Adverse childhood experiences, epigenetics and telomere length variation in childhood and beyond: a systematic review of
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REVIEW
Adverse childhood experiences, epigenetics and telomere length variation in childhood and beyond: a systematic review of the literature Jason Lang1 · Judith McKie2 · Helen Smith3 · Angela McLaughlin4 · Christopher Gillberg1,5 · Paul G. Shiels6 · Helen Minnis1 Received: 15 November 2018 / Accepted: 1 April 2019 © The Author(s) 2019
Abstract A systematic review following PRISMA guidelines was conducted to answer the question: What epigenetic, telomeric and associated biological changes are associated with exposure to adverse childhood experiences (ACEs) in the under 12s? Using PRISMA guidelines, appropriate databases were searched. 190 papers were returned with 38 articles fully reviewed. Articles were each independently quality rated by two authors using the Crowe Critical Appraisal Tool and data were extracted. Of the 38 articles, 23 were rated as very high quality. Most study participants were adults (n = 7769) with n = 727 child participants. Only seven of the very/high-quality studies were prospective and involved children. Methylation was the most studied method of epigenetic modification. There is some evidence supporting epigenetic modification of certain markers in participants exposed to ACEs measured in adulthood. Research is lacking on non-coding aspects of the epigenome and on coding aspects other than DNA methylation. There is some evidence of a more powerful effect on telomere length if physical neglect was involved. Much further work is required to model biological and psychological effects of epigenetic changes during childhood using prospective study designs. The effect of ACEs on the cellular ageing process during childhood is inadequately investigated and relies solely on measure of telomere length. Future research suggestions are proposed. Keywords Adverse childhood experiences · Epigenetics · Biomarker · Child abuse and neglect
Introduction
* Jason Lang [email protected] 1
Institute of Health and Wellbeing, MVLS, University of Glasgow, Glasgow, UK
2
NHS Lanarkshire Child and Adolescent Mental Health Services for Learning Disability, Motherwell, UK
3
NHS Greater Glasgow and Clyde Forensic CAMHS Team, Glasgow, UK
4
Department of Clinical Psychology, University of Edinburgh, Edinburgh, UK
5
Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
6
Institute of Cancer Sciences, MVLS, University of Glasgow, Glasgow, UK
It is broadly accepted that exposure to adverse childhood experiences (ACEs) is associated with a number of detrimental biological, psychological and social aspects of health [1–3]. Early life stress is associated with dysregulation of neurochemical systems, such as the hypothalamic–pituitary–adrenal axis, and this dysregulation can increase vulnerability to anxiety and mood regulation disorders [4, 5]. It is also accepted that exposure to ACEs can predispose to physical illness [6]. The precise mechanisms involved in these alterations have yet to be fully elicited. Research has examined genetic loci involved with immune,
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