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2015 ; 2
(1
): 37-51
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Developmental Programming: Priming Disease Susceptibility for Subsequent
Generations
#MMPMID26366336
Messer LC
; Boone-Heinonen J
; Mponwane L
; Wallack L
; Thornburg KL
Curr Epidemiol Rep
2015[Mar]; 2
(1
): 37-51
PMID26366336
show ga
Racial and/or ethnic minorities carry the highest burden of many adverse health
outcomes intergenerationally We propose a paradigm in which developmental
programming exacerbates the effects of racial patterning of adverse environmental
conditions, thereby contributing to health disparity persistence. Evidence that
developmental programming induces a heightened response to adverse exposures
("second hits") encountered later in life is considered. We evaluated the
evidence for the second hit phenomenon reported in animal and human studies from
three domains (air, stress, nutrition). Original research including a gestational
exposure and a childhood or adulthood second hit exposure was reviewed. Evidence
from animal studies suggest that prenatal exposure to air pollutants is
associated with an exaggerated reaction to postnatal air pollution exposure,
which results in worse health outcomes. It also indicates offspring exposed to
prenatal maternal stress produce an exaggerated response to subsequent stressors,
including anxiety and hyper-responsiveness of the hypothalamic-pituitary-adrenal
axis. Similarly, prenatal and postnatal Western-style diets induce synergistic
effects on weight gain, metabolic dysfunction, and atherosclerotic risk.
Cross-domain second hits (e.g., gestational air pollution followed by childhood
stressor) were also considered. Suboptimal gestational environments induce
exaggerated offspring responses to subsequent environmental and social exposures.
These developmental programming effects may result in enhanced sensitivity of
ongoing, racially patterned, adverse exposures in race/ethnic minorities, thereby
exacerbating health disparities from one generation to the next. Empirical
assessment of the hypothesized role of priming processes in the propagation of
health disparities is needed. Future social epidemiology research must explicitly
consider synergistic relationships among social environmental conditions to which
gestating females are exposed and offspring exposures when assessing causes for
persistent health disparities.