1 6577 100 TREATMENT STRATEGIES FOR COMPLEX BEHAVIORAL INSOMNIA IN CHILDREN WITH NEURODEVELOPMENTAL DISORDERS. PURPOSE OF REVIEW: THIS REVIEW DESCRIBES RECENT RESEARCH IN PEDIATRIC BEHAVIORAL INSOMNIAS IN NEURODEVELOPMENTAL DISORDERS AND THEIR TREATMENT. RECENT FINDINGS: INSOMNIA IN CHILDREN WITH AUTISM SPECTRUM DISORDER (ASD) AND OTHER NEURODEVELOPMENTAL DISORDERS (NDDS) IS TYPICALLY COMPLEX, CHRONIC, AND DIFFICULT TO ADEQUATELY CONTROL. ABNORMALITIES IN GENETIC AND/OR EPIGENETIC REGULATION OF SLEEP/WAKEFULNESS AND ITS TIMING PREDISPOSE PATIENTS WITH NDD TO INSOMNIA, ALTHOUGH POOR SLEEP HYGIENE, MALADAPTIVE ASSOCIATIONS, AND LIMIT-SETTING ARE LIKELY TO CONTRIBUTE. PARENTS ARE AGENTS FOR CHANGE IN PROBLEMATIC SLEEP BEHAVIORS IN PATIENTS WITH NDD. WE REVIEW THE BENEFITS OF BEHAVIORAL THERAPIES AND MELATONIN TO TREAT SLEEP PROBLEMS IN CHILDREN WITH NDD. PROBLEMATIC SLEEP IS SO PREVALENT IN SOME NEURODEVELOPMENTAL SYNDROMES (RETT, ANGELMAN, WILLIAMS, AND SMITH-MAGENIS) THAT IT IS PART OF THEIR DIAGNOSTIC CRITERIA. SUMMARY: CHILDREN AND ADOLESCENTS WITH NEUROLOGICAL DISORDERS FREQUENTLY HAVE COMPLEX SLEEP DISORDERS THAT REQUIRE TREATMENT. UNDERSTANDING THE BASIC PATHOLOGY AND TREATMENT STRATEGIES PROVIDES AN OPPORTUNITY TO IMPROVE WELL BEING AND QUALITY OF LIFE IN THOSE AFFECTED BY NDD AND THEIR FAMILIES. 2013 2 3787 24 INTERGENERATIONAL METABOLIC SYNDROME AND NEURONAL NETWORK HYPEREXCITABILITY IN AUTISM. WE REVIEW EVIDENCE THAT SUGGESTS A ROLE FOR EXCESSIVE CONSUMPTION OF ENERGY-DENSE FOODS, PARTICULARLY FRUCTOSE, AND CONSEQUENT OBESITY AND INSULIN RESISTANCE (METABOLIC SYNDROME) IN THE RECENT INCREASE IN PREVALENCE OF AUTISM SPECTRUM DISORDERS (ASD). MATERNAL INSULIN RESISTANCE, OBESITY, AND DIABETES MAY PREDISPOSE OFFSPRING TO ASD BY MECHANISMS INVOLVING CHRONIC ACTIVATION OF ANABOLIC CELLULAR PATHWAYS AND A LACK OF METABOLIC SWITCHING TO KETOSIS RESULTING IN A DEFICIT IN GABAERGIC SIGNALING AND NEURONAL NETWORK HYPEREXCITABILITY. METABOLIC REPROGRAMMING BY EPIGENETIC DNA AND CHROMATIN MODIFICATIONS MAY CONTRIBUTE TO ALTERATIONS IN GENE EXPRESSION THAT RESULT IN ASD. THESE MECHANISTIC INSIGHTS SUGGEST THAT INTERVENTIONS THAT IMPROVE METABOLIC HEALTH SUCH AS INTERMITTENT FASTING AND EXERCISE MAY AMELIORATE DEVELOPMENTAL NEURONAL NETWORK ABNORMALITIES AND CONSEQUENT BEHAVIORAL MANIFESTATIONS IN ASD. 2019 3 6863 26 [ONE AUTISM, SEVERAL AUTISMS. PHENOTYPICAL VARIABILITY IN AUTISM SPECTRUM DISORDERS]. INTRODUCTION: AUTISM SPECTRUM DISORDERS (ASD) ARE A HETEROGENEOUS GROUP OF DISORDERS THAT BEGIN IN THE EARLY MONTHS OF LIFE AND FOLLOW A CHRONIC PROGRESSION. THEY HAVE A BIOLOGICAL ORIGIN, WITH COMPLEX AETIOLOGICAL FACTORS THAT INVOLVE DIFFERENT GENETIC, EPIGENETIC AND ENVIRONMENTAL MECHANISMS THAT INTERACT WITH ONE ANOTHER. AIM: TO REVIEW THE MAIN FACTORS THAT VARY THE PRESENTATION OF AUTISM TAKING INTO ACCOUNT THE MOST RECENT SCIENTIFIC EVIDENCE. DEVELOPMENT: ASPECTS RELATED WITH THE DEVELOPMENT OF SYMPTOMS, GENDER, COMORBIDITY, AGE AND AETIOLOGY DETERMINE THE VARIABILITY IN THE CLINICAL PRESENTATION OF ASD. CONCLUSIONS: AUTISM IS HIGHLY HETEROGENEOUS AND IS PHENOTYPICALLY RELATED, AT LEAST IN PART, WITH A WIDE RANGE OF CAUSATIONS, WHICH RESEARCHERS HAVE BEGUN TO UNRAVEL BUT WHICH ARE STILL LARGELY UNKNOWN. AETIOLOGICAL RESEARCH, ESPECIALLY IN THE AREA OF GENETICS, WILL MAKE IT POSSIBLE TO IDENTIFY DIFFERENT HOMOGENEOUS SUBGROUPS WITH THEIR CORRESPONDING PHENOTYPES, WHILE ALSO OPENING UP THE WAY TO POSSIBLE THERAPEUTIC ALTERNATIVES IN THE FUTURE. 