1 2153 81 EPIGENETIC MECHANISMS ACTIVATED BY CHILDHOOD ADVERSITY. ADVERSE CHILDHOOD EXPERIENCES (ACE) IMPAIR HEALTH AND LIFE EXPECTANCY AND MAY RESULT IN AN EPIGENETIC SIGNATURE THAT DRIVES INCREASED MORBIDITY PRIMED DURING EARLY STAGES OF LIFE. THIS LITERATURE REVIEW FOCUSES ON THE CURRENT EVIDENCE FOR EPIGENETIC-MEDIATED PROGRAMMING OF BRAIN AND IMMUNE FUNCTION RESULTING FROM ACE. TO ADDRESS THIS AIM, A TOTAL OF 88 ARTICLES INDEXED IN PUBMED BEFORE AUGUST 2019 CONCERNING ACE AND EPIGENETICS WERE SURVEYED. CURRENT EVIDENCE PARTIALLY SUPPORTS EPIGENETIC PROGRAMMING OF THE HYPOTHALAMIC-PITUITARY-ADRENAL AXIS, BUT CONVINCINGLY SHOWS THAT ACE IMPAIRS IMMUNE FUNCTION. ADDITIONALLY, THE NEEDS AND CHALLENGES THAT FACE THIS AREA ARE DISCUSSED IN ORDER TO PROVIDE A FRAMEWORK THAT MAY HELP TO CLARIFY THE ROLE OF EPIGENETICS IN THE LONG-LASTING EFFECTS OF ACE. 2020 2 247 25 ADULTHOOD ASTHMA AS A CONSEQUENCE OF CHILDHOOD ADVERSITY: A SYSTEMATIC REVIEW OF EPIGENETICALLY AFFECTED GENES. THERE IS AN ACCUMULATING DATA THAT SHOWS RELATION BETWEEN CHILDHOOD ADVERSITY AND VULNERABILITY TO CHRONIC DISEASES AS WELL AS EPIGENETIC INFLUENCES THAT IN TURN GIVE RISE TO THESE DISEASES. ASTHMA IS ONE OF THE CHRONIC DISEASES THAT IS INFLUENCED FROM GENETIC REGULATION OF THE INFLAMMATORY BIOMOLECULES AND THEREFORE THE HYPOTHESIS IN THIS RESEARCH WAS CHILDHOOD ADVERSITY MIGHT HAVE CAUSED EPIGENETIC DIFFERENTIATION IN THE ASTHMA-RELATED GENES IN THE POPULATION WHO HAD CHILDHOOD TRAUMA. TO TEST THIS HYPOTHESIS, THE LITERATURE WAS SYSTEMATICALLY REVIEWED TO EXTRACT EPIGENETICALLY MODIFIED GENE DATA OF THE ADULTS WHO HAD CHILDHOOD ADVERSITY, AND AFFECTED GENES WERE FURTHER EVALUATED FOR THEIR ASSOCIATION WITH ASTHMA. PRISMA GUIDELINES WERE ADOPTED AND PUBMED AND GOOGLE SCHOLAR WERE INCLUDED IN THE SEARCHED DATABASES, TO EVALUATE EPIGENETIC MODIFICATIONS IN ASTHMA-RELATED GENES OF PHYSICALLY, EMOTIONALLY OR SEXUALLY ABUSED CHILDREN. AFTER RETRIEVING A TOTAL OF 5245 ARTICLES, 36 OF THEM WERE INCLUDED IN THE STUDY. SEVERAL GENES AND PATHWAYS THAT MAY CONTRIBUTE TO PATHOGENESIS OF ASTHMA DEVELOPMENT, INCREASED INFLAMMATION, OR RESPONSE TO ASTHMA TREATMENT WERE FOUND EPIGENETICALLY AFFECTED BY CHILDHOOD TRAUMAS. CHILDHOOD ADVERSITY, CAUSING EPIGENETIC CHANGES IN DNA, MAY LEAD TO ASTHMA DEVELOPMENT OR INFLUENCE THE COURSE OF THE DISEASE AND THEREFORE SHOULD BE TAKEN INTO ACCOUNT FOR THE PROLONGED HEALTH CONSEQUENCES. 2022 3 120 27 A SYSTEMATIC REVIEW OF CHILDHOOD MALTREATMENT AND DNA METHYLATION: CANDIDATE GENE AND EPIGENOME-WIDE APPROACHES. CHILDHOOD MALTREATMENT IS A MAJOR RISK FACTOR FOR CHRONIC AND SEVERE MENTAL AND PHYSICAL HEALTH PROBLEMS ACROSS THE LIFESPAN. INCREASING EVIDENCE SUPPORTS THE HYPOTHESIS THAT MALTREATMENT IS ASSOCIATED WITH EPIGENETIC CHANGES THAT MAY SUBSEQUENTLY SERVE AS MECHANISMS OF DISEASE. THE CURRENT REVIEW USES A SYSTEMATIC APPROACH TO IDENTIFY AND SUMMARIZE THE LITERATURE RELATED TO CHILDHOOD MALTREATMENT AND ALTERATIONS IN DNA METHYLATION IN HUMANS. A TOTAL OF 100 EMPIRICAL ARTICLES WERE IDENTIFIED IN OUR SYSTEMATIC REVIEW OF RESEARCH PUBLISHED PRIOR TO OR DURING MARCH 2020, INCLUDING STUDIES THAT FOCUSED ON CANDIDATE GENES AND STUDIES THAT LEVERAGED EPIGENOME-WIDE DATA IN BOTH CHILDREN AND ADULTS. THEMES ARISING FROM THE LITERATURE, INCLUDING CONSISTENT AND INCONSISTENT PATTERNS OF RESULTS, ARE PRESENTED. SEVERAL DIRECTIONS FOR FUTURE RESEARCH, INCLUDING IMPORTANT METHODOLOGICAL CONSIDERATIONS FOR FUTURE STUDY DESIGN, ARE DISCUSSED. TAKEN TOGETHER, THE LITERATURE ON CHILDHOOD MALTREATMENT AND DNA METHYLATION UNDERSCORES THE COMPLEXITY OF TRANSACTIONS BETWEEN THE ENVIRONMENT AND BIOLOGY ACROSS DEVELOPMENT. 