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Asma e ADHD: il possibile ruolo dello stress materno in gravidanza nello sviluppo concomitante di queste patologie
Titolo Rivista: PNEI REVIEW 
Autori/Curatori: Ornella Righi 
Anno di pubblicazione:  2019 Fascicolo: Lingua: Italiano 
Numero pagine:  14 P. 18-31 Dimensione file:  139 KB
DOI:  10.3280/PNEI2019-002003
Il DOI è il codice a barre della proprietà intellettuale: per saperne di più:  clicca qui   qui 

L’ADHD e l’asma sono condizioni prevalenti nell’infanzia, con una patofisiologia complessa che coinvolge l’interazione genetico-ambientale. L’obiettivo di questo articolo è esplorare i fattori che possono aumentare il rischio di sviluppare asma nei bambini con ADHD. I bambini nati prematuramente e/o quelli le cui madri hanno sperimentato stress durante la gravidanza hanno un rischio significativamente maggiore di sviluppare l’asma in concomitanza con ADHD, dimostrando come lo stress prenatale possa influenzare più circuiti fisiobiologici. In questo processo intervengono sia l’attivazione dell’asse ipotalamo-ipofisi-surreni (HPA) sia la mediazione di citochine infiammatorie che determinano cambiamenti funzionali e morfologici del cervello, e alterazioni immunitarie che predispongono ad atopia.

Keywords: Stress materno, Gravidanza, ADHD, Asma, Infanzia, Citochine infiammatorie.

