨在研究童年逆境与成年后自身免疫性疾病之间的关系。方法检索电子数据库（MEDLINE、PsycINFO、Embase和Web of Science），检索同行评议的英文研究，检查诊断为任何自身免疫性疾病的成年人的童年逆境发生率。本研究注册号为PROSPERO， CRD42023439745。荟萃分析包括来自27项研究的45个效应量（Ncases = 8728, Ncontrol = 3298392）。结果显示影响较小(SMD = 0.30, 95% CI [0.20-0.40], p <；儿童期逆境暴露与成年期自身免疫性疾病的关系为0.001)。异质性非常高，Egger检验和漏斗图检验表明可能存在发表偏倚。类风湿关节炎(SMD = 0.48, 95% CI [0.20-0.76], p <；0.001),牛皮癣(SMD = 0.30, 95% CI [0.17 - -0.43], p & lt;0.001)、多发性硬化症（SMD = 0.20, 95% CI [0.01-0.38], p = 0.008）和炎症性肠病（SMD = 0.31, 95% CI [0.04-0.58], p = 0.024）均与童年逆境有关。系统性红斑狼疮则没有（SMD = 0.17, 95% CI [-0.06-0.41], p = 0.141）。21项研究被评估为高偏倚风险。有证据表明童年逆境史与自身免疫性疾病之间存在关联。这种暴露可能导致自身免疫性疾病和严重精神疾病之间的合并症升高。然而，由于证据的异质性和大量研究的高偏倚风险，结果应谨慎对待。可能的机制背后的关系和影响的治疗和预防自身免疫性疾病进行了讨论。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Childhood adversity as a risk factor for autoimmune disease: A systematic review and meta-analysis with implications for psychiatry

Background

Autoimmune diseases are a heterogeneous category of disorders caused by an interaction between genetic and environmental factors which lead to a dysregulated immune response. Childhood adversity is an environmental risk factor with enduring effects on the immune system and may therefore be implicated in the aetiology of autoimmune disorders. This systematic review and meta-analysis sought to examine the association between childhood adversity and autoimmune disease in adulthood.

Methods

Electronic databases (MEDLINE, PsycINFO, Embase, and Web of Science) were searched for peer-reviewed studies in English, examining rates of childhood adversity in adults with a diagnosis of any autoimmune disease. This study was registered with PROSPERO, CRD42023439745.

Findings

The meta-analysis included 45 effect sizes from 27 studies (Ncases = 8,728, Ncontrol = 3,298,392). Results revealed a small effect (SMD = 0.30, 95 % CI [0.20–0.40], p < 0.001) of exposure to childhood adversity on autoimmune disease in adulthood. Heterogeneity was very high, and Egger’s test and funnel plot inspection suggested that publication bias may be present. Rheumatoid arthritis (SMD = 0.48, 95 % CI [0.20–0.76], p < 0.001), psoriasis (SMD = 0.30, 95 % CI [0.17–0.43], p < 0.001), multiple sclerosis (SMD = 0.20, 95 % CI [0.01–0.38], p = 0.008), and inflammatory bowel disease (SMD = 0.31, 95 % CI [0.04–0.58], p = 0.024) were each associated with childhood adversity. Systemic lupus erythematosus was not (SMD = 0.17, 95 % CI [-0.06–0.41], p = 0.141). Twenty-one studies were assessed as being at high risk of bias.

Interpretation

There is evidence of an association between a history of childhood adversity and autoimmune disorders. This exposure may contribute to the elevated comorbidity between autoimmune diseases and severe mental illnesses. Due to the heterogeneity of the evidence and the high risk of bias in numerous studies, however, results should be treated with caution. Possible mechanisms underlying the relationship and implications for treatment and prevention of autoimmune diseases are discussed.

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来源期刊

Brain, Behavior, and Immunity 医学-免疫学

CiteScore

29.60

自引率

2.00%

发文量

290

审稿时长

28 days

期刊介绍： Established in 1987, Brain, Behavior, and Immunity proudly serves as the official journal of the Psychoneuroimmunology Research Society (PNIRS). This pioneering journal is dedicated to publishing peer-reviewed basic, experimental, and clinical studies that explore the intricate interactions among behavioral, neural, endocrine, and immune systems in both humans and animals. As an international and interdisciplinary platform, Brain, Behavior, and Immunity focuses on original research spanning neuroscience, immunology, integrative physiology, behavioral biology, psychiatry, psychology, and clinical medicine. The journal is inclusive of research conducted at various levels, including molecular, cellular, social, and whole organism perspectives. With a commitment to efficiency, the journal facilitates online submission and review, ensuring timely publication of experimental results. Manuscripts typically undergo peer review and are returned to authors within 30 days of submission. It's worth noting that Brain, Behavior, and Immunity, published eight times a year, does not impose submission fees or page charges, fostering an open and accessible platform for scientific discourse.