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      Associations of attention-deficit/hyperactivity disorder with inflammatory diseases. Results from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS) Translated title: Zusammenhänge von Aufmerksamkeitsdefizit‑/Hyperaktivitätsstörung mit entzündlichen Erkrankungen. Ergebnisse aus dem bundesweiten deutschen Kinder- und Jugendgesundheitssurvey (KiGGS)

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          Abstract

          Background

          Despite conflicting data, some studies have suggested a pathophysiological relationship between inflammation and attention-deficit/hyperactivity disorder (ADHD).

          Methods

          Using data from the nationwide and representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS; n = 6922 study participants aged 11–17 years), this post hoc analysis assessed the associations between ADHD and three common inflammatory diseases.

          Results

          Results showed univariate associations between ADHD and lifetime inflammatory diseases including atopic dermatitis ( p = 0.002), otitis media ( p = 0.001), and herpes simplex infection ( p = 0.032). In logistic regression models adjusted for clinically relevant confounders, we found that ADHD remained a significant predictor of all three inflammatory diseases (atopic dermatitis, Exp(β) = 1.672, 95% confidence interval [CI] 1.239–2.257, p = 0.001; otitis media, Exp(β) = 1.571, 95% CI 1.209–2.040, p = 0.001; herpes simplex, Exp(β) = 1.483, 95% CI 1.137–1.933, p = 0.004).

          Conclusion

          Our findings demonstrate a positive link between ADHD and peripheral inflammatory diseases, including atopic dermatitis, otitis media, and herpes simplex infection. Further studies are needed to understand the exact pathophysiological mechanisms underlying these associations.

          Translated abstract

          Zielsetzung

          Trotz widersprüchlicher Daten haben einige Studien auf einen pathophysiologischen Zusammenhang zwischen Entzündungen und Aufmerksamkeitsdefizit‑/Hyperaktivitätsstörung (ADHS) hingewiesen.

          Methoden

          Anhand von Daten aus dem bundesweiten und repräsentativen Kinder- und Jugendgesundheitssurvey (KiGGS) wurden in dieser Post-hoc-Analyse an n = 6922 Studienteilnehmerinnen und Studienteilnehmern im Alter von 11 bis 17 Jahren die Zusammenhänge zwischen ADHS und drei häufigen entzündlichen Erkrankungen untersucht.

          Resultate

          Die Ergebnisse zeigten univariate Assoziationen zwischen ADHS und peripheren entzündlichen Erkrankungen einschließlich atopischer Dermatitis ( p = 0,002), Otitis media ( p = 0,001) und Herpes-simplex-Infektion ( p = 0,032). In logistischen Regressionsmodellen, die auf klinisch relevante Störfaktoren adjustiert wurden, fanden wir, dass ADHS ein signifikanter Prädiktor für alle drei entzündlichen Erkrankungen blieb (atopische Dermatitis, Exp(β) = 1,672, 95 % Konfidenzinitervall [KI] = 1,239–2,257; p = 0,001; Otitis media, Exp(β) = 1,571, 95 % KI = 1,209–2,040; p = 0,001; Herpes simplex, Exp(β) = 1,483, 95 % KI = 1,137–1,933; p = 0,004).

          Schlussfolgerung

          Unsere Ergebnisse zeigen einen positiven Zusammenhang zwischen ADHS und peripheren entzündlichen Erkrankungen, einschließlich atopischer Dermatitis, Otitis media und Herpes-simplex-Infektion. Weitere Studien sind erforderlich, um die genauen pathophysiologischen Mechanismen zu verstehen, die diesen Zusammenhängen zugrunde liegen.

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          Most cited references42

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          Vitamin D and Immune Function

          Vitamin D metabolizing enzymes and vitamin D receptors are present in many cell types including various immune cells such as antigen-presenting-cells, T cells, B cells and monocytes. In vitro data show that, in addition to modulating innate immune cells, vitamin D also promotes a more tolerogenic immunological status. In vivo data from animals and from human vitamin D supplementation studies have shown beneficial effects of vitamin D on immune function, in particular in the context of autoimmunity. In this review, currently available data are summarized to give an overview of the effects of vitamin D on the immune system in general and on the regulation of inflammatory responses, as well as regulatory mechanisms connected to autoimmune diseases particularly in type 1 diabetes mellitus.
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            The role of inflammation and microglial activation in the pathophysiology of psychiatric disorders.