2021 4 3582 20 IMPACT OF PRENATAL AND EARLY LIFE ENVIRONMENTAL EXPOSURES ON NORMAL HUMAN DEVELOPMENT. THE GLOBAL BURDEN AND PATTERN OF DISEASE HAS CHANGED IN RECENT DECADES, WITH FEWER EARLY CHILDHOOD DEATHS AND LONGER LIVES COMPLICATED BY CHRONIC DISEASE. DISRUPTION OF NORMAL HUMAN GROWTH AND DEVELOPMENT BY ADVERSE ENVIRONMENTAL EXPOSURES, ESPECIALLY DURING FOETAL DEVELOPMENT AND EARLY POSTNATAL LIFE INCREASE LIFE-LONG RISK OF CHRONIC DISEASE. THE DEVELOPMENTAL TIMING AND METHOD OF ADVERSE EXPOSURE DETERMINES THE LIKELY IMPACT ON HEALTH AND DEVELOPMENT. WHILE MANY ORGAN SYSTEMS ARE STRUCTURALLY AND FUNCTIONALLY MATURE AT BIRTH, THE CNS, RESPIRATORY AND IMMUNE SYSTEMS ARE NOT AND UNDERGO PROLONGED PERIODS OF POSTNATAL GROWTH AND DEVELOPMENT. AS SUCH, THESE ORGAN SYSTEMS ARE VULNERABLE TO ADVERSE EFFECTS OF BOTH PRENATAL AND POSTNATAL ENVIRONMENTAL EXPOSURES. WHILE THE PRECISE MECHANISMS UNDERLYING CHRONIC DISEASE ARE UNKNOWN, EPIGENETIC MECHANISMS AND THE INDUCTION OF OXIDATIVE STRESS ARE LIKELY TO BE INVOLVED. AN UNDERSTANDING OF THESE PROCESSES IS NECESSARY TO DEVELOP MITIGATION STRATEGIES AIMED AT REDUCING CHRONIC DISEASE PREVALENCE. 2021 5 1765 21 EARLY-LIFE ADVERSITY-INDUCED LONG-TERM EPIGENETIC PROGRAMMING ASSOCIATED WITH EARLY ONSET OF CHRONIC PHYSICAL AGGRESSION: STUDIES IN HUMANS AND ANIMALS. OBJECTIVES: TO EXAMINE WHETHER CHRONIC PHYSICAL AGGRESSION (CPA) IN ADULTHOOD CAN BE EPIGENETICALLY PROGRAMMED EARLY IN LIFE DUE TO EXPOSURE TO EARLY-LIFE ADVERSITY. METHODS: LITERATURE SEARCH OF PUBLIC DATABASES SUCH AS PUBMED/MEDLINE AND SCOPUS. RESULTS: CHILDREN/ADOLESCENTS SUSCEPTIBLE FOR CPA AND EXPOSED TO EARLY-LIFE ABUSE FAIL TO EFFICIENTLY COPE WITH STRESS THAT IN TURN RESULTS IN THE DEVELOPMENT OF CPA LATER IN LIFE. THIS PHENOMENON WAS OBSERVED IN HUMANS AND ANIMAL MODELS OF AGGRESSION. THE SUSCEPTIBILITY TO AGGRESSION IS A COMPLEX TRAIT THAT IS REGULATED BY THE INTERACTION BETWEEN ENVIRONMENTAL AND GENETIC FACTORS. EPIGENETIC MECHANISMS MEDIATE THIS INTERACTION. SUBJECTS EXPOSED TO STRESS EARLY IN LIFE EXHIBITED LONG-TERM EPIGENETIC PROGRAMMING THAT CAN INFLUENCE THEIR BEHAVIOUR IN ADULTHOOD. THIS PROGRAMMING AFFECTS EXPRESSION OF MANY GENES NOT ONLY IN THE BRAIN BUT ALSO IN OTHER SYSTEMS SUCH AS NEUROENDOCRINE AND IMMUNE. CONCLUSIONS: THE PROPENSITY TO ADULT CPA BEHAVIOUR IN SUBJECTS EXPERIENCED TO EARLY-LIFE ADVERSITY IS MEDIATED BY EPIGENETIC PROGRAMMING THAT INVOLVES LONG-TERM SYSTEMIC EPIGENETIC ALTERATIONS IN A WHOLE GENOME. 2019 6 6554 25 TRANSGENERATIONAL EFFECTS OF EARLY ENVIRONMENTAL INSULTS ON AGING AND DISEASE INCIDENCE. ADVERSE EARLY LIFE EXPERIENCES ARE MAJOR INFLUENCES ON DEVELOPMENTAL TRAJECTORIES WITH POTENTIALLY LIFE-LONG CONSEQUENCES. PRENATAL OR EARLY POSTNATAL EXPOSURE TO STRESS, UNDERNUTRITION OR ENVIRONMENTAL TOXICANTS MAY REPROGRAM BRAIN DEVELOPMENT AND INCREASE RISK OF BEHAVIOURAL AND NEUROLOGICAL DISORDERS LATER IN LIFE. NOT ONLY EXPERIENCE WITHIN A SINGLE LIFETIME, BUT ALSO ANCESTRAL EXPERIENCE AFFECTS HEALTH TRAJECTORIES AND CHANCES OF SUCCESSFUL AGING. THE CENTRAL MECHANISM IN TRANSGENERATIONAL PROGRAMMING OF A DISEASE MAY BE THE FORMATION OF EPIGENETIC MEMORY. THIS REVIEW EXPLORES TRANSGENERATIONAL EFFECTS OF EARLY ADVERSE EXPERIENCE ON HEALTH AND DISEASE INCIDENCE IN OLDER AGE. FIRST, WE ADDRESS MECHANISMS OF DEVELOPMENTAL AND TRANSGENERATIONAL PROGRAMMING OF DISEASE AND INHERITANCE. SECOND, WE DISCUSS EXPERIMENTAL AND CLINICAL FINDINGS LINKING EARLY ENVIRONMENTAL DETERMINANTS TO ADVERSE AGING TRAJECTORIES IN ASSOCIATION WITH POSSIBLE PARENTAL CONTRIBUTIONS AND SEX-SPECIFIC EFFECTS. THIRD, WE OUTLINE THE MAIN MECHANISMS OF AGE-RELATED FUNCTIONAL DECLINE AND SUGGEST POTENTIAL INTERVENTIONS TO REVERSE NEGATIVE EFFECTS OF TRANSGENERATIONAL PROGRAMMING. THUS, STRATEGIES THAT SUPPORT HEALTHY DEVELOPMENT AND SUCCESSFUL AGING SHOULD TAKE INTO ACCOUNT THE POTENTIAL INFLUENCES OF TRANSGENERATIONAL INHERITANCE. 