2016 4 6301 28 THE PUTATIVE ROLE OF ENVIRONMENTAL MERCURY IN THE PATHOGENESIS AND PATHOPHYSIOLOGY OF AUTISM SPECTRUM DISORDERS AND SUBTYPES. EXPOSURE TO ORGANIC FORMS OF MERCURY HAS THE THEORETICAL CAPACITY TO GENERATE A RANGE OF IMMUNE ABNORMALITIES COUPLED WITH CHRONIC NITRO-OXIDATIVE STRESS SEEN IN CHILDREN WITH AUTISM SPECTRUM DISORDER (ASD). THE PAPER DISCUSSES POSSIBLE MECHANISMS EXPLAINING THE NEUROTOXIC EFFECTS OF MERCURY AND POSSIBLE ASSOCIATIONS BETWEEN MERCURY EXPOSURE AND ASD SUBTYPES. ENVIRONMENTAL MERCURY IS NEUROTOXIC AT DOSES WELL BELOW THE CURRENT REFERENCE LEVELS CONSIDERED TO BE SAFE, WITH EVIDENCE OF NEUROTOXICITY IN CHILDREN EXPOSED TO ENVIRONMENTAL SOURCES INCLUDING FISH CONSUMPTION AND ETHYLMERCURY-CONTAINING VACCINES. POSSIBLE NEUROTOXIC MECHANISMS OF MERCURY INCLUDE DIRECT EFFECTS ON SULFHYDRYL GROUPS, PERICYTES AND CEREBRAL ENDOTHELIAL CELLS, ACCUMULATION WITHIN ASTROCYTES, MICROGLIAL ACTIVATION, INDUCTION OF CHRONIC OXIDATIVE STRESS, ACTIVATION OF IMMUNE-INFLAMMATORY PATHWAYS AND IMPAIRMENT OF MITOCHONDRIAL FUNCTIONING. (EPI-)GENETIC FACTORS WHICH MAY INCREASE SUSCEPTIBILITY TO THE TOXIC EFFECTS OF MERCURY IN ASD INCLUDE THE FOLLOWING: A GREATER PROPENSITY OF MALES TO THE LONG-TERM NEUROTOXIC EFFECTS OF POSTNATAL EXPOSURE AND GENETIC POLYMORPHISMS IN GLUTATHIONE TRANSFERASES AND OTHER GLUTATHIONE-RELATED GENES AND IN SELENOPROTEINS. FURTHERMORE, IMMUNE AND INFLAMMATORY RESPONSES TO IMMUNISATIONS WITH MERCURY-CONTAINING ADJUVANTS ARE STRONGLY INFLUENCED BY POLYMORPHISMS IN THE HUMAN LEUKOCYTE ANTIGEN (HLA) REGION AND BY GENES ENCODING EFFECTOR PROTEINS SUCH AS CYTOKINES AND PATTERN RECOGNITION RECEPTORS. SOME EPIDEMIOLOGICAL STUDIES INVESTIGATING A POSSIBLE RELATIONSHIP BETWEEN HIGH ENVIRONMENTAL EXPOSURE TO METHYLMERCURY AND IMPAIRED NEURODEVELOPMENT HAVE REPORTED A POSITIVE DOSE-DEPENDENT EFFECT. RETROSPECTIVE STUDIES, ON THE OTHER HAND, REPORTED NO RELATIONSHIP BETWEEN A RANGE OF ETHYLMERCURY-CONTAINING VACCINES AND CHRONIC NEUROPATHOLOGY OR ASD. ON THE BASIS OF THESE RESULTS, WE WOULD ARGUE THAT MORE CLINICALLY RELEVANT RESEARCH IS REQUIRED TO EXAMINE WHETHER ENVIRONMENTAL MERCURY IS ASSOCIATED WITH ASD OR SUBTYPES. SPECIFIC RECOMMENDATIONS FOR FUTURE RESEARCH ARE DISCUSSED. 2018 5 4006 24 LOST AMONG THE TREES? THE AUTONOMIC NERVOUS SYSTEM AND PAEDIATRICS. THE AUTONOMIC NERVOUS SYSTEM (ANS) HAS BEEN STRIKINGLY NEGLECTED IN WESTERN MEDICINE. DESPITE ITS PROFOUND IMPORTANCE FOR REGULATION, ADJUSTMENT AND COORDINATION OF BODY SYSTEMS, IT LACKS PRIORITY IN TRAINING AND PRACTICE AND RECEIVES SCANT ATTENTION IN NUMEROUS MAJOR TEXTBOOKS. THE ANS IS INTEGRAL TO MANIFESTATIONS OF ILLNESS, UNDERLYING FAMILIAR PHYSICAL AND PSYCHOLOGICAL SYMPTOMS. WHEN ANS ACTIVITY IS ITSELF DYSFUNCTIONAL, USUAL INDICATORS OF ACUTE ILLNESS MAY PROVE DECEPTIVE. RECOGNISING THE RELEVANCE OF THE ANS CAN INVOLVE SEEING THE FAMILIAR THROUGH FRESH EYES, CHALLENGING ASSUMPTIONS IN CLINICAL ASSESSMENT AND IN APPROACHES TO PRACTICE. ITS IMPORTANCE EXTENDS FROM PHYSICAL AND PSYCHOLOGICAL WELL-BEING TO PARENTING AND SAFEGUARDING, PUBLIC SERVICES AND THE FUNCTIONING OF SOCIETY. EXPLORATION OF ITS ROLE IN CONDITIONS RANGING FROM NEUROLOGICAL, GASTROINTESTINAL AND CONNECTIVE TISSUE DISORDERS, DIABETES AND CHRONIC FATIGUE SYNDROME, TO AUTISM, BEHAVIOURAL AND MENTAL HEALTH DIFFICULTIES MAY OPEN THERAPEUTIC AVENUES. THE ANS OFFERS A MECHANISM FOR SO-CALLED FUNCTIONAL ILLNESSES AND ILLUSTRATES THE IMPORTANCE OF RECOGNISING THAT 'STRESS' TAKES MANY FORMS, PHYSICAL, PSYCHOLOGICAL AND ENVIRONMENTAL, DESIRABLE AND OTHERWISE. EVIDENCE OF INTRAUTERINE AND POST-NATAL PROGRAMMING OF ANS REACTIVITY SUGGESTS THAT NEONATAL CARE AND SAFEGUARDING PRACTICE MAY OFFER PREVENTIVE OPPORTUNITY, AS MAY GREATER UNDERSTANDING OF EPIGENETIC CHANGE OF ANS ACTIVITY THROUGH, FOR EXAMPLE, ACCIDENTAL OR PSYCHOLOGICAL TRAUMA OR INFECTION. THE AIM OF THIS ARTICLE IS TO ACCELERATE RECOGNITION OF THE IMPORTANCE OF THE ANS THROUGHOUT PAEDIATRICS, AND OF THE POTENTIAL PHYSICAL AND PSYCHOLOGICAL COST OF NEGLECTING IT. 2014 6 4626 29 NEURODEVELOPMENTAL DISORDERS AND ENVIRONMENTAL TOXICANTS: EPIGENETICS AS AN UNDERLYING MECHANISM. THE INCREASING PREVALENCE OF NEURODEVELOPMENTAL DISORDERS, ESPECIALLY AUTISM SPECTRUM DISORDERS (ASD) AND ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD), CALLS