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Journal of the American Academy of Child and Adolescent Psychiatry最新文献

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Happiness Falls 幸福瀑布
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 DOI: 10.1016/j.jaac.2024.04.007
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引用次数: 0
Mitochondrial DNA Haplogroup K Is Protective Against Autism Spectrum Disorder Risk in Populations of European Ancestry 欧洲血统人群的线粒体 DNA 单倍群 K 对自闭症谱系障碍风险具有保护作用
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 DOI: 10.1016/j.jaac.2023.09.550

Objective

Accumulative evidence indicates a critical role of mitochondrial function in autism spectrum disorders (ASD), implying that ASD risk may be linked to mitochondrial dysfunction due to DNA (mtDNA) variations. Although a few studies have explored the association between mtDNA variations and ASD, the role of mtDNA in ASD is still unclear. Here, we aimed to investigate whether mitochondrial DNA haplogroups are associated with the risk of ASD.

Method

Two European cohorts and an Ashkenazi Jewish (AJ) cohort were analyzed, including 2,062 ASD patients in comparison with 4,632 healthy controls. DNA samples were genotyped using Illumina HumanHap550/610 and Illumina 1M arrays, inclusive of mitochondrial markers. Mitochondrial DNA (mtDNA) haplogroups were identified from genotyping data using HaploGrep2. A mitochondrial genome imputation pipeline was established to detect mtDNA variants. We conducted a case-control study to investigate potential associations of mtDNA haplogroups and variants with the susceptibility to ASD.

Results

We observed that the ancient adaptive mtDNA haplogroup K was significantly associated with decreased risk of ASD by the investigation of 2 European cohorts including a total of 2,006 cases and 4,435 controls (odds ratio = 0.64, P=1.79 × 10–5), and we replicated this association in an Ashkenazi Jewish (AJ) cohort including 56 cases and 197 controls (odds ratio = 0.35, P = 9.46 × 10–3). Moreover, we demonstrate that the mtDNA variants rs28358571, rs28358584, and rs28358280 are significantly associated with ASD risk. Further expression quantitative trait loci (eQTLs) analysis indicated that the rs28358584 and rs28358280 genotypes are associated with expression levels of nearby genes in brain tissues, suggesting those mtDNA variants may confer risk for ASD via regulation of expression levels of genes encoded by the mitochondrial genome.

Conclusion

This study helps to shed light on the contribution of mitochondria in ASD and provides new insights into the genetic mechanism underlying ASD, suggesting the potential involvement of mtDNA-encoded proteins in the development of ASD.

Plain language summary

Increasing evidence indicates that mitochondrial dysfunction may be linked to autism spectrum disorder (ASD). This study investigated potential associations of mitochondrial DNA (mtDNA) variants in 2 European and Ashkenazi Jewish cohorts including 2,062 individuals with ASD and 4,632 healthy controls. Researchers found that the ancient mtDNA haplogroup K was linked to a reduced risk of ASD in both European and Ashkenazi Jewish populations. Additionally, specific mtDNA variants were associated with ASD risk and were shown to influence the expression of nearby genes in the brain. These findings highlight the potential involvement of mtDNA in ASD development, offering new insights

