儿童过敏性疾病与注意缺陷多动障碍的关联及相关机制研究进展
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摘要
注意缺陷多动障碍(ADHD)是儿童阶段起病的神经发育障碍。近年来研究发现,其与过敏性疾病呈现高共病特点,过敏性疾病会增加儿童患ADHD的风险。二者相关性涉及复杂的神经免疫学机制:婴儿期的过敏性疾病造成的免疫失调可能影响神经发育,进而引起ADHD;ADHD也可能与过敏性哮喘等疾病涉及相似的发病机制,为累及器官在大脑的过敏性疾病。虽然大量研究认为,ADHD与神经免疫机制有关,但具体神经免疫通路有待进一步研究探索。本文对儿童过敏性疾病和ADHD关系的研究进行定性综述,并总结二者关联的机制,旨在为探索ADHD发病机制和干预方式提供新思路。
Attention deficit hyperactivity disorder(ADHD) is a neurodevelopmental disorder which onsets from childhood.It has been found that there is high co-morbidity between ADHD and atopic diseases.Children with allergic diseases are more likely to develop ADHD compared with controls.And complicated neuroimmuologic mechanisms might be involved in this association.The dysfunctional immunologic responses caused by allergic diseases in the infancy might have impact on the development of neural system.It is also proposed that ADHD is a hypersensitive disorder that shares similar etiology with allergic diseases.This review summarizes current studies on the association between ADHD and allergic diseases,as well as the related mechanisms,in order to provide new ideas for exploring the etiology and intervention of ADHD.
Attention deficit hyperactivity disorder(ADHD) is a neurodevelopmental disorder which onsets from childhood.It has been found that there is high co-morbidity between ADHD and atopic diseases.Children with allergic diseases are more likely to develop ADHD compared with controls.And complicated neuroimmuologic mechanisms might be involved in this association.The dysfunctional immunologic responses caused by allergic diseases in the infancy might have impact on the development of neural system.It is also proposed that ADHD is a hypersensitive disorder that shares similar etiology with allergic diseases.This review summarizes current studies on the association between ADHD and allergic diseases,as well as the related mechanisms,in order to provide new ideas for exploring the etiology and intervention of ADHD.
引文
[1] American Psychiatric Association.Diagnostic and statistical manual of mental disorders[M].Fifth ed.Arlington,VA:American Psychiatric Publishing,2013.
[2] Biederman J.Attention-deficit/hyperactivity disorder:a selective overview[J].Biol Psychiat,2005,57(11):1215-1220.
[3] Rappley MD.Attention deficit-hyperactivity disorder [J].New Engl J Med,2005,352(2):165-173.
[4] 童连,史慧静,臧嘉捷.中国儿童ADHD 流行状况Meta 分析 [J].中国公共卫生,2013,29(9):1279-1283.
[5] Hak E,de Vries TW,Hoekstra PJ,et al.Association of childhood attention-deficit/hyperactivity disorder with atopic diseases and skin infections?A matched case-control study using the General Practice Research Database [J].Ann Allerg Asthma Im,2013,111(2):102-106.
[6] Tsai JD,Chang SN,Mou CH,et al.Association between atopic diseases and attention-deficit/hyperactivity disorder in childhood:a population-based case-control study [J].Ann Epidemiol,2013,23(4):185-188.
[7] Yaghmaie P,Koudelka CW,Simpson EL.Mental health comorbidity in patients with atopic dermatitis [J].J Allergy Clin Immun,2013,131(2):428-433.
[8] Shyu CS,Lin HK,Lin CH,et al.Prevalence of attention-deficit/hyperactivity disorder in patients with pediatric allergic disorders:a nationwide,population-based study [J].J microbiol immunol,2012,45(3):237-242.
[9] Garg N,Silverberg JI.Association between childhood allergic disease,psychological comorbidity,and injury requiring medical attention [J].Ann Allerg Asthma Im,2014,112(6):525-532.
[10] Chen MH,Su TP,Chen YS,et al.Asthma and attention-deficit/hyperactivity disorder:a nationwide population-based prospective cohort study [J].J Chid Psychol Psyc,2013,54(11):1208-1214.
[11] Genuneit J,Braig S,Wabitsch M,et al.Infant atopic eczema and subsequent attention-deficit/hyperactivity disorder-a prospective birth cohort study [J].Pediatr Allergy Immu,2014,25(1):51-56.
[12] Schmitt J,Buske-Kirschbaum A,Roessner V.Is atopic disease a risk factor for attention-deficit/hyperactivity disorder?A systematic review [J].Allergy,2010,65(12):1506-1524.