FOR MORE RESEARCH INTO THE IDENTIFICATION OF ETIOLOGIC AND RISK FACTORS. THE DEVELOPMENTAL ORIGIN OF HEALTH AND DISEASE (DOHAD) HYPOTHESIZES THAT THE ENVIRONMENT DURING FETAL AND CHILDHOOD DEVELOPMENT AFFECTS THE RISK FOR MANY CHRONIC DISEASES IN LATER STAGES OF LIFE, INCLUDING NEURODEVELOPMENTAL DISORDERS. EPIGENETICS, A TERM DESCRIBING MECHANISMS THAT CAUSE CHANGES IN THE CHROMOSOME STATE WITHOUT AFFECTING DNA SEQUENCES, IS SUGGESTED TO BE THE UNDERLYING MECHANISM, ACCORDING TO THE DOHAD HYPOTHESIS. MOREOVER, MANY NEURODEVELOPMENTAL DISORDERS ARE ALSO RELATED TO EPIGENETIC ABNORMALITIES. EXPERIMENTAL AND EPIDEMIOLOGICAL STUDIES SUGGEST THAT EXPOSURE TO PRENATAL ENVIRONMENTAL TOXICANTS IS ASSOCIATED WITH NEURODEVELOPMENTAL DISORDERS. IN ADDITION, THERE IS ALSO EVIDENCE THAT ENVIRONMENTAL TOXICANTS CAN RESULT IN EPIGENETIC ALTERATIONS, NOTABLY DNA METHYLATION. IN THIS REVIEW, WE FIRST FOCUS ON THE RELATIONSHIP BETWEEN NEURODEVELOPMENTAL DISORDERS AND ENVIRONMENTAL TOXICANTS, IN PARTICULAR MATERNAL SMOKING, PLASTIC-DERIVED CHEMICALS (BISPHENOL A AND PHTHALATES), PERSISTENT ORGANIC POLLUTANTS, AND HEAVY METALS. WE THEN REVIEW STUDIES SHOWING THE EPIGENETIC EFFECTS OF THOSE ENVIRONMENTAL FACTORS IN HUMANS THAT MAY AFFECT NORMAL NEURODEVELOPMENT. 2017 7 548 31 AUTISM SPECTRUM DISORDER AT THE CROSSROAD BETWEEN GENES AND ENVIRONMENT: CONTRIBUTIONS, CONVERGENCES, AND INTERACTIONS IN ASD DEVELOPMENTAL PATHOPHYSIOLOGY. THE COMPLEX PATHOPHYSIOLOGY OF AUTISM SPECTRUM DISORDER ENCOMPASSES INTERACTIONS BETWEEN GENETIC AND ENVIRONMENTAL FACTORS. ON THE ONE HAND, HUNDREDS OF GENES, CONVERGING AT THE FUNCTIONAL LEVEL ON SELECTIVE BIOLOGICAL DOMAINS SUCH AS EPIGENETIC REGULATION AND SYNAPTIC FUNCTION, HAVE BEEN IDENTIFIED TO BE EITHER CAUSATIVE OR RISK FACTORS OF AUTISM. ON THE OTHER HAND, EXPOSURE TO CHEMICALS THAT ARE WIDESPREAD IN THE ENVIRONMENT, SUCH AS ENDOCRINE DISRUPTORS, HAS BEEN ASSOCIATED WITH ADVERSE EFFECTS ON HUMAN HEALTH, INCLUDING NEURODEVELOPMENTAL DISORDERS. INTERESTINGLY, EXPERIMENTAL RESULTS SUGGEST AN OVERLAP IN THE REGULATORY PATHWAYS PERTURBED BY GENETIC MUTATIONS AND ENVIRONMENTAL FACTORS, DEPICTING CONVERGENCES AND COMPLEX INTERPLAYS BETWEEN GENETIC SUSCEPTIBILITY AND TOXIC INSULTS. THE PERVASIVE NATURE OF CHEMICAL EXPOSURE POSES PIVOTAL CHALLENGES FOR NEUROTOXICOLOGICAL STUDIES, REGULATORY AGENCIES, AND POLICY MAKERS. THIS HIGHLIGHTS AN EMERGING NEED OF DEVELOPING NEW INTEGRATIVE MODELS, INCLUDING BIOMONITORING, EPIDEMIOLOGY, EXPERIMENTAL, AND COMPUTATIONAL TOOLS, ABLE TO CAPTURE REAL-LIFE SCENARIOS ENCOMPASSING THE INTERACTION BETWEEN CHRONIC EXPOSURE TO MIXTURE OF SUBSTANCES AND INDIVIDUALS' GENETIC BACKGROUNDS. IN THIS REVIEW, WE ADDRESS THE INTERTWINED ROLES OF GENETIC LESIONS AND ENVIRONMENTAL INSULTS. SPECIFICALLY, WE OUTLINE THE TRANSFORMATIVE POTENTIAL OF STEM CELL MODELS, COUPLED WITH OMICS ANALYTICAL APPROACHES AT INCREASINGLY SINGLE CELL RESOLUTION, AS CONVERGING TOOLS TO EXPERIMENTALLY DISSECT THE PATHOGENIC MECHANISMS UNDERLYING NEURODEVELOPMENTAL DISORDERS, AS WELL AS TO IMPROVE DEVELOPMENTAL NEUROTOXICOLOGY RISK ASSESSMENT. 2020 8 3606 25 IMPROVING TREATMENT OF NEURODEVELOPMENTAL DISORDERS: RECOMMENDATIONS BASED ON PRECLINICAL STUDIES. INTRODUCTION: NEURODEVELOPMENTAL DISORDERS (NDDS) ARE COMMON AND SEVERELY DEBILITATING. THEIR CHRONIC NATURE AND RELIANCE ON BOTH GENETIC AND ENVIRONMENTAL FACTORS MAKES STUDYING NDDS AND THEIR TREATMENT A CHALLENGING TASK. AREAS COVERED: HEREIN, THE AUTHORS DISCUSS THE NEUROBIOLOGICAL MECHANISMS OF NDDS, AND PRESENT RECOMMENDATIONS ON THEIR TRANSLATIONAL RESEARCH AND THERAPY, OUTLINED BY THE INTERNATIONAL STRESS AND BEHAVIOR SOCIETY. VARIOUS DRUGS CURRENTLY PRESCRIBED TO TREAT NDDS ALSO REPRESENT A HIGHLY DIVERSE GROUP. ACTING ON VARIOUS NEUROTRANSMITTER AND PHYSIOLOGICAL SYSTEMS, THESE DRUGS OFTEN LACK SPECIFICITY OF ACTION, AND ARE COMMONLY USED TO TREAT MULTIPLE OTHER PSYCHIATRIC