2020 7 5316 26 PSYCHOLOGICAL STRESS IN EARLY LIFE AS A PREDISPOSING FACTOR FOR THE DEVELOPMENT OF CHRONIC PAIN: CLINICAL AND PRECLINICAL EVIDENCE AND NEUROBIOLOGICAL MECHANISMS. A WEALTH OF RESEARCH OVER THE PAST 2 DECADES HAS EXPANDED OUR UNDERSTANDING OF THE IMPACT OF EARLY-LIFE ADVERSITY ON PHYSIOLOGICAL FUNCTION AND, CONSEQUENTLY, HEALTH AND WELLBEING IN LATER LIFE. EARLY-LIFE ADVERSITY INCREASES THE RISK OF DEVELOPING A NUMBER OF DISORDERS, SUCH AS CHRONIC PAIN, FIBROMYALGIA, AND IRRITABLE BOWEL SYNDROME. ALTHOUGH MUCH OF THE RESEARCH HAS EXAMINED THE IMPACT OF PHYSICAL MALTREATMENT, AN INCREASING NUMBER OF STUDIES HAVE BEEN PUBLISHED OVER THE PAST FEW YEARS EXAMINING THE EFFECT OF CHILDHOOD PSYCHOLOGICAL STRESS AND TRAUMA ON THE DEVELOPMENT OF VARIOUS TYPES OF CHRONIC PAIN CONDITIONS. WE REVIEW THE CLINICAL AND PRECLINICAL DATA EXAMINING THE LINK AMONG EARLY-LIFE PSYCHOLOGICAL STRESS, ALTERED NOCICEPTIVE BEHAVIOR, AND CHRONIC PAIN IN LATER LIFE. EVIDENCE SUPPORTING A ROLE FOR CERTAIN KEY NEUROBIOLOGICAL SUBSTRATES, INCLUDING THE HYPOTHALAMIC-PITUITARY-ADRENAL AXIS; MONOAMINERGIC, OPIOIDERGIC, ENDOCANNABINOID AND IMMUNE SYSTEMS; AND EPIGENETIC MECHANISMS IN THE ASSOCIATION BETWEEN EARLY-LIFE PSYCHOLOGICAL STRESS AND CHRONIC PAIN, IS PROVIDED. GREATER UNDERSTANDING OF THE IMPACT OF EARLY-LIFE STRESS MAY INFORM THE DEVELOPMENT OF PERSONALIZED TREATMENTS FOR CHRONIC PAIN IN LATER LIFE AND STRATEGIES TO PREVENT ITS ONSET IN SUSCEPTIBLE INDIVIDUALS. (C) 2016 WILEY PERIODICALS, INC. 2017 8 5164 23 PRECLINICAL AND CLINICAL EVIDENCE OF DNA METHYLATION CHANGES IN RESPONSE TO TRAUMA AND CHRONIC STRESS. EXPOSURE TO CHRONIC STRESS, EITHER REPEATED SEVERE ACUTE OR MODERATE SUSTAINED STRESS, IS ONE OF THE STRONGEST RISK FACTORS FOR THE DEVELOPMENT OF PSYCHOPATHOLOGIES SUCH AS POST-TRAUMATIC STRESS DISORDER AND DEPRESSION. CHRONIC STRESS IS LINKED WITH SEVERAL LASTING BIOLOGICAL CONSEQUENCES, PARTICULARLY TO THE STRESS ENDOCRINE SYSTEM BUT ALSO AFFECTING INTERMEDIATE PHENOTYPES SUCH AS BRAIN STRUCTURE AND FUNCTION, IMMUNE FUNCTION, AND BEHAVIOR. ALTHOUGH GENETIC PREDISPOSITION CONFERS A PROPORTION OF THE RISK, THE MOST RELEVANT MOLECULAR MECHANISMS DETERMINING THOSE SUSCEPTIBLE AND RESILIENT TO THE EFFECTS OF STRESS AND TRAUMA MAY BE EPIGENETIC. EPIGENETICS REFERS TO THE MECHANISMS THAT REGULATE GENOMIC INFORMATION BY DYNAMICALLY CHANGING THE PATTERNS OF TRANSCRIPTION AND TRANSLATION OF GENES. MOUNTING EVIDENCE FROM PRECLINICAL RODENT AND CLINICAL POPULATION STUDIES STRONGLY SUPPORT THAT EPIGENETIC MODIFICATIONS CAN OCCUR IN RESPONSE TO TRAUMATIC AND CHRONIC STRESS. HERE, WE DISCUSS THIS LITERATURE EXAMINING STRESS-INDUCED EPIGENETIC CHANGES IN PRECLINICAL MODELS AND CLINICAL COHORTS OF STRESS AND TRAUMA OCCURRING EARLY IN LIFE OR IN ADULTHOOD. WE HIGHLIGHT THAT A COMPLEX RELATIONSHIP BETWEEN THE TIMING OF ENVIRONMENTAL STRESSORS AND GENETIC PREDISPOSITIONS LIKELY MEDIATE THE RESPONSE TO CHRONIC STRESS OVER TIME, AND THAT A BETTER UNDERSTANDING OF EPIGENETIC CHANGES IS NEEDED BY FURTHER INVESTIGATIONS IN LONGITUDINAL AND POSTMORTEM BRAIN CLINICAL COHORTS. 2017 9 6065 26 THE DEVELOPMENTAL ORIGINS OF CHRONIC PHYSICAL AGGRESSION: BIOLOGICAL PATHWAYS TRIGGERED BY EARLY LIFE ADVERSITY. LONGITUDINAL EPIDEMIOLOGICAL STUDIES WITH BIRTH COHORTS HAVE SHOWN THAT PHYSICAL AGGRESSION IN HUMANS DOES NOT APPEAR SUDDENLY IN ADOLESCENCE AS COMMONLY THOUGHT. IN FACT, PHYSICALLY AGGRESSIVE BEHAVIOUR IS OBSERVED AS EARLY AS 12 MONTHS AFTER BIRTH, ITS FREQUENCY PEAKS AROUND 2-4 YEARS OF AGE AND DECREASES IN FREQUENCY UNTIL EARLY ADULTHOOD. HOWEVER, A MINORITY OF CHILDREN (3-7%) MAINTAIN A HIGH FREQUENCY OF PHYSICAL AGGRESSION FROM CHILDHOOD TO ADOLESCENCE AND DEVELOP SERIOUS SOCIAL ADJUSTMENT PROBLEMS DURING ADULTHOOD. GENETIC FACTORS AND EARLY SOCIAL EXPERIENCES, AS WELL AS THEIR INTERACTION, HAVE BEEN SHOWN TO PLAY AN IMPORTANT ROLE IN THE DEVELOPMENT OF CHRONIC AGGRESSIVE BEHAVIOUR. HOWEVER, THE BIOLOGICAL MECHANISMS UNDERLYING THESE ASSOCIATIONS ARE JUST BEGINNING TO BE UNCOVERED. RECENT EVIDENCE SUGGESTS THAT EPIGENETIC MECHANISMS ARE RESPONSIVE TO ADVERSE ENVIRONMENTS AND COULD BE INVOLVED IN THE DEVELOPMENT OF CHRONIC AGGRESSION. USING BOTH GENE CANDIDATE AND GENOMIC APPROACHES, RECENT STUDIES HAVE IDENTIFIED EPIGENETIC MARKS, SUCH AS DNA METHYLATION ALTERATIONS IN GENES INVOLVED IN THE STRESS RESPONSE AND THE SEROTONIN AND IMMUNE SYSTEMS TO BE PARTLY RESPONSIBLE FOR THE LONG-LASTING EFFECTS OF EARLY ADVERSITY. FURTHER LONGITUDINAL STUDIES WITH BIOLOGICAL, ENVIRONMENTAL AND BEHAVIOURAL ASSESSMENTS FROM BIRTH ONWARDS ARE NEEDED TO ELUCIDATE THE SEQUENCE OF EVENTS THAT LEADS TO THESE LONG-LASTING EPIGENETIC MARKS ASSOCIATED WITH EARLY ADVERSITY AND AGGRESSION. 