RESUMEN
Stem cells can be coaxed to self-organize into dynamic models of human development and early embryo formation. Despite their scientific promise, might widespread use of these technologies alter people's beliefs about what it means to be a human individual? Attention to some important philosophical distinctions may help navigate our thinking.
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Desarrollo Embrionario , Humanos , Desarrollo Humano , Modelos Biológicos , AnimalesRESUMEN
Generating a precise cellular and molecular cartography of the human embryo is essential to our understanding of the mechanisms of organogenesis in normal and pathological conditions. Here, we have combined whole-mount immunostaining, 3DISCO clearing, and light-sheet imaging to start building a 3D cellular map of the human development during the first trimester of gestation. We provide high-resolution 3D images of the developing peripheral nervous, muscular, vascular, cardiopulmonary, and urogenital systems. We found that the adult-like pattern of skin innervation is established before the end of the first trimester, showing important intra- and inter-individual variations in nerve branches. We also present evidence for a differential vascularization of the male and female genital tracts concomitant with sex determination. This work paves the way for a cellular and molecular reference atlas of human cells, which will be of paramount importance to understanding human development in health and disease. PAPERCLIP.
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Embrión de Mamíferos/citología , Feto/citología , Desarrollo Humano , Imagenología Tridimensional/métodos , Inmunohistoquímica/métodos , Microscopía/métodos , Desarrollo Embrionario , Humanos , Organogénesis , Sistema Nervioso Periférico/citología , Sistema Nervioso Periférico/crecimiento & desarrolloRESUMEN
The unprecedented resolution of high-throughput genomics has enabled the recent discovery of a phenomenon by which specific regions of the genome are shattered and then stitched together via a single devastating event, referred to as chromothripsis. Potential mechanisms governing this process are now emerging, with implications for our understanding of the role of genomic rearrangements in development and disease.
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Aberraciones Cromosómicas , Genoma Humano , Neoplasias/genética , Secuenciación de Nucleótidos de Alto Rendimiento , Desarrollo Humano , Humanos , MutaciónRESUMEN
Historically, the immune system was believed to develop along a linear axis of maturity from fetal life to adulthood. Now, it is clear that distinct layers of immune cells are generated from unique waves of hematopoietic progenitors during different windows of development. This model, known as the layered immune model, has provided a useful framework for understanding why distinct lineages of B cells and γδ T cells arise in succession and display unique functions in adulthood. However, the layered immune model has not been applied to CD8+ T cells, which are still often viewed as a uniform population of cells belonging to the same lineage, with functional differences between cells arising from environmental factors encountered during infection. Recent studies have challenged this idea, demonstrating that not all CD8+ T cells are created equally and that the functions of individual CD8+ T cells in adults are linked to when they were created in the host. In this review, we discuss the accumulating evidence suggesting there are distinct ontogenetic subpopulations of CD8+ T cells and propose that the layered immune model be extended to the CD8+ T cell compartment.
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Linfocitos T CD8-positivos , Sistema Inmunológico , Subgrupos de Linfocitos T , Humanos , Antígenos CD8/inmunología , Linfocitos T CD8-positivos/inmunología , Desarrollo Humano/fisiología , Sistema Inmunológico/citología , Sistema Inmunológico/crecimiento & desarrollo , Sistema Inmunológico/inmunología , Sistema Inmunológico/fisiología , Inmunidad/inmunología , Inmunidad/fisiología , Subgrupos de Linfocitos T/inmunologíaRESUMEN
Fossils and artifacts from Herto, Ethiopia, include the most complete child and adult crania of early Homo sapiens. The endocranial cavities of the Herto individuals show that by 160,000 y ago, brain size, inferred from endocranial size, was similar to that seen in modern human populations. However, endocranial shape differed from ours. This gave rise to the hypothesis that the brain itself evolved substantially during the past â¼200,000 y, possibly in tandem with the transition from Middle to Upper Paleolithic techno-cultures. However, it remains unclear whether evolutionary changes in endocranial shape mostly reflect changes in brain morphology rather than changes related to interaction with maxillofacial morphology. To discriminate between these effects, we make use of the ontogenetic fact that brain growth nearly ceases by the time the first permanent molars fully erupt, but the face and cranial base continue to grow until adulthood. Here we use morphometric data derived from digitally restored immature and adult H. sapiens fossils from Herto, Qafzeh, and Skhul (HQS) to track endocranial development in early H. sapiens. Until the completion of brain growth, endocasts of HQS children were similar in shape to those of modern human children. The similarly shaped endocasts of fossil and modern children indicate that our brains did not evolve substantially over the past 200,000 y. Differences between the endocranial shapes of modern and fossil H. sapiens adults developed only with continuing facial and basicranial growth, possibly reflecting substantial differences in masticatory and/or respiratory function.