            Psychiatric disorders, including major depressive disorder (MDD), bipolar disorder (BD) and schizophrenia, affect a significant percentage of the world population. These disorders are associated with educational difficulties, decreased productivity and reduced quality of life, but their underlying pathophysiological mechanisms are not fully elucidated. Recently, studies have suggested that psychiatric disorders could be considered as inflammatory disorders, even though the exact mechanisms underlying this association are not known. An increase in inflammatory response and oxidative stress may lead to inflammation, which in turn can stimulate microglia in the brain. Microglial activation is roused by the M1 phenotype, which is associated with an increase in interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α). On the contrary, M2 phenotype is associated with a release of anti-inflammatory cytokines. Thus, it is possible that the inflammatory response from microglial activation can contribute to brain pathology, as well as influence treatment responses. This review will highlight the role of inflammation in the pathophysiology of psychiatric disorders, such as MDD, BD, schizophrenia, and autism. More specifically, the role of microglial activation and associated molecular cascades will also be discussed as a means by which these neuroinflammatory mechanisms take place, when appropriate.
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              Epidemiology of Acute Otitis Media in the Postpneumococcal Conjugate Vaccine Era

              In this 10-year prospective study, we capture the epidemiology and risk factors of AOM and the otitis-prone condition in the PCV era. OBJECTIVES: To study the epidemiology of acute otitis media (AOM), especially the otitis-prone condition, during the pneumococcal conjugate vaccines 7 and 13 era. METHODS: Six hundred and fifteen children were prospectively managed from 6 to 36 months of life during a 10-year time frame (June 2006–June 2016). All clinical diagnoses of AOM were confirmed by tympanocentesis and bacterial culture of middle ear fluid. RESULTS: By 1 year of age, 23% of the children experienced ≥1 episode of AOM; by 3 years of age, 60% had ≥1 episodes of AOM, and 24% had ≥3 episodes. The peak incidence occurred at 6 to 12 months of life. Multivariable analysis of demographic and environmental data revealed a significantly increased risk of AOM associated with male sex, non-Hispanic white race, family history of recurrent AOM, day care attendance, and early occurrence of AOM. Risk factors for stringently defined (tympanocentesis-confirmed) otitis proneness, in which children suffered at least 3 episodes of AOM in a 6-month period or at least 4 within a year, were male sex, day care attendance, and family history of AOM, whereas breastfeeding in the first 6 months of life was protective. Stringently defined otitis prone children were also likely to experience their first AOM episode at a younger age. The proportion of Streptococcus pneumoniae, Haemophilus influenzae , and Moraxella catarrhalis causing AOM had dynamic changes during the past decade. CONCLUSIONS: We conclude that the epidemiology but not the risk factors for AOM have undergone substantial changes since the introduction of pneumococcal conjugate vaccines.
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                Author and article information

                Contributors
                thomas.meyer@med.uni-goettingen.de
                Journal
                Neuropsychiatr
                Neuropsychiatr
                Neuropsychiatrie
                Springer Vienna (Vienna )
                0948-6259
                2194-1327
                17 August 2023
                17 August 2023
                2024
                : 38
                : 4
                : 182-188
                Affiliations
                [1 ]GRID grid.7450.6, ISNI 0000 0001 2364 4210, Klinik für Psychosomatische Medizin und Psychotherapie, , Universität Göttingen, ; Göttingen, Germany
                [2 ]GRID grid.7450.6, ISNI 0000 0001 2364 4210, Department of Psychosomatic Medicine and Psychotherapy, German Center for Cardiovascular Research, , University of Göttingen, ; Von-Siebold-Str. 5, Göttingen, Germany
                Author information
                http://orcid.org/0000-0003-3509-1400
                Article
                479
                10.1007/s40211-023-00479-8
                11599504
                37589869
                b8bc0de2-b639-4b93-8a5e-0da9927df764
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 13 April 2023
                : 6 July 2023
                Funding
                Funded by: Georg-August-Universität Göttingen (1018)
                Categories
                Original Article
                Custom metadata
                © Springer-Verlag GmbH Austria, ein Teil von Springer Nature 2024

                25-hydroxyvitamin d,atopic dermatitis,otitis media,herpes simplex,inflammation,atopische dermatitis,entzündung

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