2015 10 1151 28 CONNECTIONS AMONG BIOLOGIC EMBEDDING OF CHILDHOOD ADVERSITY, ADULT CHRONIC ILLNESS, AND WOUND CARE: A REVIEW OF THE LITERATURE. ADVERSE CHILDHOOD EXPERIENCES (ACES) BIOLOGICALLY EMBED BY ALTERING BRAIN DEVELOPMENT AND INFLUENCING EPIGENETIC MECHANISMS. THESE EXPERIENCES MAY GENERATE HEALTH RISK FACTORS. PURPOSE: A LITERATURE REVIEW WAS CONDUCTED TO COMPARE ACE-GENERATED HEALTH RISK FACTORS WITH RISK FACTORS FOR WOUND DEVELOPMENT AND ABERRANT HEALING, AS WELL AS TO IDENTIFY A GAP IN LITERATURE REGARDING CRITICAL CONNECTIONS BETWEEN ACES, CHRONIC ILLNESS, AND WOUND DEVELOPMENT/HEALING, WITH ASSOCIATED PRACTICE IMPLICATIONS. METHODOLOGY: A LITERATURE SEARCH OF ENGLISH-LANGUAGE ARTICLES WAS CONDUCTED USING THE CUMULATIVE INDEX OF NURSING AND ALLIED HEALTH LITERATURE, MEDLINE, AND PUBMED USING THE SEARCH TERMS ADVERSE CHILDHOOD EXPERIENCES, ADULTS, WOUNDS, CHRONIC DISEASE OR ILLNESS, AND EPIGENETICS. THE SEARCHES YIELDED 561 PUBLICATIONS REGARDING ACES, CHRONIC ILLNESS OR DISEASE, AND ADULT; 182 FOR ACES; AND 547 FOR EPIGENETICS AND WOUNDS. ABSTRACTS WERE REVIEWED TO REMOVE DUPLICATES AND STUDIES WITH PARTICIPANTS WHO WERE <18 YEARS OLD. PUBLICATIONS WERE REVIEWED FOR SALIENCE; THOSE DISCUSSING THE BIOLOGIC PLAUSIBILITY OF ACES CONTRIBUTING TO ADULT ILLNESSES AND ASSOCIATED WOUND DEVELOPMENT AND HEALING WERE REVIEWED FOR INCLUSION. RESULTS: SIXTY-EIGHT (68) PUBLICATIONS WERE FOUND APPROPRIATE FOR REVIEW AND INCLUDED POPULATION-BASED STUDIES; LITERATURE REVIEWS; EPIDEMIOLOGIC DATA; META-ANALYSES; AND SYSTEMATIC, CROSS-SECTIONAL, OBSERVATIONAL, AND PROSPECTIVE STUDIES AS SINGULAR OR MIXED METHODS DESIGNS. A SUBSTANTIAL OVERLAP WAS FOUND IN TERMS OF RISK FACTORS GENERATED BY ACE EXPOSURE AND RISK FACTORS FOR WOUND DEVELOPMENT/HEALING, AS WAS A GAP IN THE LITERATURE REGARDING THIS RELATIONSHIP. EPIGENETIC MECHANISMS AND ALTERED BRAIN DEVELOPMENT ARE IMPLICATED IN PROCESSES THROUGH WHICH CHILDHOOD ADVERSITY ERODES HUMAN HEALTH. CONCLUSION: ADULT HEALTH RISKS AS A RESULT OF EXPOSURE TO ACES AND CRITICAL CONNECTIONS WITH RISKS FOR WOUND DEVELOPMENT AND DISRUPTED WOUND HEALING VIA EPIGENETIC INFLUENCES ARE RECOGNIZED IN THE LITERATURE. PRACTICE IMPLICATIONS INCLUDE CONSIDERING SCREENING FOR THE RISK FACTOR OF ACES EXPOSURE IN ADULT PATIENTS TO IDENTIFY THIS ADDITIONAL RISK FACTOR AND PRACTICING PATIENT-CENTERED, TRAUMA-INFORMED CARE. FURTHER RESEARCH INTO THE INTEGRATIVE ROLES OF THESE FACTORS IS WARRANTED. 2019 11 4591 22 NARRATIVE REVIEW OF THE COMPLEX INTERACTION BETWEEN PAIN AND TRAUMA IN CHILDREN: A FOCUS ON BIOLOGICAL MEMORY, PRECLINICAL DATA, AND EPIGENETIC PROCESSES. THE INCIDENCE AND COLLECTIVE IMPACT OF EARLY ADVERSE EXPERIENCES, TRAUMA, AND PAIN CONTINUE TO INCREASE. THIS UNDERSCORES THE URGENT NEED FOR TRANSLATIONAL EFFORTS BETWEEN CLINICAL AND PRECLINICAL RESEARCH TO BETTER UNDERSTAND THE UNDERLYING MECHANISMS AND DEVELOP EFFECTIVE THERAPEUTIC APPROACHES. AS OUR UNDERSTANDING OF THESE ISSUES IMPROVES FROM STUDIES IN CHILDREN AND ADOLESCENTS, WE CAN CREATE MORE PRECISE PRECLINICAL MODELS AND ULTIMATELY TRANSLATE OUR FINDINGS BACK TO CLINICAL PRACTICE. A MULTIDISCIPLINARY APPROACH IS ESSENTIAL FOR ADDRESSING THE COMPLEX AND WIDE-RANGING EFFECTS OF THESE EXPERIENCES ON INDIVIDUALS AND SOCIETY. THIS NARRATIVE REVIEW AIMS TO (1) DEFINE PAIN AND TRAUMA EXPERIENCES IN CHILDHOOD AND ADOLESCENTS, (2) DISCUSS THE RELATIONSHIP BETWEEN PAIN AND TRAUMA, (3) CONSIDER THE ROLE OF BIOLOGICAL MEMORY, (4) DECIPHER THE RELATIONSHIP BETWEEN PAIN AND TRAUMA USING PRECLINICAL DATA, AND (5) EXAMINE THE ROLE OF THE ENVIRONMENT BY INTRODUCING THE IMPORTANCE OF EPIGENETIC PROCESSES. THE ULTIMATE SCOPE IS TO BETTER UNDERSTAND THE WIDE-RANGING EFFECTS OF TRAUMA, ABUSE, AND CHRONIC PAIN ON CHILDREN AND ADOLESCENTS, HOW THEY OCCUR, AND HOW TO PREVENT OR MITIGATE THEIR EFFECTS AND DEVELOP EFFECTIVE TREATMENT STRATEGIES THAT ADDRESS BOTH THE UNDERLYING CAUSES AND THE ASSOCIATED PHYSIOLOGICAL AND PSYCHOLOGICAL EFFECTS. 