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Evolución Biológica , Fósiles , Desarrollo Humano , Cráneo , Adulto , Encéfalo/anatomía & histología , Encéfalo/crecimiento & desarrollo , Niño , Etiopía , Fósiles/anatomía & histología , Humanos , Cráneo/anatomía & histología , Cráneo/crecimiento & desarrolloRESUMEN
ACADEMIC ABSTRACT: We articulate an intergenerational model of positive psychosocial development that centers storytelling in an ecological framework and is motivated by an orientation toward social justice. We bring together diverse literature (e.g., racial-ethnic socialization, family storytelling, narrative psychology) to argue that the intergenerational transmission of stories about one's group is equally important for elders and youth, and especially important for groups who are marginalized, because stories provide a developmental resource for resistance and resilience in the face of injustice. We describe how storytelling activities can support positive psychosocial development in culturally dynamic contexts and illustrate our model with a case study involving LGBTQ+ communities, arguing that intergenerational storytelling is uniquely important for this group given issues of access to stories. We argue that harnessing the power of intergenerational storytelling could provide a culturally safe and sustaining practice for fostering psychosocial development among LGBTQ+ people and other equity-seeking populations. PUBLIC ABSTRACT: Understanding one's identity as part of a group with shared history and culture that has existed through time is important for positive psychological functioning. This is especially true for marginalized communities for whom identity-relevant knowledge is often erased, silenced, or distorted in mainstream public discourses (e.g., school curricula, news media, television, and film). To compensate for these limitations around access, one channel for the transmission of this knowledge is through oral storytelling between generations of elders and youth. Contemporary psychological science has often assumed that such storytelling occurs within families, but when families cannot or would not share such knowledge, youth suffer. We present a model of intergenerational storytelling that expands our ideas around who counts as "family" and how knowledge can be transmitted through alternative channels, using LGBTQ+ communities as a case example.
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Relaciones Intergeneracionales , Narración , Minorías Sexuales y de Género , Humanos , Minorías Sexuales y de Género/psicología , Marginación Social , Justicia Social , Desarrollo HumanoRESUMEN
Ivancovsky et al.'s Novelty-Seeking Model suggests several mechanisms that might underlie developmental change in creativity and curiosity. We discuss how these implications both do and do not align with extant developmental findings, suggest two further elements that can provide a more complete developmental account, and discuss current methodological barriers to formulating an integrated developmental model of curiosity and creativity.
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Creatividad , Conducta Exploratoria , Humanos , Conducta Exploratoria/fisiología , Modelos Psicológicos , Desarrollo Humano/fisiologíaRESUMEN
While model organisms have had many historians, this article places studies of humans, and particularly our development, in the politics of species choice. Human embryos, investigated directly rather than via animal surrogates, have gone through cycles of attention and neglect. In the past 60 years they moved from the sidelines to center stage. Research was resuscitated in anatomy, launched in reproductive biomedicine, molecular genetics, and stem-cell science, and made attractive in developmental biology. I explain this surge of interest in terms of rivalry with models and reliance on them. The greater involvement of medicine in human reproduction, especially through in vitro fertilization, gave access to fresh sources of material that fed critiques of extrapolation from mice and met demands for clinical relevance or "translation." Yet much of the revival depended on models. Supply infrastructures and digital standards, including biobanks and virtual atlases, emulated community resources for model organisms. Novel culture, imaging, molecular, and postgenomic methods were perfected on less precious samples. Toing and froing from the mouse affirmed the necessity of the exemplary mammal and its insufficiency justified inquiries into humans. Another kind of model-organoids and embryo-like structures derived from stem cells-enabled experiments that encouraged the organization of a new field, human developmental biology. Research on humans has competed with and counted on models.
