This study provides a comprehensive review of the published research on the association between early life adversity and markers of inflammation in children and adolescents. We conducted a systematic review of the published literature on the association between early life adversity and markers of inflammation in pediatric populations. To date, 27 studies have been published in this area representing a wide range of global populations and diverse methods of which nearly half were prospective, longitudinal studies. Of these 27, only 13 studies shared an inflammatory outcome with 4 or more other studies; 9 for CRP, and 7 for IL-6. The association between early life adversity and both CRP, z = 0.06 [-0.01, 0.14], and IL-6, z = 0.06 [-0.17, 0.30], was small and non-significant when subjected to meta-analysis, although comparable in magnitude to the effects observed in adult samples. Descriptively, the association between early life adversity and CRP appeared to be stronger in studies conducted in infants and adolescents compared with middle childhood. There was minimal evidence of publication bias for studies measuring CRP, but evidence of publication bias for studies using IL-6. Eight studies have looked at the association between early life adversity and stimulated inflammatory cytokines in vitro, and both the methods and results of these studies were mixed; the majority observed exaggerated production of inflammatory cytokines despite mixed methodological approaches that make comparisons across studies difficult. In summary, the evidence supporting an association between early life adversity and inflammation in pediatric samples is limited so far by the number of studies and their heterogeneous methodological approaches. More research that is grounded in a developmental framework and informed by the complexity of the innate immune system is needed in this area.

中文翻译：

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儿童和青少年早期生活逆境暴露和炎症循环标志物：系统评价和荟萃分析

本研究对已发表的关于儿童和青少年早期生活逆境与炎症标志物之间关联的研究进行了全面回顾。我们对已发表的关于儿科人群早期生活逆境与炎症标志物之间关联的文献进行了系统评价。迄今为止，该领域已经发表了 27 项研究，代表了广泛的全球人群和不同的方法，其中近一半是前瞻性纵向研究。在这 27 项研究中，只有 13 项研究与 4 项或更多其他研究共享炎症结果；CRP 为 9，IL-6 为 7。当进行荟萃分析时，早期生活逆境与 CRP z = 0.06 [-0.01, 0.14] 和 IL-6, z = 0.06 [-0.17, 0.30] 之间的关联很小且不显着，尽管在规模上与在成人样本中观察到的影响相当。描述性地，与儿童中期相比，在婴儿和青少年中进行的研究中，早期生活逆境与 CRP 之间的关联似乎更强。测量 CRP 的研究存在发表偏倚的证据极少，但使用 IL-6 的研究存在发表偏倚的证据。八项研究在体外研究了早期生活逆境与刺激性炎症细胞因子之间的关系，这些研究的方法和结果是混合的；尽管混合的方法学方法使得跨研究的比较变得困难，但大多数人观察到了炎性细胞因子的过度产生。总之，迄今为止，支持儿童样本中早期生活逆境与炎症之间关联的证据受到研究数量及其异质方法学方法的限制。该领域需要更多基于发育框架并了解先天免疫系统复杂性的研究。