2023 12 634 23 BIOLOGICAL EMBEDDING OF EARLY-LIFE ADVERSITY AND A SCOPING REVIEW OF THE EVIDENCE FOR INTERGENERATIONAL EPIGENETIC TRANSMISSION OF STRESS AND TRAUMA IN HUMANS. SEVERE OR CHRONIC STRESS AND TRAUMA CAN HAVE A DETRIMENTAL IMPACT ON HEALTH. EVIDENCE SUGGESTS THAT EARLY-LIFE ADVERSITY CAN BECOME BIOLOGICALLY EMBEDDED AND HAS THE POTENTIAL TO INFLUENCE HEALTH OUTCOMES DECADES LATER. EPIGENETICS IS ONE MECHANISM THAT HAS BEEN IMPLICATED IN THESE LONG-LASTING EFFECTS. OBSERVATIONAL STUDIES IN HUMANS INDICATE THAT THE EFFECTS OF STRESS COULD EVEN PERSIST ACROSS GENERATIONS, ALTHOUGH WHETHER OR NOT EPIGENETIC MECHANISMS ARE INVOLVED REMAINS UNDER DEBATE. HERE, WE PROVIDE AN OVERVIEW OF STUDIES IN ANIMALS AND HUMANS THAT DEMONSTRATE THE EFFECTS OF EARLY-LIFE STRESS ON DNA METHYLATION, ONE OF THE MOST WIDELY STUDIED EPIGENETIC MECHANISMS, AND SUMMARIZE FINDINGS FROM ANIMAL MODELS DEMONSTRATING THE INVOLVEMENT OF EPIGENETICS IN THE TRANSMISSION OF STRESS ACROSS GENERATIONS. WE THEN DESCRIBE THE RESULTS OF A SCOPING REVIEW TO DETERMINE THE EXTENT TO WHICH THE TERMS INTERGENERATIONAL OR TRANSGENERATIONAL HAVE BEEN USED IN HUMAN STUDIES INVESTIGATING THE TRANSMISSION OF TRAUMA AND STRESS VIA EPIGENETIC MECHANISMS. WE END WITH A DISCUSSION OF KEY AREAS FOR FUTURE RESEARCH TO ADVANCE UNDERSTANDING OF THE ROLE OF EPIGENETICS IN THE LEGACY EFFECTS OF STRESS AND TRAUMA. 2023 13 6729 28 VULNERABILITY TO STROKE: IMPLICATIONS OF PERINATAL PROGRAMMING OF THE HYPOTHALAMIC-PITUITARY-ADRENAL AXIS. CHRONIC STRESS IS CAPABLE OF EXACERBATING EACH MAJOR, MODIFIABLE, ENDOGENOUS RISK FACTOR FOR CEREBROVASCULAR AND CARDIOVASCULAR DISEASE. INDEED, EXPOSURE TO STRESS CAN INCREASE BOTH THE INCIDENCE AND SEVERITY OF STROKE, PRESUMABLY THROUGH ACTIVATION OF THE HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS. NOW THAT CHARACTERIZATION OF THE MECHANISMS UNDERLYING EPIGENETIC PROGRAMMING OF THE HPA AXIS IS WELL UNDERWAY, THERE HAS BEEN RENEWED INTEREST IN EXAMINING THE ROLE OF EARLY ENVIRONMENT ON THE EVOLUTION OF HEALTH CONDITIONS ACROSS THE ENTIRE LIFESPAN. INDEED, NEONATAL MANIPULATIONS IN RODENTS THAT REDUCE STRESS RESPONSIVITY, AND SUBSEQUENT LIFE-TIME EXPOSURE TO GLUCOCORTICOIDS, ARE ASSOCIATED WITH A REDUCTION IN THE DEVELOPMENT OF NEUROENDOCRINE, NEUROANATOMICAL, AND COGNITIVE DYSFUNCTIONS THAT TYPICALLY PROGRESS WITH AGE. ALTHOUGH IMPROVED DAY TO DAY REGULATION OF THE HPA AXIS ALSO MAY BE ACCOMPANIED BY A DECREASE IN STROKE RISK, EVIDENCE FROM RODENT STUDIES SUGGEST THAT AN ASSOCIATED COST COULD BE INCREASED SUSCEPTIBILITY TO INFLAMMATION AND NEURONAL DEATH IN THE EVENT THAT A STROKE DOES OCCUR AND THE INDIVIDUAL IS EXPOSED TO PERSISTENTLY ELEVATED CORTICOSTEROIDS. GIVEN ITS IMPORTANCE IN REGULATION OF HEALTH AND DISEASE STATES, ANY LONG-TERM MODULATION OF THE HPA AXIS IS LIKELY TO BE ASSOCIATED WITH BOTH BENEFITS AND POTENTIAL RISKS. THE GOALS OF THIS REVIEW ARTICLE ARE TO EXAMINE (1) THE CLINICAL AND EXPERIMENTAL DATA SUGGESTING THAT NEONATAL EXPERIENCES CAN SHAPE HPA AXIS REGULATION, (2) THE INFLUENCE OF STRESS AND THE HPA AXIS ON STROKE INCIDENCE AND SEVERITY, AND (3) THE POTENTIAL FOR NEONATAL PROGRAMMING OF THE HPA AXIS TO IMPACT ADULT CEREBROVASCULAR HEALTH. 