Retrospectively reported childhood adversity is associated with asthma and chronic bronchitis, independent of mental health

Rethinking minority stress: A social safety perspective on the health effects of stigma in sexually-diverse and gender-diverse populations

For over two decades, the minority stress model has guided research on the health of sexually-diverse individuals (those who are not exclusively heterosexual) and gender-diverse individuals (those whose gender identity/expression differs from their birth-assigned sex/gender). According to this model, the cumulative stress caused by stigma and social marginalization fosters stress-related health problems. Yet studies linking minority stress to physical health outcomes have yielded mixed results, suggesting that something is missing from our understanding of stigma and health. Social safety may be the missing piece. Social safety refers to reliable social connection, inclusion, and protection, which are core human needs that are imperiled by stigma. The absence of social safety is just as health-consequential for stigmatized individuals as the presence of minority stress, because the chronic threat-vigilance fostered by insufficient safety has negative long-term effects on cognitive, emotional, and immunological functioning, even when exposure to minority stress is low. We argue that insufficient social safety is a primary cause of stigma-related health disparities and a key target for intervention.

Early Adversity and Changes in Cortisol and Negative Affect in Response to Interpersonal Threats in the Laboratory

Adverse childhood experiences, such as abuse and neglect, are associated with poor health outcomes. This association may be partially explained by differences in stress physiology. Though most early adverse experiences occur within the context of interpersonal relationships, stress exposures manipulated in the laboratory rarely involve interpersonal interactions beyond the mere presence of others. This study examines whether adverse childhood experiences are associated with differences in affective and cortisol reactivity to two stressors which may more closely resemble the powerlessness and the lack of control characteristic of many adverse childhood experiences: a dominant (vs. submissive) interaction partner and lower (vs. higher) social status. We also manipulate social-evaluative threat as a test of whether these interpersonal stressors are more germane to stress reactivity associated with early adversity than the performance anxiety evoked by more traditional laboratory stressors, such as the Trier Social Stress Test. The results partially support the hypothesis that participants with greater early adversity may be more reactive to interpersonal stressors reminiscent of early adverse experience. Given the interpersonal nature of most adverse childhood experiences, conceptualizing and measuring associations with stress physiology in an interpersonal context may more closely capture the psychological and biological embedding of these early experiences.

Health and financial costs of adverse childhood experiences in 28 European countries: a systematic review and meta-analysis

BACKGROUND

Adverse childhood experiences (ACEs) are associated with increased health risks across the life course. We aimed to estimate the annual health and financial burden of ACEs for 28 European countries.

METHODS

In this systematic review and meta-analysis, we searched MEDLINE, CINAHL, PsycINFO, Applied Social Sciences Index and Abstracts, Criminal Justice Databases, and Education Resources Information Center for quantitative studies (published Jan 1, 1990, to Sept 8, 2020) that reported prevalence of ACEs and risks of health outcomes associated with ACEs. Pooled relative risks were calculated for associations between ACEs and harmful alcohol use, smoking, illicit drug use, high body-mass index, depression, anxiety, interpersonal violence, cancer, type 2 diabetes, cardiovascular disease, stroke, and respiratory disease. Country-level ACE prevalence was calculated using available data. Country-level population attributable fractions (PAFs) due to ACEs were generated and applied to 2019 estimates of disability-adjusted life-years. Financial costs (US$ in 2019) were estimated using an adapted human capital approach.

FINDINGS

In most countries, interpersonal violence had the largest PAFs due to ACEs (range 14·7-53·5%), followed by harmful alcohol use (15·7-45·0%), illicit drug use (15·2-44·9%), and anxiety (13·9%-44·8%). Harmful alcohol use, smoking, and cancer had the highest ACE-attributable costs in many countries. Total ACE-attributable costs ranged from $0·1 billion (Montenegro) to $129·4 billion (Germany) and were equivalent to between 1·1% (Sweden and Turkey) and 6·0% (Ukraine) of nations' gross domestic products.

INTERPRETATION

Availability of ACE data varies widely between countries and country-level estimates cannot be directly compared. However, findings suggest ACEs are associated with major health and financial costs across European countries. The cost of not investing to prevent ACEs must be recognised, particularly as countries look to recover from the COVID-19 pandemic, which interrupted services and education, and potentially increased risk factors for ACEs.

