在儿童重症病多年后,HPA轴基因内的DNA甲基化异常
Grégoire Coppens1, Ilse Vanhorebeek1, Fabian Güiza1
1Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
Clinical epigenetics
|February 23, 2024
概括
在儿科重症监护病房 (PICU) 接受治疗的儿童在下丘脑-垂体-上腺 (HPA) 轴基因中显示长期异常DNA甲基化,这与发育障碍有关. 葡萄糖皮质体治疗可能会加剧这些表观遗传变化,影响神经发育.
科学领域:
- 表观遗传学 在表观遗传学中,表观遗传学是指表观遗传学.
- 儿科重症监护 儿科重症监护
- 神经发育障碍 神经发育障碍
背景情况:
- 重症儿童经历长期的身体和神经认知缺陷.
- 葡萄糖皮质类药物治疗可以改变大脑下丘脑-垂体-上腺 (HPA) 轴中的DNA甲基化,可能影响大脑发育和行为.
- 这项研究调查了前儿科重症监护室 (PICU) 患者的长期表观遗传变化.
研究的目的:
- 为了确定前PICU患者是否在HPA轴基因内长期表现出异常DNA甲基化.
- 评估性别,年龄和葡萄糖皮质体治疗对这些表观遗传变化的影响.
- 为了将HPA轴DNA甲基化变化与长期发育障碍相关联.
主要方法:
- 对PEPaNIC-RCT及其两年后续数据的二次分析.
- 从818名前PICU患者和392名健康儿童口腔粘膜中DNA甲基化的分析.
- 鉴定HPA轴基因内的不同甲基化位置和区域,并对共变量进行调整和多重测试.
主要成果:
- 前PICU患者在26个CpG位点和3个DNA区域表现出异常的DNA甲基化,主要是低甲基化.
- 这些异常大多是独立于性别的,但部分依赖于年龄.
- 在PICU中的葡萄糖皮质体治疗部分导致FKBP5,SRD5A1和AKR1D1的异常甲基化;FKBP5和AKR1D1的甲基化变化与发育障碍最强烈相关.
结论:
- 危急病后两年,儿童表现出HPA轴基因甲基化异常,特别是FKBP5和AKR1D1.
- 这些表观遗传变化部分与PICU葡萄糖皮质体暴露有关,并导致长期发育缺陷.
- 研究结果表明,在PICU设置中,在自由使用葡萄糖皮质激素方面需要谨慎.
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