Early life Exposure to Environmental Tobacco Exposure and Atherogenesis

摘要

Background: Early exposure to environmental tobacco smoke (ETS) is associated with adverse health outcomes in children and adolescents: reduced lung function growth, asthma and adverse birth outcomes. Less is known on the impact of early life ETS exposure on cardiovascular health and atherosclerosis, although ETS is considered to be highly atherogenic in adults and remains a prevalent exposure in utero and childhood. Aim: 1. Present the state of knowledge on early life/childhood risk factors for atherogenesis, focusing on early life ETS exposure. 2. Present complexity and challenges in investigating early life origins of health and disease 3. and the SAPALDIA Youth Study designed to study early life factors of atherosclerosis. Results: Atherosclerosis is a multi-factorial disease with origins in childhood and in utero. Metabolic and morphologic alterations may result from ETS with toxic compounds crossing the placenta barrier and vaso-constrictive agents reducing the blood flow to the fetus. Childhood ETS exposure has been associated with cardiovascular risk factors: obesity,metabolic syndrome,leptin, adinopectin, CRP, oxidative stress. Studies on ETS and functional or structural changes of the vasculature in children are few. The challenge in research on early life origins of disease lies in the disparity of timing of exposure and disease manifestation. Developmental plasticity and adaptive responses of the human organism add to the complexity. The SAPALDIA Youth Study, the first Swiss offspring study, is designed to study early life factors and cardiovascular health, with a focus on atherosclerosis, addressing vulnerable time windows. Conclusion: ETS exposure in childhood is a risk factor for atherogenesis in adults and children. Considerable evidence supports the early life impact of ETS exposure on children's cardiovascular risk profile. First findings pointing to functional and structural changes to the vasculature in children need affirmation. The SAPALDIA Youth Study can bridge the time windows of early exposure and later disease manifestation.