CONDITIONS. THERE HAS ALSO BEEN RELATIVELY LITTLE PROGRESS IN THE DEVELOPMENT OF NOVEL MEDICATIONS TO TREAT NDDS. BASED ON CLINICAL, PRECLINICAL AND TRANSLATIONAL MODELS OF NDDS, OUR RECOMMENDATIONS COVER A WIDE RANGE OF METHODOLOGICAL APPROACHES AND CONCEPTUAL STRATEGIES. EXPERT OPINION: TO IMPROVE PHARMACOTHERAPY AND DRUG DISCOVERY FOR NDDS, WE NEED A STRONGER EMPHASIS ON TARGETING MULTIPLE ENDOPHENOTYPES, A BETTER DISSECTION OF GENETIC/EPIGENETIC FACTORS OR "HIDDEN HERITABILITY," AND A CAREFUL CONSIDERATION OF POTENTIAL DEVELOPMENTAL/TROPHIC ROLES OF BRAIN NEUROTRANSMITTERS. THE VALIDITY OF ANIMAL NDD MODELS CAN BE IMPROVED THROUGH DISCOVERY OF NOVEL (BEHAVIORAL, PHYSIOLOGICAL AND NEUROIMAGING) BIOMARKERS, APPLYING PROPER ENVIRONMENTAL ENRICHMENT, WIDENING THE SPECTRUM OF MODEL ORGANISMS, TARGETING DEVELOPMENTAL TRAJECTORIES OF NDD-RELATED BEHAVIORS AND COMORBID CONDITIONS BEYOND TRADITIONAL NDDS. WHILE THESE RECOMMENDATIONS CANNOT BE ADDRESSED ALL IN ONCE, OUR INCREASED UNDERSTANDING OF NDD PATHOBIOLOGY MAY TRIGGER INNOVATIVE CROSS-DISCIPLINARY RESEARCH EXPANDING BEYOND TRADITIONAL METHODS AND CONCEPTS. 2016 9 1410 34 DIETARY INTERVENTIONS FOR AUTISM SPECTRUM DISORDER: AN UPDATED SYSTEMATIC REVIEW OF HUMAN STUDIES. AUTISM IS A COMPLEX SPECTRUM OF DISORDERS WITH GENETIC, EPIGENETIC, AUTOIMMUNE, OXIDATIVE STRESS, AND ENVIRONMENTAL ETIOLOGIES. TREATMENT OF ASD USING DIETARY APPROACH IS A PROMISING STRATEGY, ESPECIALLY OWING TO ITS SAFETY AND AVAILABILITY. OUR STUDY CRITICALLY ANALYSED THE ROLES AND EFFICACY OF ANTIOXIDANTS, PROBIOTICS, PREBIOTICS, CAMEL MILK AND VITAMIN D. THIS SYSTEMATIC REVIEW PROVIDES AN UPDATED SYNOPSIS OF HUMAN STUDIES THAT INVESTIGATED THERAPEUTIC BENEFITS OF THESE DIETARY INTERVENTIONS IN AUTISM. A TOTAL OF 943 PAPERS WERE IDENTIFIED OUT OF WHICH 21 ARTICLES WERE INCLUDED IN THE SYSTEMATIC REVIEW. THE SELECTED STUDIES INVESTIGATED THE IMPACT OF 5 DIFFERENT DIETARY SUPPLEMENTATIONS IN ASD SYMPTOM AND BEHAVIOURS. THESE AGENTS INCLUDE; ANTIOXIDANTS/POLYPHENOLIC COMPOUNDS, PROBIOTICS, PREBIOTICS, CAMEL MILK AND VITAMIN D. FROM THE RESULTS OF THE PRESENT REVIEW, ANTIOXIDANTS/POLYPHENOLIC COMPOUNDS DECREASED THE LEVELS OF INFLAMMATORY CYTOKINES AND IMPROVED BEHAVIOURAL SYMPTOMS. PROBIOTICS IMPROVED BEHAVIOURAL AND GI SYMPTOMS AS WELL AS RESTORED GUT MICROBIOTA EQUILIBRIUM. PREBIOTICS DECREASED LEVELS OF INFLAMMATORY CYTOKINES, IMPROVED BEHAVIOURAL AND GI SYMPTOMS AND IMPROVED GUT MICROBIOTA. VITAMIN D IMPROVED BEHAVIOURAL SYMPTOMS AND OFFERED PROTECTIVE EFFECTS AGAINST NEUROTOXICITY. CAMEL MILK REDUCED INFLAMMATORY RESPONSES AND OXIDATIVE STRESS. GIVEN THE CHRONIC NATURE AS WELL AS EARLY ONSET OF ASD, DIETARY SUPPLEMENTS BECOME USEFUL TO COMPLEMENT NUTRITIONAL DEFICIENCIES IN CHILDREN WITH ASD. KEY BENEFITS OF THESE AGENTS STEM FROM THEIR ABILITY TO TARGET MULTIPLE PHYSIOLOGICAL AREAS VIA THE GUT BRAIN-AXIS AND ARE DEVOID OF POTENTIAL HARMFUL OR AGGRAVATING EFFECTS ON ASD PATIENTS. THE EVIDENCE COLLATED IN THIS REVIEW PROPOSE THAT DIETARY INTERVENTION MAY PROVIDE A NEW PLATFORM FOR THE MANAGEMENT OF AUTISM. 2022 10 6227 26 THE LINK OF ORGANOPHOSPHORUS PESTICIDES WITH NEURODEGENERATIVE AND NEURODEVELOPMENTAL DISEASES BASED ON EVIDENCE AND MECHANISMS. ORGANOPHOSPHORUS (OP) COMPOUNDS HAVE BEEN KNOWN AS THE MOST WIDELY USED PESTICIDES DURING THE PAST HALF CENTURY AND THERE HAVE BEEN A HUGE BODY OF LITERATURE REGARDING THEIR ASSOCIATION WITH HUMAN CHRONIC DISEASES. NEURODEGENERATIVE AND NEURODEVELOPMENTAL DISORDERS INCLUDING ALZHEIMER, PARKINSON, AMYOTROPHIC LATERAL SCLEROSIS (ALS), ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD), AND AUTISM ARE AMONG THE AFFLICTING NEUROLOGICAL DISEASES WHICH OVERSHADOW HUMAN LIFE AND THEIR HIGHER RISK IN RELATION TO OP EXPOSURES HAVE BEEN UNCOVERED BY EPIDEMIOLOGICAL STUDIES. IN ADDITION, EXPERIMENTAL STUDIES EXPLORING THE UNDERLYING MECHANISMS HAVE PROVIDED SOME EVIDENCE FOR INVOLVEMENT OF