目的累积的证据表明,线粒体功能在 ASD 中起着关键作用,这意味着 ASD 风险可能与 DNA(mtDNA)变异导致的线粒体功能障碍有关。虽然有一些研究探讨了mtDNA变异与ASD之间的关联,但mtDNA在ASD中的作用仍不清楚。方法分析了两个欧洲队列和一个阿什肯纳兹犹太人(AJ)队列,其中包括 2,062 名 ASD 患者和 4,632 名健康对照者。DNA 样本使用 Illumina HumanHap550/610 和 Illumina 1M 阵列进行基因分型,包括线粒体标记。使用 HaploGrep2 从基因分型数据中确定了线粒体 DNA (mtDNA) 单倍群。建立了一个线粒体基因组估算管道来检测 mtDNA 变异。我们进行了一项病例对照研究,以调查 mtDNA 单倍群和变异与 ASD 易感性的潜在关联。结果我们通过对两个欧洲队列(包括总共 2,006 例病例和 4,435 例对照)的调查发现,古老的适应性 mtDNA 单倍群 K 与 ASD 风险的降低显著相关(几率比 0.64,P=1.79 × 10-5),我们在包括 56 例病例和 197 例对照的阿什肯纳兹犹太人(AJ)队列中重复了这一关联(几率比 0.35,P=9.46 × 10-3)。此外,我们还证明了 mtDNA 变体 rs28358571、rs28358584 和 rs28358280 与 ASD 风险显著相关。进一步的表达量性状位点(eQTLs)分析表明,rs28358584 和 rs28358280 基因型与脑组织中附近基因的表达水平相关,这表明这些 mtDNA 变异可能通过调节线粒体基因组编码基因的表达水平而导致 ASD 风险。结论这项研究有助于揭示线粒体在 ASD 中的作用,并为 ASD 的遗传机制提供了新的见解,提示 mtDNA 编码的蛋白质可能参与了 ASD 的发病。
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引用次数: 0
Council Page 理事会网页
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 DOI: 10.1016/S0890-8567(24)00271-5
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引用次数: 0
Youth With Sexual or Gender-Diverse Identities and Military Connection: Recommendations to Optimize Clinical Care 具有性或性别多样化身份和军事联系的青年:优化临床护理的建议。
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 DOI: 10.1016/j.jaac.2023.08.014
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引用次数: 0
Editorial: Can Improving Youth Mental Health Reduce Mortality? 社论:正确治疗精神障碍能否降低死亡率?
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 DOI: 10.1016/j.jaac.2024.04.009
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引用次数: 0
The Myth of Normal: Trauma, Illness & Healing in a Toxic Culture 正常的神话:有毒文化中的创伤、疾病与治愈
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 DOI: 10.1016/j.jaac.2024.04.008
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引用次数: 0
Editorial: Mitochondrial Gene Variations Increase Autism Risk: Uncovering the Complex Polygenetic Landscape of Autism 社论:线粒体基因变异增加自闭症风险:揭示自闭症的复杂多基因格局
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 DOI: 10.1016/j.jaac.2023.12.002
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引用次数: 0
Editorial: Why Are Children Hurting Themselves and What Can We Do? 为什么孩子们会伤害自己,我们能做些什么?
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-07-31 DOI: 10.1016/j.jaac.2024.07.914
Randy P Auerbach

Alarmingly, suicide is now a leading cause of death for preadolescent youth (ie, less than 13 years of age), and among community samples, 2.56% report lifetime suicide attempts with 15.08% experiencing suicidal ideation.1 Predictable but preventable factors have conspired to propel us toward this public health crisis. Chief among them is that approximately 45% of individuals in the United States reside in communities with shortages of mental health professionals,2 a problem that is disproportionately affecting youth of color. The reduced access to psychiatric care means that treatment for many preadolescent youth, particularly during non-acute periods when many interventions are most effective, is delayed given limited clinician availability. Furthermore, the increased acuity of the modal case may be contributing to clinician burnout, further diminishing an already beleaguered workforce. Moreover, societal cracks present prior to the COVID-19 pandemic were further exacerbated, including increased loneliness and isolation3 as well as educational inequities,4 which have led to more pronounced social disconnectedness and greater stress exposure (eg, academic challenges)-factors directly implicated in suicidal thoughts and behaviors (STB).5 Although substantial efforts are underway to improve the short-term prediction of adolescent and adult STB, limited research has focused on clarifying which preadolescent youth are at risk and when that risk is greatest.

