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Adverse childhood experiences and chronic lung diseases in adulthood: a systematic review and meta-analysis.

ABSTRACT: Background: Adverse childhood experiences (ACE) affect physical and mental health and may appear as risk factors for the development of different conditions in adult life. Objective: To perform a literature review and meta-analysis on risk indicators for the development of chronic lung diseases in adulthood associated with ACE. Method: We conducted a systematic literature review according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the online databases PubMed, PsycINFO, and Web of Science. Quantitative studies involving male and female adults were included. Fixed- and random-effect models were used in the estimation of meta-analytical measures. The heterogeneity between studies was assessed using I² statistics and Cochran's Q test. Results: A total of 19 studies were selected for the meta-analysis. The analyses showed statistically significant associations between ACE and lung diseases in general (OR = 1.41; CI 95%: 1.28-1.54), besides specific associations with asthma (OR = 1.32; CI 95%: 1.13-1.50) and COPD (OR = 1.44; CI 95%: 1.13-1.76). When the mediating effect of smoking was assessed separately we found a significant - although not quite expressive - association (OR = 1.06; CI 95%: 1.02 to 1.10), which weakens the hypothesis that a direct relationship exists between childhood trauma and the occurrence of lung diseases. Conclusions: ACE are an important risk factor for the development of lung diseases in adulthood, whether through direct or indirect contribution to this outcome, which highlights the relevance of increasing the awareness of health staff for the early detection and intervention in situations of vulnerability or risk in childhood as an important preventative measure.

SUBMITTER: Lopes S

PROVIDER: S-EPMC7034480 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundAdverse childhood experiences have been linked to increased multimorbidity, with physical and mental health consequences throughout life. Chronic pain is often associated with mood disorders, such as major depressive disorder (MDD); both have been linked to adverse childhood experiences. It is unclear how the effect of adverse childhood experiences on neural processing impacts on vulnerability to chronic pain, MDD, or both, and whether there are shared mechanisms. We aimed to assess evidence for central neural changes associated with adverse childhood experiences in subjects with chronic pain, MDD, or both using systematic review and meta-analysis.MethodsElectronic databases were systematically searched for neuroimaging studies of adverse childhood experiences, with chronic pain, MDD, or both. Two independent reviewers screened title, abstracts, and full text, and assessed quality. After extraction of neuroimaging data, activation likelihood estimate meta-analysis was performed to identify significant brain regions associated with these comorbidities.ResultsForty-nine of 2414 studies were eligible, of which 43 investigated adverse childhood experiences and MDD and six investigated adverse childhood experiences and chronic pain. None investigated adverse childhood experiences, chronic pain, and MDD together. Functional and structural brain abnormalities were identified in the superior frontal, lingual gyrus, hippocampus, insula, putamen, superior temporal, inferior temporal gyrus, and anterior cerebellum in patients with MDD exposed to adverse childhood experiences. In addition, brain function abnormalities were identified for patients with MDD or chronic pain and exposure to adverse childhood experiences in the cingulate gyrus, inferior parietal lobule, and precuneus in task-based functional MRI studies.ConclusionsWe found that adverse childhood experiences exposure can result in different functional and structural brain alterations in adults with MDD or chronic pain compared with those without adverse childhood experiences.Systematic review protocolPROSPERO CRD42021233989.

Project description:Epigenetic mechanisms are potential mediators of the physiological response to abuse by altering the genetic predisposition of the cellular response to the environment, leading to changes in the regulation of multiple organ systems. This study was established to review the epigenetic mechanisms associated with childhood abuse as well as the long-term determinants that these epigenetic changes may have on future illness. We retrospectively analysed the effect of exposure to adverse childhood experiences (ACEs, specifically those relating to childhood maltreatment) between the ages of 0 and 16 years on the human epigenome, as well as possible clinical associations. After meeting inclusion and exclusion criteria, 36 articles were included in this systematic review. Eight of these studies did not find a relationship between childhood maltreatment and DNA methylation. Of the remaining 28 studies, nine were genome-wide association studies, whereas the rest were candidate gene studies, mainly studying effects on neuroendocrine, serotoninergic and immunoregulatory systems. Meta-analysis of correlation coefficients from candidate gene studies estimated an association of childhood adversity and DNA methylation variation at r = 0.291 (P < 0.0001), and meta-analysis of two epigenome-wide association studies (EWASs) identified 44 differentially methylated CpG sites. In conclusion, childhood maltreatment may mediate epigenetic mechanisms through DNA methylation, thereby affecting physiological responses and conferring a predisposition to an increased risk for psychopathology and forensic repercussions. Similar evidence for somatic illnesses is not yet available. KEY POINTSAdverse childhood experiences are associated with increased mortality partly explained by acquired epigenetic changesThere is a positive correlation between childhood abuse and DNA methylation at specific gene sitesThe cumulative effect of different types of childhood abuse and neglect may lead to changes in DNA methylationEpigenome changes associated with childhood abuse appear to be involved in the development of psychiatric illness in adulthoodStudying epigenetic changes may have important public health and forensic applications in the future.

Project description:Adverse childhood experiences (ACEs) are presumed to influence internalizing and externalizing behaviors that can significantly debilitate long-term biopsychological development in individuals. Psychological resilience has been shown to effectively mediate the relationship between ACEs and negative health outcomes since individuals with low levels of resilience may have difficulty with bouncing back from toxic exposure to ACEs. Thus, the present systematic review and meta-analysis was aimed toward synthesizing current knowledge of the relationship between ACEs and psychological resilience in youths. A combination of key words relevant to the present study was searched on the PubMed, EMBASE, Scopus, Cochrane, and Google Scholar databases. The results were restricted to English publications and human studies, with subjects ranging between the age of 0 to 35 years. Effect-size measures inclusive of pooled correlation coefficients for correlation analyses and pooled odds ratios for regression analyses, respectively, were calculated using random-effect models to determine the relationship between ACEs and psychological resilience. The searches identified 85 potentially relevant studies. Among them, 76 were excluded due to limited access, irrelevant data, and the fact that the variables of interest were not explicitly measured or disclosed, leaving a final total of nine studies considered valid for the meta-analysis. Findings from correlational meta-analysis (n = 6) revealed a significantly negative association between ACEs and resilience (β = -0.120 [-0.196, -0.043]). The meta-analysis of the studies (n = 3) reporting dichotomous outcomes (ACE ≥ 1 vs. no ACE) indicated that subjects who experienced an ACE were 63% less likely to display high resilience, in comparison to subjects without such experiences. Our results support a negative association between ACEs and psychological resilience and highlight the multiple dimensions that constitute resilience in an ACE-exposure context. These findings may be particularly useful to policy makers and healthcare institutions in terms of helping them devise effective medical interventions and community outreach programs intended to develop resilience in youths, thus reducing health-risk behaviors and negative health outcomes.

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Adverse childhood experiences and chronic lung diseases in adulthood: a systematic review and meta-analysis.

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