CHOLINERGIC DEFICIT, OXIDATIVE STRESS, NEURO-INFLAMMATION, AND EPIGENETIC MODIFICATIONS AS THE PROCESSES WHICH ARE COMMON IN THE TOXICITY OF THE OP AND PATHOPHYSIOLOGY OF THE MENTIONED DISEASES. IN ADDITION, GENETIC MUTATIONS AND POLYMORPHISMS OF DIFFERENT VARIANTS OF SOME GENES LIKE PARAOXONASE HAVE BEEN SHOWN TO BE IMPLICATED IN BOTH SUSCEPTIBILITY TO OPS TOXICITY AND NEUROLOGICAL DISEASES. IN THIS ARTICLE, WE REVIEWED THE EPIDEMIOLOGICAL AS WELL AS EXPERIMENTAL STUDIES EVIDENCING THE ASSOCIATION OF EXPOSURE TO OPS AND INCIDENCE OF NEURODEGENERATIVE AND NEURODEVELOPMENTAL DISEASES. 2018 11 5310 21 PSYCHOBIOLOGY AND MOLECULAR GENETICS OF RESILIENCE. EVERY INDIVIDUAL EXPERIENCES STRESSFUL LIFE EVENTS. IN SOME CASES ACUTE OR CHRONIC STRESS LEADS TO DEPRESSION AND OTHER PSYCHIATRIC DISORDERS, BUT MOST PEOPLE ARE RESILIENT TO SUCH EFFECTS. RECENT RESEARCH HAS BEGUN TO IDENTIFY THE ENVIRONMENTAL, GENETIC, EPIGENETIC AND NEURAL MECHANISMS THAT UNDERLIE RESILIENCE, AND HAS SHOWN THAT RESILIENCE IS MEDIATED BY ADAPTIVE CHANGES IN SEVERAL NEURAL CIRCUITS INVOLVING NUMEROUS NEUROTRANSMITTER AND MOLECULAR PATHWAYS. THESE CHANGES SHAPE THE FUNCTIONING OF THE NEURAL CIRCUITS THAT REGULATE REWARD, FEAR, EMOTION REACTIVITY AND SOCIAL BEHAVIOUR, WHICH TOGETHER ARE THOUGHT TO MEDIATE SUCCESSFUL COPING WITH STRESS. 2009 12 168 20 ABNORMAL TRANSMETHYLATION/TRANSSULFURATION METABOLISM AND DNA HYPOMETHYLATION AMONG PARENTS OF CHILDREN WITH AUTISM. AN INTEGRATED METABOLIC PROFILE REFLECTS THE COMBINED INFLUENCE OF GENETIC, EPIGENETIC, AND ENVIRONMENTAL FACTORS THAT AFFECT THE CANDIDATE PATHWAY OF INTEREST. RECENT EVIDENCE SUGGESTS THAT SOME AUTISTIC CHILDREN MAY HAVE REDUCED DETOXIFICATION CAPACITY AND MAY BE UNDER CHRONIC OXIDATIVE STRESS. BASED ON REPORTS OF ABNORMAL METHIONINE AND GLUTATHIONE METABOLISM IN AUTISTIC CHILDREN, IT WAS OF INTEREST TO EXAMINE THE SAME METABOLIC PROFILE IN THE PARENTS. THE RESULTS INDICATED THAT PARENTS SHARE SIMILAR METABOLIC DEFICITS IN METHYLATION CAPACITY AND GLUTATHIONE-DEPENDENT ANTIOXIDANT/DETOXIFICATION CAPACITY OBSERVED IN MANY AUTISTIC CHILDREN. STUDIES ARE UNDERWAY TO DETERMINE WHETHER THE ABNORMAL PROFILE IN PARENTS REFLECTS LINKED GENETIC POLYMORPHISMS IN THESE PATHWAYS OR WHETHER IT SIMPLY REFLECTS THE CHRONIC STRESS OF COPING WITH AN AUTISTIC CHILD. 2008 13 4632 24 NEUROIMAGING GENETIC APPROACHES TO POSTTRAUMATIC STRESS DISORDER. NEUROIMAGING GENETIC STUDIES THAT ASSOCIATE GENETIC AND EPIGENETIC VARIATION WITH NEURAL ACTIVITY OR STRUCTURE PROVIDE AN OPPORTUNITY TO LINK GENES TO PSYCHIATRIC DISORDERS, OFTEN BEFORE PSYCHOPATHOLOGY IS DISCERNABLE IN BEHAVIOR. HERE WE REVIEW NEUROIMAGING GENETICS STUDIES WITH PARTICIPANTS WHO HAVE POSTTRAUMATIC STRESS DISORDER (PTSD). RESULTS SHOW THAT GENES RELATED TO THE PHYSIOLOGICAL STRESS RESPONSE (E.G., GLUCOCORTICOID RECEPTOR AND ACTIVITY, NEUROENDOCRINE RELEASE), LEARNING AND MEMORY (E.G., PLASTICITY), MOOD, AND PAIN PERCEPTION ARE TIED TO NEURAL INTERMEDIATE PHENOTYPES ASSOCIATED WITH PTSD. THESE GENES ARE ASSOCIATED WITH AND SOMETIMES PREDICT NEURAL STRUCTURE AND FUNCTION IN AREAS INVOLVED IN ATTENTION, EXECUTIVE FUNCTION, MEMORY, DECISION-MAKING, EMOTION REGULATION, SALIENCE OF POTENTIAL THREATS, AND PAIN PERCEPTION. EVIDENCE SUGGESTS THESE RISK POLYMORPHISMS AND NEURAL INTERMEDIATE PHENOTYPES ARE VULNERABILITIES TOWARD DEVELOPING PTSD IN THE AFTERMATH OF TRAUMA, OR VULNERABILITIES TOWARD PARTICULAR SYMPTOMS ONCE PTSD HAS DEVELOPED. WORK DISTINGUISHING BETWEEN THE RE-EXPERIENCING AND DISSOCIATIVE SUB-TYPES OF PTSD, AND EXAMINING OTHER PTSD SYMPTOM CLUSTERS IN ADDITION TO THE RE-EXPERIENCING AND HYPERAROUSAL SYMPTOMS, WILL FURTHER CLARIFY NEUROBIOLOGICAL MECHANISMS AND INCONSISTENT FINDINGS. FURTHERMORE, AN EXCITING POSSIBILITY IS THAT GENETIC ASSOCIATIONS WITH PTSD MAY EVENTUALLY BE UNDERSTOOD THROUGH DIFFERENTIAL INTERMEDIATE PHENOTYPES OF NEURAL CIRCUIT STRUCTURE AND FUNCTION, POSSIBLY