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Biología Evolutiva , Humanos , Animales , Historia del Siglo XX , Ratones , Biología Evolutiva/historia , Investigaciones con Embriones/historia , Modelos Animales , Historia del Siglo XXI , Desarrollo Humano/fisiologíaRESUMEN
Convolutional neural networks (CNN) can accurately predict chronological age in healthy individuals from structural MRI brain scans. Potentially, these models could be applied during routine clinical examinations to detect deviations from healthy ageing, including early-stage neurodegeneration. This could have important implications for patient care, drug development, and optimising MRI data collection. However, existing brain-age models are typically optimised for scans which are not part of routine examinations (e.g., volumetric T1-weighted scans), generalise poorly (e.g., to data from different scanner vendors and hospitals etc.), or rely on computationally expensive pre-processing steps which limit real-time clinical utility. Here, we sought to develop a brain-age framework suitable for use during routine clinical head MRI examinations. Using a deep learning-based neuroradiology report classifier, we generated a dataset of 23,302 'radiologically normal for age' head MRI examinations from two large UK hospitals for model training and testing (age range = 18-95 years), and demonstrate fast (< 5 s), accurate (mean absolute error [MAE] < 4 years) age prediction from clinical-grade, minimally processed axial T2-weighted and axial diffusion-weighted scans, with generalisability between hospitals and scanner vendors (Δ MAE < 1 year). The clinical relevance of these brain-age predictions was tested using 228 patients whose MRIs were reported independently by neuroradiologists as showing atrophy 'excessive for age'. These patients had systematically higher brain-predicted age than chronological age (mean predicted age difference = +5.89 years, 'radiologically normal for age' mean predicted age difference = +0.05 years, p < 0.0001). Our brain-age framework demonstrates feasibility for use as a screening tool during routine hospital examinations to automatically detect older-appearing brains in real-time, with relevance for clinical decision-making and optimising patient pathways.
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Envejecimiento , Encéfalo/diagnóstico por imagen , Desarrollo Humano , Imagen por Resonancia Magnética , Neuroimagen , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Envejecimiento/patología , Envejecimiento/fisiología , Aprendizaje Profundo , Desarrollo Humano/fisiología , Humanos , Imagen por Resonancia Magnética/métodos , Imagen por Resonancia Magnética/normas , Persona de Mediana Edad , Neuroimagen/métodos , Neuroimagen/normas , Adulto JovenRESUMEN
Medial frontal theta-band oscillations are a robust marker of action-outcome monitoring. In a large developmental sample (n = 432, 9-16 years), we examined whether phase and non-phase locked medial frontal theta power were related to inhibitory control among children and adolescents. Our results showed that the well-established increase in medial frontal theta power during inhibitory control was captured largely by non-phase locked dynamics, which partially mediated the positive effect of age on task performance. A person-centered approach also revealed latent classes of individuals based on their multivariate theta power dynamics (phase locked/non-phase locked, GO/NOGO). The class of individuals showing low phase locked and high non-phase locked medial frontal theta were significantly older, had better inhibitory control, scored higher on measures of general cognitive function, and were more efficient in their behavioural responses. The functional significance of phase and non-phase locked theta dynamics, and their potential changes, could have important implications for action-outcome monitoring and cognitive function in both typical and atypical development, as well as related psychopathology .
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Electroencefalografía/métodos , Función Ejecutiva/fisiología , Desarrollo Humano/fisiología , Inhibición Psicológica , Corteza Prefrontal/fisiología , Desempeño Psicomotor/fisiología , Ritmo Teta/fisiología , Adolescente , Niño , Femenino , Humanos , MasculinoRESUMEN
The human gut microbiome is a collection of bacteria, protozoa, fungi, and viruses that coexist in our bodies and are essential in protective, metabolic, and physiologic functions of human health. Gut dysbiosis has traditionally been linked to increased risk of infection, but imbalances within the intestinal microbial community structure that correlate with untoward inflammatory responses are increasingly recognized as being involved in disease processes that affect many organ systems in the body. Furthermore, it is becoming more apparent that the connection between gut dysbiosis and age-related diseases may lie in how the gut microbiome communicates with both the intestinal mucosa and the systemic immune system, given that these networks have a common interconnection to frailty. We therefore discuss recent advances in our understanding of the important role the microbiome plays in aging and how this knowledge opens the door for potential novel therapeutics aimed at shaping a less dysbiotic microbiome to prevent or treat age-related diseases.
