TY - JOUR
T1 - The epigenetic impact of adverse childhood experiences through the lens of personalized medicine
AU - Levy, Sheldon
AU - Muench, John
N1 - Publisher Copyright:
© 2022 Future Medicine Ltd.. All rights reserved.
PY - 2022/4
Y1 - 2022/4
N2 - Over the last two decades, there has been increasing evidence that adverse childhood experiences (ACEs; e.g., physical, emotional and sexual abuse; household member substance misuse; incarceration; mental illness; parental divorce; or witnessing intimate partner violence) before age 18 contribute to the development of disease in adults, including mental illness, cancer, heart disease and diseases of the endocrine system [1,2]. Although there is evidence that ACEs can result in epigenetic changes, leading to increased susceptibility to illness [3], the relative strength of each of the various ACEs in this association has not been well delineated. However, there is some evidence that sexual, physical and emotional abuse has the greatest impact on inflammatory markers [4]. Despite the known impact of ACEs on individual health and treatment outcomes, this understanding has yet to be incorporated into standard medical practice. Many clinicians do not know of the strong association between ACEs and disease, many are worried that they might upset or trigger anxiety in their patient by asking and many feel they do not have the tools to help patients with high ACE scores. We offer evidence that suggests that ACEs are an important aspect of how individuals respond to both disease and treatment. In addition, we suggest that this information as well as information about resiliency can be useful in risk assessment.We further suggest that the ACE information of individuals participating in clinical trials would be helpful in determining the efficacy of various treatment approaches and intensities, with the goal of creating truly personalized medical treatment.
AB - Over the last two decades, there has been increasing evidence that adverse childhood experiences (ACEs; e.g., physical, emotional and sexual abuse; household member substance misuse; incarceration; mental illness; parental divorce; or witnessing intimate partner violence) before age 18 contribute to the development of disease in adults, including mental illness, cancer, heart disease and diseases of the endocrine system [1,2]. Although there is evidence that ACEs can result in epigenetic changes, leading to increased susceptibility to illness [3], the relative strength of each of the various ACEs in this association has not been well delineated. However, there is some evidence that sexual, physical and emotional abuse has the greatest impact on inflammatory markers [4]. Despite the known impact of ACEs on individual health and treatment outcomes, this understanding has yet to be incorporated into standard medical practice. Many clinicians do not know of the strong association between ACEs and disease, many are worried that they might upset or trigger anxiety in their patient by asking and many feel they do not have the tools to help patients with high ACE scores. We offer evidence that suggests that ACEs are an important aspect of how individuals respond to both disease and treatment. In addition, we suggest that this information as well as information about resiliency can be useful in risk assessment.We further suggest that the ACE information of individuals participating in clinical trials would be helpful in determining the efficacy of various treatment approaches and intensities, with the goal of creating truly personalized medical treatment.
KW - childhood adversity
KW - personalized medicine
KW - social epigenetics
UR - http://www.scopus.com/inward/record.url?scp=85130004423&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85130004423&partnerID=8YFLogxK
U2 - 10.2217/epi-2022-0041
DO - 10.2217/epi-2022-0041
M3 - Article
C2 - 35220755
AN - SCOPUS:85130004423
SN - 1750-1911
VL - 14
SP - 425
EP - 429
JO - Epigenomics
JF - Epigenomics
IS - 8
ER -