UNDERLYING THE DIFFERENT SYMPTOM CLUSTERS SEEN WITHIN PTSD. 2016 14 1722 22 DYSREGULATION OF BRAIN DOPAMINE SYSTEMS IN MAJOR DEPRESSIVE DISORDER. MAJOR DEPRESSIVE DISORDER (MDD OR DEPRESSION) IS A DEBILITATING NEUROPSYCHIATRIC SYNDROME WITH GENETIC, EPIGENETIC, AND ENVIRONMENTAL CONTRIBUTIONS. DEPRESSION IS ONE OF THE LARGEST CONTRIBUTORS TO CHRONIC DISEASE BURDEN; IT AFFECTS MORE THAN ONE IN SIX INDIVIDUALS IN THE UNITED STATES. A WIDE ARRAY OF CELLULAR AND MOLECULAR MODIFICATIONS DISTRIBUTED ACROSS A VARIETY OF NEURONAL PROCESSES AND CIRCUITS UNDERLIE THE PATHOPHYSIOLOGY OF DEPRESSION-NO ESTABLISHED MECHANISM CAN EXPLAIN ALL ASPECTS OF THE DISEASE. MDD SUFFERS FROM A VAST TREATMENT GAP WORLDWIDE, AND LARGE NUMBERS OF INDIVIDUALS WHO REQUIRE TREATMENT DO NOT RECEIVE ADEQUATE CARE. THIS MINI-REVIEW FOCUSES ON DYSREGULATION OF BRAIN DOPAMINE (DA) SYSTEMS IN THE PATHOPHYSIOLOGY OF MDD AND DESCRIBING NEW CELLULAR TARGETS FOR POTENTIAL MEDICATION DEVELOPMENT FOCUSED ON DA-MODULATED MICRO-CIRCUITS. WE ALSO EXPLORE HOW NEURODEVELOPMENTAL FACTORS MAY MODIFY RISK FOR LATER EMERGENCE OF MDD, POSSIBLY THROUGH DOPAMINERGIC SUBSTRATES IN THE BRAIN. 2021 15 6483 27 TOXIC STRESS, EPIGENETICS AND CHILD DEVELOPMENT. OBJECTIVES: TO DESCRIBE THE CONCEPT OF TOXIC STRESS, PRESENT THE BASICS OF EPIGENETICS AND DISCUSS THEIR RELATIONSHIP WITH CHILD DEVELOPMENT. DATA SOURCE: NARRATIVE LITERATURE REVIEW THROUGH A SEARCH IN THE SCIELO, LILACS, MEDLINE DATABASES USING THE TERMS ADVERSE CHILDHOOD EXPERIENCE OR EARLY LIFE STRESS, EPIGENOMIC OR EPIGENETIC, CHILD DEVELOPMENT OR INFANT DEVELOPMENT. DATA SYNTHESIS: CONTINUING STRESS RESPONSE, KNOWN AS TOXIC STRESS, CAN OCCUR WHEN A CHILD EXPERIENCES INTENSE, FREQUENT, AND/OR PROLONGED ADVERSITY-SUCH AS PHYSICAL OR EMOTIONAL ABUSE, CHRONIC NEGLECT, FOR EXAMPLE-WITHOUT ADEQUATE ADULT SUPPORT. THIS TOXIC STRESS CAN HAVE HARMFUL EFFECTS ON LEARNING, BEHAVIOR, AND HEALTH THROUGHOUT LIFE. EPIGENETICS, AN EMERGING SCIENTIFIC RESEARCH AREA?, SHOWS HOW ENVIRONMENTAL INFLUENCES AFFECT GENE EXPRESSIONS AND EXPLAINS HOW EARLY EXPERIENCES CAN IMPACT THROUGHOUT LIFE. CONCLUSIONS: TOXIC STRESS CAUSES CHANGES IN THE HUMAN BODY RESPONSE SYSTEMS THAT CAN BE EXPLAINED IN PART BY EPIGENETIC CHANGES, WHICH CAN BE TEMPORARY OR LONG-LASTING. PEDIATRICIANS MUST BE AWARE OF THESE MECHANISMS AND THEIR CONSEQUENCES, SEEKING TO PREVENT THEM AND THUS PROMOTE THE HEALTH, WELL-BEING, AND QUALITY OF LIFE OF CHILDREN, CONTRIBUTING TO THEIR FULL DEVELOPMENT. 2022 16 2850 27 FROM CHILD ABUSE TO DEVELOPING BORDERLINE PERSONALITY DISORDER INTO ADULTHOOD: EXPLORING THE NEUROMORPHOLOGICAL AND EPIGENETIC PATHWAY. BORDERLINE PERSONALITY DISORDER (BPD) IS ONE OF THE MOST COMMON PERSONALITY DISORDERS SEEN IN THE GENERAL POPULATION. AMONG MULTIPLE IDENTIFIED RISK FACTORS, ONE OF THE MOST INFLUENTIAL ELEMENTS IS EXPOSURE TO AN ADVERSE CHILDHOOD EXPERIENCE IN TERMS OF EMOTIONAL, PHYSICAL, OR SEXUAL ABUSE. A CASCADE OF NEUROMORPHOLOGICAL AND EPIGENETIC CHANGES OCCURS IN RESPONSE TO THESE CHILDHOOD STRESSORS, WHICH MAY HAVE A STRONG LINK TO THE DEVELOPMENT OF BPD. PUBMED AND GOOGLE SCHOLAR WERE SEARCHED FOR ARTICLES RELEVANT TO CHILD ABUSE AND THE DEVELOPMENT OF BPD. THE SEARCH WAS NOT RESTRICTED TO ANY TIME FRAME OR GEOGRAPHIC LOCATION. SIGNIFICANT EPIGENETIC AND NEUROMORPHOLOGICAL CHANGES ARE SEEN WITH CHILD ABUSE, CONTRIBUTING TO THE DEVELOPMENT OF BPD. CHRONIC STRESSORS LEAD TO HYPOTHALAMIC-PITUITARY AXIS (HPA) ACTIVATION, RELEASING CORTISOL THAT ACTS ON THE PREFRONTAL CORTEX, AMYGDALA, AND HIPPOCAMPUS, PRODUCING THE BEHAVIORAL PATTERNS SEEN IN BPD. OVERSTIMULATION OF GRAY MATTER LEADS TO PERMANENT NEUROMORPHOLOGICAL CHANGES, WHICH CAN BE VISUALIZED IN FUNCTIONAL MRI/BRAIN SCANS. HYPERMETHYLATION OF MESSENGER RIBONUCLEIC ACID IN VARIOUS SITES SUGGESTS THE IMPACT OF CHILD ABUSE ON THE GENETIC LEVEL. INTERESTINGLY, THE PREVALENCE OF BPD IS SEEN EQUALLY IN BOTH GENDERS BUT IS DIAGNOSED MORE FREQUENTLY IN FEMALES BECAUSE THEY TEND TO BE MORE LIKELY TO SEEK HELP. UNDERSTANDING THE IMPACT OF EARLY AGE LIFE STRESSORS INTO ADULTHOOD CALLS FOR SERIOUS FOCUS ON EARLY DIAGNOSIS AND INTERVENTION. THIS IMPLIES THE NEED FOR MORE STUDIES IN PATIENTS WITH BPD WITH OR WITHOUT ANY CHILDHOOD TRAUMATIC EXPERIENCE AND A BETTER UNDERSTANDING OF THE CHANGES THAT OCCUR BIOPSYCHOLOGICALLY AND GENETICALLY IN RESPONSE TO TRAUMA. 