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Envejecimiento/fisiología , Disbiosis/microbiología , Fragilidad/fisiopatología , Microbioma Gastrointestinal/fisiología , Interacciones Microbiota-Huesped/fisiología , Anciano , Animales , Modelos Animales de Enfermedad , Disbiosis/inducido químicamente , Disbiosis/fisiopatología , Fragilidad/microbiología , Salud , Desarrollo Humano/fisiología , HumanosRESUMEN
Delineating the association of age and cortical thickness in healthy individuals is critical given the association of cortical thickness with cognition and behavior. Previous research has shown that robust estimates of the association between age and brain morphometry require large-scale studies. In response, we used cross-sectional data from 17,075 individuals aged 3-90 years from the Enhancing Neuroimaging Genetics through Meta-Analysis (ENIGMA) Consortium to infer age-related changes in cortical thickness. We used fractional polynomial (FP) regression to quantify the association between age and cortical thickness, and we computed normalized growth centiles using the parametric Lambda, Mu, and Sigma method. Interindividual variability was estimated using meta-analysis and one-way analysis of variance. For most regions, their highest cortical thickness value was observed in childhood. Age and cortical thickness showed a negative association; the slope was steeper up to the third decade of life and more gradual thereafter; notable exceptions to this general pattern were entorhinal, temporopolar, and anterior cingulate cortices. Interindividual variability was largest in temporal and frontal regions across the lifespan. Age and its FP combinations explained up to 59% variance in cortical thickness. These results may form the basis of further investigation on normative deviation in cortical thickness and its significance for behavioral and cognitive outcomes.
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Corteza Cerebral/anatomía & histología , Corteza Cerebral/diagnóstico por imagen , Desarrollo Humano/fisiología , Neuroimagen , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
For many traits, males show greater variability than females, with possible implications for understanding sex differences in health and disease. Here, the ENIGMA (Enhancing Neuro Imaging Genetics through Meta-Analysis) Consortium presents the largest-ever mega-analysis of sex differences in variability of brain structure, based on international data spanning nine decades of life. Subcortical volumes, cortical surface area and cortical thickness were assessed in MRI data of 16,683 healthy individuals 1-90 years old (47% females). We observed significant patterns of greater male than female between-subject variance for all subcortical volumetric measures, all cortical surface area measures, and 60% of cortical thickness measures. This pattern was stable across the lifespan for 50% of the subcortical structures, 70% of the regional area measures, and nearly all regions for thickness. Our findings that these sex differences are present in childhood implicate early life genetic or gene-environment interaction mechanisms. The findings highlight the importance of individual differences within the sexes, that may underpin sex-specific vulnerability to disorders.
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Variación Biológica Poblacional/fisiología , Encéfalo/anatomía & histología , Encéfalo/diagnóstico por imagen , Desarrollo Humano/fisiología , Imagen por Resonancia Magnética , Neuroimagen , Caracteres Sexuales , Grosor de la Corteza Cerebral , Corteza Cerebral/anatomía & histología , Corteza Cerebral/diagnóstico por imagen , Femenino , Humanos , MasculinoRESUMEN
Age has a major effect on brain volume. However, the normative studies available are constrained by small sample sizes, restricted age coverage and significant methodological variability. These limitations introduce inconsistencies and may obscure or distort the lifespan trajectories of brain morphometry. In response, we capitalized on the resources of the Enhancing Neuroimaging Genetics through Meta-Analysis (ENIGMA) Consortium to examine age-related trajectories inferred from cross-sectional measures of the ventricles, the basal ganglia (caudate, putamen, pallidum, and nucleus accumbens), the thalamus, hippocampus and amygdala using magnetic resonance imaging data obtained from 18,605 individuals aged 3-90 years. All subcortical structure volumes were at their maximum value early in life. The volume of the basal ganglia showed a monotonic negative association with age thereafter; there was no significant association between age and the volumes of the thalamus, amygdala and the hippocampus (with some degree of decline in thalamus) until the sixth decade of life after which they also showed a steep negative association with age. The lateral ventricles showed continuous enlargement throughout the lifespan. Age was positively associated with inter-individual variability in the hippocampus and amygdala and the lateral ventricles. These results were robust to potential confounders and could be used to examine the functional significance of deviations from typical age-related morphometric patterns.
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Amígdala del Cerebelo/anatomía & histología , Cuerpo Estriado/anatomía & histología , Hipocampo/anatomía & histología , Desarrollo Humano/fisiología , Neuroimagen , Tálamo/anatomía & histología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Amígdala del Cerebelo/diagnóstico por imagen , Niño , Preescolar , Cuerpo Estriado/diagnóstico por imagen , Femenino , Hipocampo/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Tálamo/diagnóstico por imagen , Adulto JovenRESUMEN
Professor Sir Michael Rutter died on 23 October 2021. He had made an unparalleled and profound contribution to the science underpinning our understanding of the origins and development of psychopathology in children and young people. The unique combination of reforming motivations, intellectual curiosity and commitment to hypothesis-driven science that made this possible are discussed in the editorial for this issue (Sonuga-Barke, Fearon & Scott, 2022). I have recently compiled a systematic and comprehensive Digest of his life's work - 546 journal papers and 52 books published [https://doi.org/10.13056/acamh.13072]. This Editorial Perspective will summarise some highlights of the main areas of his many scientific achievements.