2009 14 1938 26 EPIDEMIOLOGIC EVIDENCE FOR ASSOCIATION BETWEEN ADVERSE ENVIRONMENTAL EXPOSURES IN EARLY LIFE AND EPIGENETIC VARIATION: A POTENTIAL LINK TO DISEASE SUSCEPTIBILITY? A GROWING BODY OF EVIDENCE SUGGESTS THAT THE RISK OF DEVELOPMENT AND PROGRESSION OF A VARIETY OF HUMAN CHRONIC DISEASES DEPENDS ON EPIGENETIC MODIFICATIONS TRIGGERED BY ENVIRONMENTAL CUES DURING EARLY LIFE SENSITIVE STAGES. EXPOSURES TO ENVIRONMENTAL FACTORS SUCH AS ADVERSE NUTRITIONAL, PSYCHOLOGICAL, AND SOCIAL CONDITIONS, AS WELL AS POLLUTANTS AND SUBSTANCE ABUSE IN EARLY LIFE, HAVE BEEN SHOWN TO BE IMPORTANT DETERMINANTS OF EPIGENETIC PROGRAMMING OF CHRONIC PATHOLOGICAL CONDITIONS IN HUMAN POPULATIONS. OVER THE PAST YEARS, IT HAS BECOME INCREASINGLY CLEAR DUE TO THE EPIGENOME-WIDE ASSOCIATION STUDIES (EWASS) THAT EARLY LIFE ADVERSE ENVIRONMENTAL EVENTS MAY TRIGGER WIDESPREAD AND PERSISTENT ALTERATIONS IN TRANSCRIPTIONAL PROFILING. SEVERAL CANDIDATE GENES HAVE BEEN IDENTIFIED UNDERLYING THESE ASSOCIATIONS. IN THIS CONTEXT, DNA METHYLATION IS THE MOST INTENSIVELY STUDIED EPIGENETIC PHENOMENON. IN THIS REVIEW, THE CLINICAL AND EPIDEMIOLOGICAL EVIDENCE FOR THE ROLE OF EPIGENETIC FACTORS IN MEDIATING THE LINK BETWEEN EARLY LIFE EXPERIENCES AND LONG-TERM HEALTH OUTCOMES ARE SUMMARIZED. 2015 15 1229 26 CRITICAL WINDOWS: EXPLORING THE ASSOCIATION BETWEEN PERINATAL TRAUMA, EPIGENETICS, AND CHRONIC PAIN. CHRONIC PAIN IS HIGHLY PREVALENT AND BURDENSOME, AFFECTING MILLIONS OF PEOPLE WORLDWIDE. ALTHOUGH IT EMERGES AT ANY POINT IN LIFE, IT OFTEN MANIFESTS IN ADOLESCENCE. GIVEN THAT ADOLESCENCE IS A UNIQUE DEVELOPMENTAL PERIOD, ADDITIONAL STRAINS ASSOCIATED WITH PERSISTENT AND OFTEN IDIOPATHIC PAIN LEAD TO SIGNIFICANT LONG-TERM CONSEQUENCES. WHILE THERE IS NO SINGULAR CAUSE FOR THE CHRONIFICATION OF PAIN, EPIGENETIC MODIFICATIONS THAT LEAD TO NEURAL REORGANIZATION MAY UNDERPIN CENTRAL SENSITIZATION AND SUBSEQUENT MANIFESTATION OF PAIN HYPERSENSITIVITY. EPIGENETIC PROCESSES ARE PARTICULARLY ACTIVE DURING THE PRENATAL AND EARLY POSTNATAL YEARS. WE DEMONSTRATE HOW EXPOSURE TO VARIOUS TRAUMAS, SUCH AS INTIMATE PARTNER VIOLENCE WHILE IN UTERO OR ADVERSE CHILDHOOD EXPERIENCES, CAN SIGNIFICANTLY INFLUENCE EPIGENETIC REGULATION WITHIN THE BRAIN AND IN TURN MODIFY PAIN-RELATED PROCESSES. WE PROVIDE COMPELLING EVIDENCE THAT THE BURDEN OF CHRONIC PAIN IS LIKELY INITIATED EARLY IN LIFE, OFTEN BEING TRANSMITTED FROM MOTHER TO OFFSPRING. WE ALSO HIGHLIGHT TWO PROMISING PROPHYLACTIC STRATEGIES, OXYTOCIN ADMINISTRATION AND PROBIOTIC USE, THAT HAVE THE POTENTIAL TO ATTENUATE THE EPIGENETIC CONSEQUENCES OF EARLY ADVERSITY. OVERALL, WE ADVANCE UNDERSTANDING OF THE CAUSAL RELATIONSHIP BETWEEN TRAUMA AND ADOLESCENT CHRONIC PAIN BY HIGHLIGHTING EPIGENETIC MECHANISMS THAT UNDERLIE THIS TRANSMISSION OF RISK, ULTIMATELY INFORMING HOW TO PREVENT THIS RISING EPIDEMIC. 2023 16 2495 26 EPIGENETICS AND DOHAD: FROM BASICS TO BIRTH AND BEYOND. DEVELOPMENTAL ORIGINS OF HEALTH AND DISEASE (DOHAD) IS THE STUDY OF HOW THE EARLY LIFE ENVIRONMENT CAN IMPACT THE RISK OF CHRONIC DISEASES FROM CHILDHOOD TO ADULTHOOD AND THE MECHANISMS INVOLVED. EPIGENETIC MODIFICATIONS SUCH AS DNA METHYLATION, HISTONE MODIFICATIONS AND NON-CODING RNAS ARE INVOLVED IN MEDIATING HOW EARLY LIFE ENVIRONMENT IMPACTS LATER HEALTH. THIS REVIEW IS A SUMMARY OF THE EPIGENETICS AND DOHAD WORKSHOP HELD AT THE 2016 DOHAD SOCIETY OF AUSTRALIA AND NEW ZEALAND CONFERENCE. OUR EXTENSIVE KNOWLEDGE OF HOW THE EARLY LIFE ENVIRONMENT IMPACTS LATER RISK FOR CHRONIC DISEASE WOULD NOT HAVE BEEN POSSIBLE WITHOUT ANIMAL MODELS. IN THIS REVIEW WE HIGHLIGHT SOME ANIMAL MODEL EXAMPLES THAT DEMONSTRATE HOW AN ADVERSE EARLY LIFE EXPOSURE RESULTS IN EPIGENETIC AND GENE EXPRESSION CHANGES THAT MAY CONTRIBUTE TO INCREASED RISK OF CHRONIC DISEASE LATER IN LIFE. TYPE 2 DIABETES AND CARDIOVASCULAR DISEASE ARE CHRONIC DISEASES WITH AN INCREASING INCIDENCE DUE TO THE INCREASED NUMBER OF CHILDREN AND ADULTS THAT ARE OBESE. EPIGENETIC CHANGES SUCH AS DNA METHYLATION HAVE BEEN SHOWN TO BE ASSOCIATED WITH METABOLIC HEALTH MEASURES AND POTENTIALLY PREDICT FUTURE METABOLIC HEALTH STATUS. ALTHOUGH MORE DIFFICULT TO ELUCIDATE IN HUMANS, RECENT STUDIES SUGGEST THAT DNA METHYLATION MAY BE ONE OF THE EPIGENETIC MECHANISMS THAT MEDIATES THE EFFECTS OF EARLY LIFE EXPOSURES ON LATER LIFE RISK OF OBESITY AND OBESITY RELATED DISEASES. FINALLY, WE DISCUSS THE ROLE OF THE MICROBIOME AND HOW IT IS A NEW PLAYER IN DEVELOPMENTAL PROGRAMMING AND MEDIATING EARLY LIFE EXPOSURES ON LATER RISK OF CHRONIC DISEASE. 