Childhood Sexual Abuse and Indicators of Immune Activity: A Systematic Review

Abstract

Background: Childhood sexual abuse (CSA) is a prevalent subtype of early life stress associated with changes in immunological and neuroendocrine systems leading to inflammatory responses of the organism and increasing several inflammatory and immune markers. We aimed to conduct a systematic review concerning the association between CSA and indicators of immune activity.Methods: We conducted a search for articles in PubMed, Scopus, PsycINFO, and Web of Science, using the key words: (“Child sexual abuse” OR “childhood maltreatment” OR “sexual violence” OR “posttraumatic stress disorder” OR “rape”) AND (“cytokines” OR “inflammatory markers” OR “interleukin” OR “tumor necrosis factor” OR “C-reactive protein”). PRISMA guidelines were used in order to improve the quality of this research, and MeSH terms were used in PubMed.Results: A total of 3,583 studies were found and, after application of the exclusion criteria, 17 studies were included in this review. Most studies reported an increase of inflammatory activity associated with the presence of early abuse. IL-6, TNF- α, and C-reactive protein were the most frequently analyzed markers and some studies showed higher levels in individuals that suffered CSA compared with controls, although the results were heterogeneous, as was the assessment of CSA, repeated trauma, and time of occurrence. It was not possible to perform a meta-analysis because the results were diversified.Conclusion: CSA is associated with changes in inflammatory markers levels. Improving the assessment of subtypes of trauma is important to further understand the complex correlations of CSA and its biological consequences such as psychiatric and physical illness in later life.

Prevalence of Childhood Sexual Abuse Among Women Using the Childhood Trauma Questionnaire: A Worldwide Meta-Analysis

“…CSA was shown to induce negative outcomes by contributing to structural brain changes such as the reduction of cortical thickness in ventromedial and ventrolateral prefrontal cortex and medial and lateral temporal cortex (Gold et al, 2016); these changes were related to mental diseases in later life (Cross et al, 2017). Furthermore, CSA was shown to be associated with upregulation of immune activity (D’Elia et al, 2018), which may even accelerate telomere erosion (Li et al, 2017).…”

Psychobiological Consequences of Childhood Sexual Abuse: Current Knowledge and Clinical Implications

“…The complexity of this evaluation is well demonstrated in a recent systematic review that aimed to describe the association between CSA and indicators of immune activity. The diversity in studies that were collected, and the heterogeneity of CSA and trauma assessments prevented a meta-analysis from being performed ( D’Elia et al, 2018 ).…”

Socioeconomic Deprivation, Adverse Childhood Experiences and Medical Disorders in Adulthood: Mechanisms and Associations

“…The association between childhood sexual abuse and the development of persistent oxidative stress and inflammation is difficult to assess despite the existence of a plethora of studies investigating the subject. Some authors have reported an increase in both parameters in the short term but not in the long term while other authors have reported no difference compared with age- and sex-matched children with no history of such experiences [258, 259] (reviewed in [260]). The relationship between childhood maltreatment and the development of persistent oxidative stress appears to be much clearer however despite the difficulties in consistently defining the term [259, 261–263].…”