[13] van der Schans J,Pleiter JC,de Vries TW,et al.Association between medication prescription for atopic diseases and attention-deficit/hyperactivity disorder [J].Ann Allerg Asthma Im,2016,117(2):186-191.
[14] 王亚莉,方凤,潘志尧.儿童多动症、抽动症与过敏原 [J].中国心理卫生杂志,2006,20(6):370-370.
[15] 任华丽,王学艳,张曼.儿童多动症与食物特异性IgG关系研究 [J].山东医药,2010,50(24):18-19.
[16] 于睿莉,丁佳琪,杨波,等.儿童注意缺陷多动障碍伴过敏性鼻结膜炎4例并文献复习[J].解放军医学院学报,2018,39(3):262-265.
[17] 钱兴国,曾小周,王培席,等.儿童注意缺陷多动障碍与哮喘及过敏性疾病关系的病例对照研究[J].中国儿童保健杂志,2014,22(7):699-701.
[18] Romanos M,Gerlach M,Warnke A,et al.Association of attention-deficit/hyperactivity disorder and atopic eczema modified by sleep disturbance in a large population-based sample [J].J Epidemiol Commun H,2010,64(3):269-273.
[19] Buske-Kirschbaum A,Schmitt J,Plessow F,et al.Psychoendocrine and psychoneuroimmunological mechanisms in the comorbidity of atopic eczema and attention deficit/hyperactivity disorder [J].Psychoneuroendocrino,2013,38(1):12-23.
[20] Liao T,Lien Y,Wang S,et al.Comorbidity of atopic disorders with autism spectrum disorder and attention deficit/hyperactivity disorder [J].J Pediatr,2016,171:248-255.
[21] Yang C,Yang CC,Wang I.Association between allergic diseases,allergic sensitization and attention-deficit/hyperactivity disorder in children:a large-scale,population-based study[J].J Chin Med Assoc,2018,81(3):277-283.
[22] Corominas-Roso M,Armario A,Palomar G,et al.IL-6 and TNF-α in unmedicated adults with ADHD:relationship to cortisol awakening response [J].Psychoneuroendocrino,2017,79:67-73.
[23] Pelsser LM,Buitelaar JK,and Savelkoul HFJ.ADHD as a(non) allergic hypersensitivity disorder:a hypothesis [J].Pediatr Allergy Immu,2009,20:107-112.
[24] Pelsser LM,Frankena K,Toorman J,et al.Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder(INCA study):a randomised controlled trial [J].Lancet,2011,377:494-503.
[25] Boris M,Mandel FS.Foods and additives are common causes of the attention deficit hyperactive disorder in children [J].Ann Allerg,1994,72:462-467.
[26] Banerjee TD,Middleton F,Faraone SV.Environmental risk factors for attention-deficit hyperactivity disorder [J].Acta Paediatr,2007,96:1269-1274.
[27] Teyhan A,Galobardes B,Henderson J.Child allergic symptoms and mental well-being:the role of maternal anxiety and depression[J].J Pediatr,2014,165(3):592-599.
[28] Ritz BW,Lord RS.Case study:the effectivenss of a dietary supplement regimen in reducing IgG-mediated food sensitivity in ADHD [J].Altern Ther Health M,2005,11:72-75.
[29] Karaku?a-Juchnowicz H,Szachta P,Opolska A,et al.The role of IgG hypersensitivity in the pathogenesis and therapy of depressive disorders [J].Nutr Neurosci,2017(20):110-118.
[2] Biederman J.Attention-deficit/hyperactivity disorder:a selective overview[J].Biol Psychiat,2005,57(11):1215-1220.
[3] Rappley MD.Attention deficit-hyperactivity disorder [J].New Engl J Med,2005,352(2):165-173.
[4] 童连,史慧静,臧嘉捷.中国儿童ADHD 流行状况Meta 分析 [J].中国公共卫生,2013,29(9):1279-1283.
[5] Hak E,de Vries TW,Hoekstra PJ,et al.Association of childhood attention-deficit/hyperactivity disorder with atopic diseases and skin infections?A matched case-control study using the General Practice Research Database [J].Ann Allerg Asthma Im,2013,111(2):102-106.
[6] Tsai JD,Chang SN,Mou CH,et al.Association between atopic diseases and attention-deficit/hyperactivity disorder in childhood:a population-based case-control study [J].Ann Epidemiol,2013,23(4):185-188.
[7] Yaghmaie P,Koudelka CW,Simpson EL.Mental health comorbidity in patients with atopic dermatitis [J].J Allergy Clin Immun,2013,131(2):428-433.