2017 17 6478 28 TOPICAL REVIEW: THE EMERGING FIELD OF EPIGENETICS: INFORMING MODELS OF PEDIATRIC TRAUMA AND PHYSICAL HEALTH. OBJECTIVE: TRAUMA EXPERIENCED DURING CHILDHOOD AND ADOLESCENCE HAS BEEN LINKED TO A NUMBER OF CHRONIC MEDICAL CONCERNS. WE HIGHLIGHT MAJOR FINDINGS FROM THE PEDIATRIC TRAUMA LITERATURE TO PROVIDE A MODEL FOR UNDERSTANDING THIS ASSOCIATION. METHODS: STUDIES EXAMINING THE EFFECTS OF TRAUMA WERE SYSTEMATICALLY REVIEWED AND SYNTHESIZED INTO A MODEL PROPOSING A CENTRAL ROLE FOR EPIGENETICS IN THE WAYS THAT CHILDHOOD EXPERIENCES CAN AFFECT HEALTH. RESULTS: EARLY HYPOTHALAMIC PITUITARY ADRENAL (HPA) AXIS RESPONSE MAY IMPACT INITIAL TRAUMA EXPERIENCE, WITH DOWNSTREAM EFFECTS ON POSTTRAUMA ADJUSTMENT REFLECTED IN POSTTRAUMA NEUROBIOLOGY, PSYCHOLOGICAL HEALTH, AND PHYSICAL HEALTH. CONCLUSIONS: PROSPECTIVE RESEARCH WITH CHILDREN AND ADOLESCENTS EXPOSED TO TRAUMA IS NEEDED TO BETTER CHARACTERIZE THE GENETIC AND EPIGENETIC INFLUENCES ON THE COURSE OF HPA AND IMMUNE PROCESSES AS RELATED TO POSTTRAUMA PSYCHOLOGICAL AND PHYSICAL HEALTH OUTCOMES. 2016 18 6781 34 [BREATHING: AMBIENT AIR POLLUTION AND HEALTH - PART III]. THE THIRD PART OF THE DGP STATEMENT INTRODUCES THE CURRENT BODY OF KNOWLEDGE ON LESS STUDIED HEALTH OUTCOMES ASSOCIATED WITH EXPOSURE TO AMBIENT AIR POLLUTION: THE NEGATIVE IMPACT ON METABOLISM LEADING TO IMPAIRED GLUCOSE TOLERANCE AND DIABETES AS WELL AS CONTRIBUTION TO THE DEVELOPMENT OF NEURODEGENERATIVE DISORDERS AND DELAYED COGNITIVE FUNCTION IN CHILDREN. FURTHERMORE, PRENATAL EXPOSURE AND ADVERSE EFFECTS ON MOTHER AND CHILD ARE ADDRESSED. FINALLY, THE CURRENTLY DISCUSSED BIOLOGICAL MECHANISMS UNDERLYING VARIOUS HEALTH EFFECTS ASSOCIATED WITH EXPOSURE TO AIR POLLUTION ARE DESCRIBED.DIFFERING, BUT OFTEN COMPLEMENTARY BIOLOGICAL MECHANISMS CREATE THE BASIS FOR THE DIVERSE HEALTH OUTCOMES CAUSED BY AIR POLLUTION. OXIDATIVE STRESS AND A SUBCLINICAL INFLAMMATORY RESPONSE IN THE LUNGS AND ON A SYSTEMIC LEVEL ("LOW-GRADE SYSTEMIC INFLAMMATION") ARE CONSIDERED TO BE KEY MECHANISMS. THEY PROMOTE SECONDARY ALTERATIONS IN THE BODY, SUCH AS VASCULAR OR METABOLIC PROCESSES, AND MAY ALSO RESULT IN THE CURRENTLY STUDIED EPIGENETIC PHENOMENA OR NEUROINFLAMMATION. IN THIS CONTEXT, THE HEALTH SIGNIFICANCE OF SOLUBLE PARTICULATE MATTER AND THE ROLE OF ULTRAFINE PARTICLES TRANSLOCATED ACROSS BIOLOGICAL MEMBRANES INTO BLOOD VESSEL AND TRANSPORTED VIA THE CIRCULATION TO SECONDARY TARGET ORGANS, SUCH AS LIVER, BRAIN OR THE FETUS, ARE INTENSIVELY DISCUSSED.DIABETES IS ONE OF THE LEADING CHRONIC DISEASES WORLDWIDE, WITH A PREVALENCE OF ALMOST 14 % IN GERMANY. ALTHOUGH LIFESTYLE FACTORS ARE THE MAIN CAUSES, CURRENT EVIDENCE SUGGESTS THAT LONG-TERM EXPOSURE TO AIR POLLUTION MAY ADDITIONALLY INCREASE THE RISK FOR TYPE 2 DIABETES. SUPPORTING EVIDENCE FOR A CAUSAL ROLE OF AIR POLLUTION IS PROVIDED BY STUDIES ADDRESSING THE REGULATION OF THE BLOOD GLUCOSE LEVELS IN METABOLICALLY HEALTHY PARTICIPANTS, INSULIN SENSITIVITY, OR PREGNANCY-RELATED DIABETES. EXPERIMENTAL STUDIES PROVIDE FURTHER SUPPORT FOR PLAUSIBLE BIOLOGICAL MECHANISMS. HOWEVER, PROSPECTIVE STUDIES ARE NEEDED TO GAIN MORE EVIDENCE, TAKING MULTIPLE LIFESTYLE AND ENVIRONMENTAL FACTORS, SUCH AS GREEN SPACE AND NOISE, AND AN IMPROVED INDIVIDUAL EXPOSURE ASSESSMENT INTO ACCOUNT.THE AGING POPULATION HAS AN INCREASED RISK OF NEURODEGENERATIVE DISEASES. FIRST STUDIES POINT TOWARDS A CONTRIBUTION OF CHRONIC EXPOSURE TO AIR POLLUTION, SPECIFICALLY BY PARTICULATE MATTER. SEVERAL STUDIES REPORT ITS ASSOCIATION WITH DECREASED NEUROCOGNITIVE CAPACITY OR AN INCREASED PREVALENCE OF DEMENTIA OR ALZHEIMER'S DISEASE IN ADULTS. HOWEVER, THE STUDIES ARE INHOMOGENEOUS REGARDING DESIGN, EXPOSURE AND OUTCOME, LEADING TO INCONSISTENT RESULTS. WITH RESPECT TO THE INFLUENCE ON NEUROCOGNITIVE DEVELOPMENT OF CHILDREN, FIRST STUDIES SUGGEST AN