  1. Babenko O., Kovalchuk I. and Metz G.A. (2015). Stress-induced perinatal and transgenerational epigenetic programming of brain development and mental health. Neurosci. Biobehav. Rev., 48: 70-91.
  2. Brew B.K., Lundholm C., Viktorin A., Lichtenstein P., Larsson H. and Almqvist C. (2018). Ongitudinal
  3. depression or anxiety in mothers and offspring asthma: a Swedish population-based study. Int. J. Epidemiol., 47(1): 166-174.
  4. Chen M.H., Su T.P., Chen Y.S., Hsu J.W., Huang K.L., Chang W.H., Chen T.J., Pan T.L. and Bai Y.M. (2014). Is atopy in early childhood a risk factor for ADHD and ASD? a longitudinal study. J. Psychosom. Res., 77(4): 316-321.
  5. Cherkasova M., Sulla E.M., Dalena K.L., Pondé M.P. and Hechtman L. (2013). Developmental course of attention deficit hyperactivity disorder and its predictors. J. Can. Acad. Child. Adolesc. Psychiatry, 22(1): 47-54.
  6. Chida Y., Sudo N., Sonoda J., Hiramoto T. and Kubo C. (2007). Early-life psychological stress exacerbates adult mouse asthma via the hypothalamus-pituitary-adrenal axis. Am. J. Respir. Crit. Care Med., 175(4): 316-322.
  7. Danese A. and J Lewis S. (2017). Psychoneuroimmunology of Early-Life Stress: The Hidden Wounds of Childhood Trauma? Neuropsychopharmacology, 42(1): 99-114.
  8. Davis E.P., Head K., Buss C. and Sandman C.A. (2017). Prenatal maternal cortisol concentrations predict neurodevelopment in middle childhood. Psychoneuroendocrinology, 75: 56-63.
  9. Douros K., Moustaki M., Tsabouri S., Papadopoulou A., Papadopoulos M. and Priftis K.N. (2017). Prenatal Maternal Stress and the Risk of Asthma in Children. Front. Pediatr., 5: 202.
  10. Effros R.M. and Nagaraj H. (2007). Asthma: new developments concerning immune mechanisms, diagnosis and treatment. Curr. Opin. Pulm. Med., 13(1): 37-43.
  11. Felger J.C. (2018). Imaging the Role of Inflammation in Mood and Anxiety-related Disorders. Curr. Neuropharmacol., 16(5): 533-558., DOI: 10.2174/1570159X1566617112320114
  12. Froidure A., Mouthuy J., Durham S.R., Chanez P., Sibille Y. and Pilette C. (2016). Asthma phenotypes and IgE responses. Eur. Respir. J., 47(1): 304-319., DOI: 10.1183/13993003.01824-201
  13. Glover V. (2015). Prenatal stress and its effects on the fetus and the child: possible underlying biological mechanisms. Adv. Neurobiol., 10: 269-283., DOI: 10.1007/978-1-4939-1372-5_1
  14. Graham A.M., Rasmussen J.M., Entringer S., Ben Ward E., Rudolph M.D., Gilmore J.H., Styner M., Wadhwa P.D., Fair D.A. and Buss C. (2019). Maternal Cortisol Concentrations During Pregnancy and Sex-Specific Associations With Neonatal Amygdala Connectivity and Emerging Internalizing Behaviors. Biol. Psychiatry, 85(2): 172-181.
  15. Grizenko N., Shayan Y.R., Polotskaia A., Ter-Stepanian M. and Joober R. (2008). Relation of maternal stress during pregnancy to symptom severity and response to treatment in children with ADHD. J. Psychiatry Neurosci., 33(1): 10-16.
  16. Gumusoglu S.B., Fine R.S., Murray S.J., Bittle J.L. and Stevens H.E. (2017). The role of IL-6 in neurodevelopment after prenatal stress. Brain Behav. Immun., 65: 274-283.
  17. Harris A. and Seckl J. (2011). Glucocorticoids, prenatal stress and the programming of disease. Horm. Behav., 59(3): 279-289.
  18. Jaakkola J.J., Ahmed P., Ieromnimon A., Goepfert P., Laiou E., Quansah R. and Jaakkola M.S. (2006). Preterm delivery and asthma: a systematic review and meta-analysis. J. Allergy. Clin. Immunol., 118(4): 823-830.
  19. Johnson C.C. and Ownby D.R. (2017). The infant gut bacterial microbiota and risk of pediatric asthma and allergic diseases. Transl. Res., 179: 60-70.
  20. Langley K., Holmans P.A., van den Bree M.B. and Thapar A. (2007). Effects of low birth weight, maternal smoking in pregnancy and social class on the phenotypic manifestation of Attention Deficit Hyperactivity Disorder and associated antisocial behaviour: investigation in a clinical sample. BMC Psychiatry, 7: 26., DOI: 10.1186/1471-244X-7-2
  21. Lekander M., Karshikoff B., Johansson E., Soop A., Fransson P., Lundström J.N., Andreasson A., Ingvar M., Petrovic P., Axelsson J. and Nilsonne G. (2016). Intrinsic functional connectivity of insular cortex and symptoms of sickness during acute experimental inflammation. Brain Behav. Immun., 56: 34-41.
  22. Lim R., Fedulov A.V. and Kobzik L. (2014). Maternal stress during pregnancy increases neonatal allergy susceptibility: role of glucocorticoids. Am. J. Physiol. Lung. Cell. Mol. Physiol., 307(2): L141-148.
  23. Linnet K.M., Dalsgaard S., Obel C., Wisborg K., Henriksen T.B., Rodriguez A., Kotimaa A., Moilanen I., Thomsen P.H., Olsen J. and Jarvelin M.R. (2003). Maternal lifestyle factors in pregnancy risk of attention deficit hyperactivity disorder and associated behaviors: review of the current evidence. Am. J. Psychiatry, 160(6): 1028-1040.
  24. McAllister A.K. and Patterson P.H. (2012). Introduction to special issue on neuroimmunology in brain development and disease. Dev. Neurobiol., 72(10): 1269-1271.
  25. Metsälä J., Kilkkinen A., Kaila M., Tapanainen H., Klaukka T., Gissler M. and Virtanen S.M. (2008). Perinatal factors and the risk of asthma in childhood--a population-based register study in Finland. Am. J. Epidemiol., 168(2): 170-178.
  26. Morsi A., DeFranco D. and Witchel S.F. (2018) The Hypothalamic-Pituitary-Adrenal Axis and the Fetus. Horm. Res. Paediatr., 89(5): 380-387., DOI: 10.1159/00048810
  27. NAEPP (2007). Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. National Asthma Education and Prevention Program. National Heart, Lung, and Blood Institute. -- Testo disponibile al sito:, visitato lo 01/07/2019.
  28. Olszak T., An D., Zeissig S., Vera M.P., Richter J., Franke A., Glickman J.N., Siebert R., Baron R.M., Kasper D.L. and Blumberg R.S. (2012). Microbial exposure during early life has persistent effects on natural killer T cell function. Science, 336(6080): 489-493.
  29. Ouchi R., Kawano T., Yoshida H., Ishii M., Miyasaka T., Ohkawara Y., Takayanagi M., Takahashi T. and Ohno I. (2018). Maternal Separation as Early-Life Stress Causes Enhanced Allergic Airway Responses by Inhibiting Respiratory Tolerance in Mice. Tohoku J. Exp. Med., 246(3): 155-165.
  30. Painter R.C., Roseboom T.J. and de Rooij S.R. (2012). Long-term effects of prenatal stress and glucocorticoid exposure. Birth Defects Res. C Embryo Today, 96(4): 315-324.
  31. Pryce C.R., Aubert Y., Maier C., Pearce P.C. and Fuchs E. (2011). The developmental impact of prenatal stress, prenatal dexamethasone and postnatal social stress on physiology, behaviour and neuroanatomy of primate offspring: studies in rhesus macaque and common marmoset. Psychopharmacology (Berl), 214(1): 33-53.
  32. Rosa M.J., Lee A.G. and Wright R.J. (2018). Evidence establishing a link between prenatal and early-life stress and asthma development. Curr. Opin. Allergy Clin. Immunol., 18(2):148-158., DOI: 10.1097/ACI.000000000000042
  33. Saito S., Nakashima A., Shima T. and Ito M. (2010). Th1/Th2/Th17 and regulatory T-cell paradigm in pregnancy. Am. J. Reprod. Immunol., 63(6): 601-610.
  34. Suh D.I., Chang H.Y., Lee E., Yang S.I. and Hong S.J. (2017). Prenatal Maternal Distress and Allergic Diseases in Offspring: Review of Evidence and Possible Pathways. Allergy Asthma Immunol. Res., 9(3): 200-211.
  35. Van den Bergh B.R.H., van den Heuvel M.I., Lahti M., Braeken M., de Rooij S.R., Entringer S., Hoyer D., Roseboom T., Räikkönen K., King S. and Schwab M. (2017). Prenatal developmental origins of behavior and mental health: The influence of maternal stress in pregnancy. Neurosci. Biobehav. Rev. [Epub ahead of print]
  36. Wang H., Liu J.S., Peng S.H., Deng X.Y., Zhu D.M., Javidiparsijani S., Wang G.R., Li D.Q., Li L.X., Wang Y.C. and Luo J.M. (2013). Gut-lung crosstalk in pulmonary involvement with inflammatory bowel diseases. World J. Gastroenterol., 19(40): 6794-6804.

Ornella Righi, in "PNEI REVIEW" 2/2019, pp. 18-31, DOI:10.3280/PNEI2019-002003


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