令人震惊的是,自杀现在已成为青少年(即 13 岁以下)的主要死因;在社区样本中,2.56% 的人报告一生中有过自杀企图,15.08% 的人有过自杀念头1 。其中最主要的是,美国约有 45% 的人居住在缺乏心理健康专业人员的社区,2 这一问题对有色人种青少年的影响尤为严重。获得精神科治疗的机会减少意味着许多青春期前青少年的治疗,尤其是在许多干预措施最有效的非急性期,会因为临床医生的可用性而延迟。此外,一般病例的严重性增加可能会导致临床医生的职业倦怠,进一步削弱本已陷入困境的医疗队伍。此外,在 COVID-19 大流行之前就已存在的社会裂痕进一步加剧,包括孤独感和隔离感的增加3 以及教育不公平4 ,这导致了更明显的社会脱节和更大的压力暴露(如学业挑战)--这些因素与自杀想法和行为(STB)直接相关。
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引用次数: 0
Transdermal Asenapine for Agitation and Irritability in a Child With Complete Intravenous Dependence. 经皮阿塞那平治疗一名完全静脉依赖儿童的躁动和易激惹。
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-07-31 DOI: 10.1016/j.jaac.2024.07.913
Julia N Stimpfl, Katherine C Soe

Atypical antipsychotics are often effective for managing behavioral disturbances in children with neurodevelopmental disabilities; however, limited evidence-based pharmacologic therapies exist for those dependent upon intravenous and transdermal routes. Transdermal asenapine is US Food and Drug Administration (FDA) approved for adult schizophrenia, but lacks data regarding pediatric use and tolerability. To our knowledge, there are no reports of transdermal asenapine use in children.1,2 Sublingual asenapine is FDA approved for pediatric bipolar mania monotherapy (ages 10-17 years), but was found to lack efficacy for schizophrenia in adolescents.1,3-5 Reportedly, its pediatric tolerability profile resembles those of other second-generation antipsychotics, with pharmacokinetic and safety data comparable to those in adults.3,6,7 We present the case of a 5-year-old child for whom transdermal asenapine effectively and safely managed agitation and improved tolerance of medical therapies and quality of life. Our case suggests that this may be an effective, well-tolerated pharmacologic option for agitation management in a subset of children. Guardian informed consent was obtained prior to publication.

非典型抗精神病药物通常能有效控制神经发育障碍儿童的行为障碍;然而,对于那些依赖静脉注射和透皮途径的儿童来说,循证药物疗法却十分有限。美国食品和药物管理局(FDA)批准透皮阿塞那平用于治疗成人精神分裂症,但缺乏有关儿童使用和耐受性的数据。1,2阿塞那平舌下含服已获 FDA 批准用于小儿双相躁狂症的单药治疗(10-17 岁),但对青少年精神分裂症缺乏疗效。据报道,其儿科耐受性与其他第二代抗精神病药物相似,药代动力学和安全性数据与成人相当。3,6,7 我们介绍了一例 5 岁儿童的病例,经皮阿塞那平可有效、安全地控制躁动,改善对药物治疗的耐受性和生活质量。我们的病例表明,这可能是一种有效、耐受性良好的药物治疗方法,适用于部分儿童的躁动控制。本文发表前已获得监护人的知情同意。
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引用次数: 0
The Education Crisis and the Allied Role of School-Based Mental Health Care. 教育危机与校本心理保健的联合作用。
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-07-26 DOI: 10.1016/j.jaac.2024.07.911
Andrew S Chun, Alex S Keuroghlian

The COVID-19 pandemic has had a profound impact on educational services, leading the World Bank, UNESCO, and UNICEF to jointly declare the "worst educational crisis on record."1 In the United States, standardized testing revealed large declines in reading and mathematics.1 Disadvantaged students have been disproportionately affected as the achievement gap widened for students from historically marginalized and low-income backgrounds.1 Experts predict a culminative exacerbation of these learning losses in the years ahead.1.

COVID-19 大流行病对教育服务产生了深远影响,导致世界银行、教科文组织和儿童 基金会联合宣布发生了 "有史以来最严重的教育危机 "1 。在美国,标准化测试表明 阅读和数学成绩大幅下降1 。
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引用次数: 0
期刊
Journal of the American Academy of Child and Adolescent Psychiatry
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