FUNDING

WHO Regional Office for Europe.

Finding a molecular genetic marker for the incidence of recurrent episodes of acute obstructive bronchitis in children

Over the last ten years, the incidence of the pathology of the bronchus-pulmonary system in children has increased 3.6 times, mainly due to acute and recurrent inflammatory diseases of the upper and lower respiratory tract. Thus, the problem of identifying children with recurrent episodes of acute obstructive bronchitis and an increased risk of developing asthma is relevant and promising. The goal of this study was to find molecular genetic markers associated with increased susceptibility of children to repeated episodes of acute obstructive bronchitis. The molecular genetic testing of the IL4 gene of a single nucleotide polymorphism C-33T was performed in 35 children with recurrent episodes of acute obstructive bronchitis and 35 children with acute bronchitis. The results were statistically processed on a personal computer with the calculation of values the arithmetic mean (M), of the errors arithmetic mean (m), Student criterion (t), the degree of probability (p), Pearson criterion (χ2), and the odds ratio (OR). Statistically significant differences were figured at p<0.01 and p<0.05. It has been proved that the presence of a child's genotype 33CT IL4 increases the risk of recurrent acute obstructive bronchitis four times.

Confounding, Mediation, or Independent Effect? Childhood Psychological Abuse, Mental Health, Mood/Psychological State, COPD, and Migraine

In some settings, it may be difficult to differentiate between a confounder and a mediator. For instance, the observed association of self-reported childhood psychological abuse (CPA) with onset of chronic obstructive pulmonary disease (COPD) and migraine may be confounded by current mood/psychological state (e.g., the subjective evaluation of one's own affective state), as well as mediated by an individual's psychopathological symptoms. In this study, we propose the "independence hypothesis," which could prove meaningful to explore in data that lack prospective or objective indices of CPA. We used cross-sectional data from wave VI (2007-2008) of the Tromsø Study, Norway (N = 12,981). The associations between CPA and COPD and migraine were assessed with Poisson regression models. CPA was associated with a 46% increased risk of COPD (relative risk [RR] = 1.46, 95% confidence interval [CI]: [1.02, 1.90]) and a 28% increased risk of migraine in adulthood (RR = 1.28, 95% CI: [1.04, 1.53]), independent of age, sex, parental history of psychiatric problems/asthma/dementia, smoking, respondent's mood/psychological state, and mental health. These findings suggest that the association between retrospectively reported CPA and COPD and migraine is not driven entirely by respondent's mood/psychological state and mental health. Assessing the independent effect of self-reported CPA on COPD and migraine in retrospective studies may prove more meaningful than exploring the mediating role of mental health. Here, we provide the analytical rationale for assessing the independent effect in settings where it is difficult to differentiate between a confounder and a mediator. Moreover, we provide a theoretical rationale for assessing the independent effect of retrospectively reported childhood adversity on health and well-being.

Rutin prevents inflammation induced by lipopolysaccharide in RAW 264.7 cells via conquering the TLR4-MyD88-TRAF6-NF-κB signalling pathway

OBJECTIVES

Inflammation widely exists in many diseases and poses a great threat to human and animal health. Rutin, quercetin-3-rhamnosyl glucoside, has a variety of pharmacological effects, including anti-oxidant, anti-inflammatory, antibacterial, anticancer and radioresistance effects. The current study focused on evaluation of its anti-inflammatory activity and described the mechanism of rutin in lipopolysaccharide-induced RAW 264.7 cells.

METHODS

The related gene and protein expression levels were investigated by quantification real-time PCR and western blotting, respectively.

KEY FINDINGS

This study revealed that rutin can decrease inducible nitric oxide synthase (iNOS) gene and protein expression levels, effectively increase IκB gene expression, reduce toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), tumour necrosis factor receptor-associated factor 6 (TRAF6) and p65 gene expression and inhibit the phosphorylation of IκB and p65 and the proteins expression of TLR4, MyD88 and TRAF6.

CONCLUSIONS

These results suggest that rutin might exert anti-inflammatory effect on LPS-stimulated RAW 264.7 cells and will be potentially useful as an adjuvant treatment for inflammatory diseases.