2020 17 6184 22 THE IMPACT OF ENVIRONMENTAL FACTORS IN SEVERE PSYCHIATRIC DISORDERS. DURING THE LAST DECADES, SCHIZOPHRENIA HAS BEEN REGARDED AS A DEVELOPMENTAL DISORDER. THE NEURODEVELOPMENTAL HYPOTHESIS PROPOSES SCHIZOPHRENIA TO BE RELATED TO GENETIC AND ENVIRONMENTAL FACTORS LEADING TO ABNORMAL BRAIN DEVELOPMENT DURING THE PRE- OR POSTNATAL PERIOD. FIRST DISEASE SYMPTOMS APPEAR IN EARLY ADULTHOOD DURING THE SYNAPTIC PRUNING AND MYELINATION PROCESS. META-ANALYSES OF STRUCTURAL MRI STUDIES REVEALING HIPPOCAMPAL VOLUME DEFICITS IN FIRST-EPISODE PATIENTS AND IN THE LONGITUDINAL DISEASE COURSE CONFIRM THIS HYPOTHESIS. APART FROM THE INFLUENCE OF RISK GENES IN SEVERE PSYCHIATRIC DISORDERS, ENVIRONMENTAL FACTORS MAY ALSO IMPACT BRAIN DEVELOPMENT DURING THE PERINATAL PERIOD. SEVERAL ENVIRONMENTAL FACTORS SUCH AS ANTENATAL MATERNAL VIRUS INFECTIONS, OBSTETRIC COMPLICATIONS ENTAILING HYPOXIA AS COMMON FACTOR OR STRESS DURING NEURODEVELOPMENT HAVE BEEN IDENTIFIED TO PLAY A ROLE IN SCHIZOPHRENIA AND BIPOLAR DISORDER, POSSIBLY CONTRIBUTING TO SMALLER HIPPOCAMPAL VOLUMES. IN MAJOR DEPRESSION, PSYCHOSOCIAL STRESS DURING THE PERINATAL PERIOD OR IN ADULTHOOD IS AN IMPORTANT TRIGGER. IN ANIMAL STUDIES, CHRONIC STRESS OR REPEATED ADMINISTRATION OF GLUCOCORTICOIDS HAVE BEEN SHOWN TO INDUCE DEGENERATION OF GLUCOCORTICOID-SENSITIVE HIPPOCAMPAL NEURONS AND MAY CONTRIBUTE TO THE PATHOPHYSIOLOGY OF AFFECTIVE DISORDERS. EPIGENETIC MECHANISMS ALTERING THE CHROMATIN STRUCTURE SUCH AS HISTONE ACETYLATION AND DNA METHYLATION MAY MEDIATE EFFECTS OF ENVIRONMENTAL FACTORS TO TRANSCRIPTIONAL REGULATION OF SPECIFIC GENES AND BE A PROMINENT FACTOR IN GENE-ENVIRONMENTAL INTERACTION. IN ANIMAL MODELS, GENE-ENVIRONMENTAL INTERACTION SHOULD BE INVESTIGATED MORE INTENSELY TO UNRAVEL PATHOPHYSIOLOGICAL MECHANISMS. THESE FINDINGS MAY LEAD TO NEW THERAPEUTIC STRATEGIES INFLUENCING EPIGENETIC TARGETS IN SEVERE PSYCHIATRIC DISORDERS. 2014 18 6626 23 UNDERSTANDING RESILIENCE. RESILIENCE IS THE ABILITY TO ADAPT SUCCESSFULLY IN THE FACE OF STRESS AND ADVERSITY. STRESSFUL LIFE EVENTS, TRAUMA, AND CHRONIC ADVERSITY CAN HAVE A SUBSTANTIAL IMPACT ON BRAIN FUNCTION AND STRUCTURE, AND CAN RESULT IN THE DEVELOPMENT OF POSTTRAUMATIC STRESS DISORDER (PTSD), DEPRESSION AND OTHER PSYCHIATRIC DISORDERS. HOWEVER, MOST INDIVIDUALS DO NOT DEVELOP SUCH ILLNESSES AFTER EXPERIENCING STRESSFUL LIFE EVENTS, AND ARE THUS THOUGHT TO BE RESILIENT. RESILIENCE AS SUCCESSFUL ADAPTATION RELIES ON EFFECTIVE RESPONSES TO ENVIRONMENTAL CHALLENGES AND ULTIMATE RESISTANCE TO THE DELETERIOUS EFFECTS OF STRESS, THEREFORE A GREATER UNDERSTANDING OF THE FACTORS THAT PROMOTE SUCH EFFECTS IS OF GREAT RELEVANCE. THIS REVIEW FOCUSES ON RECENT FINDINGS REGARDING GENETIC, EPIGENETIC, DEVELOPMENTAL, PSYCHOSOCIAL, AND NEUROCHEMICAL FACTORS THAT ARE CONSIDERED ESSENTIAL CONTRIBUTORS TO THE DEVELOPMENT OF RESILIENCE. NEURAL CIRCUITS AND PATHWAYS INVOLVED IN MEDIATING RESILIENCE ARE ALSO DISCUSSED. THE GROWING UNDERSTANDING OF RESILIENCE FACTORS WILL HOPEFULLY LEAD TO THE DEVELOPMENT OF NEW PHARMACOLOGICAL AND PSYCHOLOGICAL INTERVENTIONS FOR ENHANCING RESILIENCE AND MITIGATING THE UNTOWARD CONSEQUENCES. 