ASSOCIATION BETWEEN THE LEVEL OF AIR POLLUTION, E. G. AT SCHOOL, AND DELAYED COGNITIVE DEVELOPMENT.EVEN THOUGH THE EVIDENCE FOR THE DIFFERENT BIOLOGICAL ENDPOINTS DURING PREGNANCY IS STILL HETEROGENEOUS, THE STUDIES GENERALLY POINT TOWARDS AN ADVERSE IMPACT OF AIR POLLUTION ON THE MATERNAL AND FETAL ORGANISMS. THE STRONGEST EVIDENCE EXISTS FOR LOW BIRTH WEIGHT, WITH SMALL EFFECT SIZES OF ONLY SOME GRAMS, AND FOR A HIGHER INCIDENCE OF REDUCED BIRTH WEIGHT (< 2500 G). AN INCREASED RISK FOR GESTATIONAL HYPERTENSION AND PREECLAMPSIA UNDERSCORES THE POSSIBLE IMPACT OF EXPOSURE TO AIR POLLUTION ON THE MATERNAL ORGANISM. HOWEVER, THE CURRENT BODY OF EVIDENCE DOES NOT YET ALLOW A FINAL CONCLUSION ON THE INFLUENCE OF INTRAUTERINE EXPOSURE TO AIR POLLUTION REGARDING EARLY CHILDHOOD LUNG FUNCTION AND DEVELOPMENT OF ALLERGIES, PARTICULARLY IN LIGHT OF THE FACT THAT IT IS HARD TO DISTINGUISH IN EPIDEMIOLOGICAL STUDIES BETWEEN THE EFFECTS OF PRE- AND POSTNATAL EXPOSURE. 2019 19 585 22 BEHAVIORAL PERINATOLOGY: BIOBEHAVIORAL PROCESSES IN HUMAN FETAL DEVELOPMENT. BEHAVIORAL PERINATOLOGY IS AS AN INTERDISCIPLINARY AREA OF RESEARCH THAT INVOLVES CONCEPTUALIZATION OF THEORETICAL MODELS AND CONDUCT OF EMPIRICAL STUDIES OF THE DYNAMIC TIME-, PLACE-, AND CONTEXT-DEPENDENT INTERPLAY BETWEEN BIOLOGICAL AND BEHAVIORAL PROCESSES IN FETAL, NEONATAL, AND INFANT LIFE USING AN EPIGENETIC FRAMEWORK OF DEVELOPMENT. THE BIOBEHAVIORAL PROCESSES OF PARTICULAR INTEREST TO OUR RESEARCH GROUP RELATE TO THE EFFECTS OF MATERNAL PRE- AND PERINATAL STRESS AND MATERNAL-PLACENTAL-FETAL STRESS PHYSIOLOGY. WE PROPOSE THAT BEHAVIORAL PERINATOLOGY RESEARCH MAY HAVE IMPORTANT IMPLICATIONS FOR A BETTER UNDERSTANDING OF THE PROCESSES THAT UNDERLIE OR CONTRIBUTE TO THE RISK OF THREE SETS OF OUTCOMES: PREMATURITY, ADVERSE NEURODEVELOPMENT, AND CHRONIC DEGENERATIVE DISEASES IN ADULTHOOD. BASED ON OUR UNDERSTANDING OF THE ONTOGENY OF HUMAN FETAL DEVELOPMENT AND THE PHYSIOLOGY OF PREGNANCY AND FETAL DEVELOPMENT, WE HAVE ARTICULATED A NEUROBIOLOGICAL MODEL OF PRE- AND PERINATAL STRESS. OUR MODEL PROPOSES THAT CHRONIC MATERNAL STRESS MAY EXERT A SIGNIFICANT INFLUENCE ON FETAL DEVELOPMENTAL OUTCOMES. MATERNAL STRESS MAY ACT VIA ONE OR MORE OF THREE MAJOR PHYSIOLOGICAL PATHWAYS: NEUROENDOCRINE, IMMUNE/INFLAMMATORY, AND VASCULAR. WE FURTHER SUGGEST THAT PLACENTAL CORTICOTROPIN-RELEASING HORMONE (CRH) MAY PLAY A CENTRAL ROLE IN COORDINATING THE EFFECTS OF ENDOCRINE, IMMUNE/INFLAMMATORY, AND VASCULAR PROCESSES ON FETAL DEVELOPMENTAL OUTCOMES. FINALLY, WE HYPOTHESIZE THAT THE EFFECTS OF MATERNAL STRESS ARE MODULATED BY THE NATURE, DURATION, AND TIMING OF OCCURRENCE OF STRESS DURING GESTATION. IN THIS PAPER, WE ELABORATE ON THE CONCEPTUAL AND EMPIRICAL BASIS FOR THIS MODEL, HIGHLIGHT SOME RELEVANT ISSUES AND QUESTIONS, AND MAKE RECOMMENDATIONS FOR FUTURE RESEARCH IN THIS AREA. 2002 20 6823 24 [GENERAL CONCEPTS OF EPIGENETICS: PROJECTIONS IN PAEDIATRICS]. CURRENT EVIDENCE SUPPORTS THE NOTION THAT ALTERATIONS IN INTRAUTERINE GROWTH AND DURING THE FIRST YEARS OF LIFE HAVE A SUBSTANTIAL EFFECT ON THE RISK FOR THE DEVELOPMENT OF CHRONIC DISEASE, WHICH IN SOME CASES IS EVEN HIGHER THAN THOSE DUE TO GENETIC FACTORS. THE PERSISTENCE AND REPRODUCIBILITY OF THE PHENOTYPES ASSOCIATED WITH ALTERED EARLY DEVELOPMENT SUGGEST THE PARTICIPATION OF MECHANISMS THAT WOULD RECORD ENVIRONMENTAL CUES, GENERATING A CELLULAR REPROGRAMMING (I.E., EPIGENETIC MECHANISMS). THIS REVIEW IS AN INTRODUCTION TO A SERIES OF FIVE ARTICLES FOCUSED ON THE PARTICIPATION OF EPIGENETIC MECHANISMS IN THE DEVELOPMENT OF HIGHLY PREVALENT CHRONIC DISEASES (I.E., CARDIOVASCULAR, METABOLIC, ASTHMA/ALLERGIES AND CANCER) AND THEIR ORIGINS IN THE FOETAL AND NEONATAL PERIOD. THIS SERIES OF ARTICLES AIMS TO SHOW THE STATE OF THE ART IN THIS RESEARCH AREA AND PRESENT THE UPCOMING CLUES AND CHALLENGES, IN WHICH PAEDIATRICIANS HAVE A PROMINENT ROLE, DEVELOPING STRATEGIES FOR THE PREVENTION, EARLY DETECTION AND FOLLOW-UP. 2016