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Pränatale, geschlechtsspezifische Programmierung und chronische Erkrankungen oder Finis Ab Orígine Pendet

Prenatal sex-specific programming and chronic diseases or Finis Ab Orígine Pendet

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Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Über die letzten 5 Jahrzehnte wurden erhöhte Prävalenzen/Inzidenzen für chronisch immunologische Erkrankungen, wie beispielsweise Allergien, multiple Sklerose, Diabetes mellitus vom Typ 2, aber auch für Adipositas, kardiovaskuläre und psychiatrische Erkrankungen verzeichnet. Da sich das menschliche Genom während der letzten Jahrzehnte auf DNA-Ebene nicht signifikant verändert hat, werden Gen-Umwelt-Interaktionen und damit assoziierte epigenetische Prozesse als ursächlich für diese Erhöhung diskutiert. In diesem Zusammenhang wird der Pränatalphase eine besondere Vulnerabilität zugesprochen, da das Risiko für die Ausprägung von Erkrankungen im späteren Leben über vorgeburtlich wirkende Umwelteinflüsse erhöht werden kann. Dieses als „pränatale Programmierung von Gesundheit oder Krankheit“ beschriebene Phänomen wird derzeit auf wissenschaftlicher und klinischer Ebene intensiv beforscht, um zukünftig Richtlinien zur primären Krankheitsprävention ableiten zu können. Während die Erkenntnisse aus diesen Forschungsansätzen graduell Einblicke in die der fetalen Programmierung zugrunde liegenden Mechanismen erlauben, sind hier geschlechtsspezifische Zusammenhänge noch weitestgehend unklar. Eine stärkere Berücksichtigung des Geschlechts in aktuellen und zukünftigen Studien ist daher dringend erforderlich.

Abstract

An increasing incidence of chronic immune diseases such as allergies, multiple sclerosis, and type 2 diabetes, as well as obesity and cardiovascular and psychiatric disorders has been reported over the last five decades. Since the human genome has not altered significantly over this period of time, gene–environment interactions are suspected to be responsible for these increased disease incidences. In this context, the prenatal period is believed to significantly contribute to altered disease susceptibilities, which could be associated with environmental factors to which pregnant women were exposed to. This observation has led to a concept entitled ‘developmental origin of health and disease’, a topic that is enjoying much attention in clinical and basic science research. The aim of these research endeavors is to postulate guidelines for primary disease prevention. Whilst the emerging insights from this field of research provide significant pieces of the puzzle, one area is still largely neglected: the clear identification of a sex-specific programming effect. Thus it is essential that such an approach becomes fully integrated in future research goals.

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Interessenkonflikt

P. C. Arck und K. Hecher geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag ist eine Zusammenfassung der Literatur und beinhaltet keine neu erhobenen Daten aus Studien an Menschen oder Tieren.

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  1. Klinik für Geburtshilfe und Pränatalmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland

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Arck, P., Hecher, K. Pränatale, geschlechtsspezifische Programmierung und chronische Erkrankungen oder Finis Ab Orígine Pendet . Bundesgesundheitsbl. 57, 1061–1066 (2014). https://doi.org/10.1007/s00103-014-2015-3

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