2013 19 2874 27 FUNCTIONAL NUTRITION AS INTEGRATED INTERVENTION FOR IN- AND OUTPATIENT WITH SCHIZOPHRENIA. SCHIZOPHRENIA IS A CHRONIC AND PROGRESSIVE DISORDER CHARACTERIZED BY COGNITIVE, EMOTIONAL,AND BEHAVIORAL ABNORMALITIES ASSOCIATED WITH NEURONAL DEVELOPMENT AND SYNAPTIC PLASTICITY ALTERATIONS. GENETIC AND EPIGENETIC ABNORMALITIES IN CORTICAL PARVALBUMIN-POSITIVE GABAERGIC INTERNEURONS AND CONSEQUENT ALTERATIONS IN GLUTAMATE-MEDIATED EXCITATORY NEUROTRANSMISSION DURING EARLY NEURODEVELOPMENT UNDERLIE SCHIZOPHRENIA MANIFESTATION AND PROGRESSION. ALSO, EPIGENETIC ALTERATIONS DURING PREGNANCY OR EARLY PHASES OF POSTNATAL LIFE ARE ASSOCIATED WITH SCHIZOPHRENIA VULNERABILITY AND IN-FLAMMATORY PROCESSES, WHICH ARE AT THE BASIS OF BRAIN PATHOLOGY AND A HIGHER RISK OF COMORBIDITIES, INCLUDING CARDIOVASCULAR DISEASES AND METABOLIC SYNDROME. IN ADDITION, SCHIZOPHRENIA PATIENTS ADOPT AN UNHEALTHY LIFESTYLE AND POOR NUTRITION, LEADING TO PREMATURE DEATH. HERE, I EXPLORED THE ROLE OF FUNCTIONAL NUTRITION AS AN INTEGRATED INTERVENTION FOR THE LONG-TERM MANAGEMENT OF PATIENTS WITH SCHIZOPHRENIA. SEVERAL NATURAL BIOACTIVE COMPOUNDS IN PLANT-BASED WHOLE FOODS, INCLUDING FLAVONOIDS, PHYTONUTRIENTS, VITAMINS, FATTY ACIDS, AND MINERALS, MODULATE BRAIN FUNCTIONING BY TARGETING NEUROINFLAMMATION AND IMPROVING COGNITIVE DECLINE. ALTHOUGH FURTHER CLINICAL STUDIES ARE NEEDED, A FUNCTIONAL DIET RICH IN NATURAL BIOACTIVE COMPOUNDS MIGHT BE EFFECTIVE IN SYNERGISM WITH STANDARD TREATMENTS TO IMPROVE SCHIZOPHRENIA SYMPTOMS AND REDUCE THE RISK OF COMORBIDITIES. 2023 20 1779 26 EDITORIAL: MATERNAL INFLAMMATION DURING PREGNANCY: A MODIFIABLE PATHWAY TOWARD IMPROVING OFFSPRING SOCIOEMOTIONAL OUTCOMES IN CHILDHOOD AND ADOLESCENCE. CHILDHOOD PSYCHOPATHOLOGY IS A WELL-ESTABLISHED PREDICTOR OF POOR ADULT LIFE-COURSE OUTCOMES INCLUDING LOWER RATES OF EDUCATIONAL ATTAINMENT AND REDUCED FAMILY INCOME, WITH A TOTAL ECONOMIC LOSS OF $2.1 TRILLION IN THE UNITED STATES.(1) GIVEN THIS HIGH LEVEL OF INDIVIDUAL AND SOCIETAL BURDEN, MUCH EFFORT HAS BEEN DEVOTED TO IDENTIFYING THE MODIFIABLE RISK FACTORS THAT CONFER RISK FOR PSYCHIATRIC DISORDERS DURING EARLY CHILDHOOD. INDEED, NUMEROUS ASPECTS OF EARLY LIFE ADVERSITY, SUCH AS SOCIOECONOMIC DISADVANTAGE, STRESSFUL/TRAUMATIC LIFE EVENTS, AND DISRUPTED PARENT-CHILD RELATIONSHIPS, DEMONSTRATE STRONG ASSOCIATIONS WITH SOCIOEMOTIONAL PROBLEMS AND PSYCHIATRIC DISORDERS INTO ADOLESCENCE.(2) HOWEVER, THE UNDERLYING BIOLOGICAL MECHANISMS THAT ALSO CONTRIBUTE TO THIS RISK TRAJECTORY REMAIN LESS WELL UNDERSTOOD. ONE PROPOSED BIOLOGICAL MECHANISM THAT IS RAPIDLY GAINING MOMENTUM IN THE FIELD OF DEVELOPMENTAL PSYCHOPATHOLOGY CONCERNS EXCESSIVE IMMUNE SYSTEM ACTIVATION AND/OR PROINFLAMMATORY RESPONSES IN THE ORIGINS OF HEALTH AND DISEASE.(3) OF PARTICULAR INTEREST IS THE PRENATAL PERIOD, REPRESENTING A WINDOW OF VULNERABILITY IN WHICH PRENATAL EXPOSURES PREPARE OR PROGRAM THE FETUS FOR THE EXPECTED POSTNATAL ENVIRONMENT.(3-5) MORE SPECIFICALLY, FETAL PROGRAMMING POSITS THAT THE EFFECTS OF MATERNAL ADVERSITY DURING PREGNANCY ARE, AT LEAST IN PART, TRANSMITTED TO THE FETUS VIA MULTIPLE RELATED PATHWAYS INCLUDING CHRONIC MATERNAL INFLAMMATION AND/OR OVERACTIVATION OF THE HYPOTHALAMIC-PITUITARY-ADRENAL AXIS, RESULTING IN ABERRANT MATERNAL-FETAL IMMUNE/GLUCOCORTICOID SYSTEMS AND DOWNSTREAM EPIGENETIC ALTERATIONS IN THE DEVELOPING FETUS. TOGETHER, THESE FACTORS WORK TO INCREASE THE SUSCEPTIBILITY OF OFFSPRING TO ADVERSITY IN THE POSTNATAL ENVIRONMENT AND, IN TURN, ENHANCE RISK FOR PSYCHIATRIC DISORDERS.(3-6) HOWEVER, MUCH OF THE EXISTING LITERATURE IS BASED ON PRECLINICAL ANIMAL MODELS WITH COMPARATIVELY FEWER CLINICAL STUDIES.(3) AS SUCH, THERE REMAINS A PAUCITY OF LARGE, PROSPECTIVELY DESIGNED CLINICAL STUDIES EXAMINING MATERNAL PROINFLAMMATORY CONDITIONS DURING PREGNANCY IN RELATION TO PSYCHOPATHOLOGY IN OFFSPRING. AS PART OF THE LANDMARK NATIONAL INSTITUTES OF HEALTH-FUNDED ECHO (ENVIRONMENTAL INFLUENCES ON CHILD HEALTH OUTCOMES) CONSORTIUM, THE STUDY BY FRAZIER ET AL.(7) REPRESENTS ONE OF THE LARGEST INVESTIGATIONS LINKING PERINATAL MATERNAL PROINFLAMMATORY CONDITIONS WITH CO-OCCURRING PSYCHIATRIC SYMPTOMS IN CHILDREN AND ADOLESCENTS. 2023