[8] Shyu CS,Lin HK,Lin CH,et al.Prevalence of attention-deficit/hyperactivity disorder in patients with pediatric allergic disorders:a nationwide,population-based study [J].J microbiol immunol,2012,45(3):237-242.
[9] Garg N,Silverberg JI.Association between childhood allergic disease,psychological comorbidity,and injury requiring medical attention [J].Ann Allerg Asthma Im,2014,112(6):525-532.
[10] Chen MH,Su TP,Chen YS,et al.Asthma and attention-deficit/hyperactivity disorder:a nationwide population-based prospective cohort study [J].J Chid Psychol Psyc,2013,54(11):1208-1214.
[11] Genuneit J,Braig S,Wabitsch M,et al.Infant atopic eczema and subsequent attention-deficit/hyperactivity disorder-a prospective birth cohort study [J].Pediatr Allergy Immu,2014,25(1):51-56.
[12] Schmitt J,Buske-Kirschbaum A,Roessner V.Is atopic disease a risk factor for attention-deficit/hyperactivity disorder?A systematic review [J].Allergy,2010,65(12):1506-1524.
[13] van der Schans J,Pleiter JC,de Vries TW,et al.Association between medication prescription for atopic diseases and attention-deficit/hyperactivity disorder [J].Ann Allerg Asthma Im,2016,117(2):186-191.
[14] 王亚莉,方凤,潘志尧.儿童多动症、抽动症与过敏原 [J].中国心理卫生杂志,2006,20(6):370-370.
[15] 任华丽,王学艳,张曼.儿童多动症与食物特异性IgG关系研究 [J].山东医药,2010,50(24):18-19.
[16] 于睿莉,丁佳琪,杨波,等.儿童注意缺陷多动障碍伴过敏性鼻结膜炎4例并文献复习[J].解放军医学院学报,2018,39(3):262-265.
[17] 钱兴国,曾小周,王培席,等.儿童注意缺陷多动障碍与哮喘及过敏性疾病关系的病例对照研究[J].中国儿童保健杂志,2014,22(7):699-701.
[18] Romanos M,Gerlach M,Warnke A,et al.Association of attention-deficit/hyperactivity disorder and atopic eczema modified by sleep disturbance in a large population-based sample [J].J Epidemiol Commun H,2010,64(3):269-273.
[19] Buske-Kirschbaum A,Schmitt J,Plessow F,et al.Psychoendocrine and psychoneuroimmunological mechanisms in the comorbidity of atopic eczema and attention deficit/hyperactivity disorder [J].Psychoneuroendocrino,2013,38(1):12-23.
[20] Liao T,Lien Y,Wang S,et al.Comorbidity of atopic disorders with autism spectrum disorder and attention deficit/hyperactivity disorder [J].J Pediatr,2016,171:248-255.
[21] Yang C,Yang CC,Wang I.Association between allergic diseases,allergic sensitization and attention-deficit/hyperactivity disorder in children:a large-scale,population-based study[J].J Chin Med Assoc,2018,81(3):277-283.
[22] Corominas-Roso M,Armario A,Palomar G,et al.IL-6 and TNF-α in unmedicated adults with ADHD:relationship to cortisol awakening response [J].Psychoneuroendocrino,2017,79:67-73.
[23] Pelsser LM,Buitelaar JK,and Savelkoul HFJ.ADHD as a(non) allergic hypersensitivity disorder:a hypothesis [J].Pediatr Allergy Immu,2009,20:107-112.
[24] Pelsser LM,Frankena K,Toorman J,et al.Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder(INCA study):a randomised controlled trial [J].Lancet,2011,377:494-503.
[25] Boris M,Mandel FS.Foods and additives are common causes of the attention deficit hyperactive disorder in children [J].Ann Allerg,1994,72:462-467.
[26] Banerjee TD,Middleton F,Faraone SV.Environmental risk factors for attention-deficit hyperactivity disorder [J].Acta Paediatr,2007,96:1269-1274.
[27] Teyhan A,Galobardes B,Henderson J.Child allergic symptoms and mental well-being:the role of maternal anxiety and depression[J].J Pediatr,2014,165(3):592-599.
[28] Ritz BW,Lord RS.Case study:the effectivenss of a dietary supplement regimen in reducing IgG-mediated food sensitivity in ADHD [J].Altern Ther Health M,2005,11:72-75.
[29] Karaku?a-Juchnowicz H,Szachta P,Opolska A,et al.The role of IgG hypersensitivity in the pathogenesis and therapy of depressive disorders [J].Nutr Neurosci,2017(20):110-118.