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Desarrollo Humano , Psicopatología , Adolescente , Niño , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Psicopatología/historiaRESUMEN
The causes of obesity are complex and multifactorial. We propose that one unconsidered but likely important factor is the energetic demand of brain development, which could constrain energy available for body growth and other functions, including fat deposition. Humans are leanest during early childhood and regain body fat in later childhood. Children reaching this adiposity rebound (AR) early are at risk for adult obesity. In aggregate data, the developing brain consumes a lifetime peak of 66% of resting energy expenditure in the years preceding the AR, and brain energy use is inversely related to body weight gain from infancy until puberty. Building on this finding, we hypothesize that individual variation in childhood brain energy expenditure will help explain variation in the timing of the AR and subsequent obesity risk. The idea that brain energetics constrain fat deposition is consistent with evidence that genes that elevate BMI are expressed in the brain and mediate a trade-off between the size of brain structures and BMI. Variability in energy expended on brain development and function could also help explain widely documented inverse relationships between the BMI and cognitive abilities. We estimate that variability in brain energetics could explain the weight differential separating children at the 50th and 70th BMI-for-age centiles immediately before the AR. Our model proposes a role for brain energetics as a driver of variation within a population's BMI distribution and suggests that educational interventions that boost global brain energy use during childhood could help reduce the burden of obesity.
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Encéfalo/metabolismo , Metabolismo Energético/fisiología , Obesidad/etiología , Adiposidad/fisiología , Adolescente , Factores de Edad , Composición Corporal , Índice de Masa Corporal , Encéfalo/fisiología , Niño , Preescolar , Femenino , Glucosa/metabolismo , Desarrollo Humano/fisiología , Humanos , Lactante , Recién Nacido , Masculino , Modelos Biológicos , Obesidad/metabolismo , Obesidad Infantil/etiología , Obesidad Infantil/metabolismo , Adulto JovenRESUMEN
We investigated the role of age and gender in cognitive estimation abilities. Participants completed two online tasks, where different categories of estimation were assessed (speed estimation by time and distance, and auditory estimation). Data from a total of 18886 participants (9911 females) with ages between 18 and 65 years old were gathered. Results showed variations in the estimation capacity as a function of age, with a slow but progressive decline. Estimates of duration and sound seemed to be more affected by age than estimates of speed and movement. Overall, male participants showed a better performance on both auditory and visual estimation tasks compared to females.
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Función Ejecutiva/fisiología , Desarrollo Humano/fisiología , Desempeño Psicomotor/fisiología , Pensamiento/fisiología , Adolescente , Adulto , Factores de Edad , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Converging evidence from biopsychosocial research in humans and animals demonstrates that chronic sensory stimulation (via excessive screen exposure) affects brain development increasing the risk of cognitive, emotional, and behavioural disorders in adolescents and young adults. Emerging evidence suggests that some of these effects are similar to those seen in adults with symptoms of mild cognitive impairment (MCI) in the early stages of dementia, including impaired concentration, orientation, acquisition of recent memories (anterograde amnesia), recall of past memories (retrograde amnesia), social functioning, and self-care. Excessive screen time is known to alter gray matter and white volumes in the brain, increase the risk of mental disorders, and impair acquisition of memories and learning which are known risk factors for dementia. Chronic sensory overstimulation (i.e., excessive screen time) during brain development increases the risk of accelerated neurodegeneration in adulthood (i.e., amnesia, early onset dementia). This relationship is affected by several mediating/moderating factors (e.g., IQ decline, learning impairments and mental illness). We hypothesize that excessive screen exposure during critical periods of development in Generation Z will lead to mild cognitive impairments in early to middle adulthood resulting in substantially increased rates of early onset dementia in later adulthood. We predict that from 2060 to 2100, the rates of Alzheimer's disease and related dementias (ADRD) will increase significantly, far above the Centres for Disease Control (CDC) projected estimates of a two-fold increase, to upwards of a four-to-six-fold increase. The CDC estimates are based entirely on factors related to the age, sex, race and ethnicity of individuals born before 1950 who did not have access to mobile digital technology during critical periods of brain development. Compared to previous generations, the average 17-19-year-old spends approximately 6 hours a day on mobile digital devices (MDD) (smartphones, tablets, and laptop computers) whereas individuals born before 1950 at the same age spent zero. Our estimates include the documented effects of excessive screen time on individuals born after 1980, Millennials and Generation Z, who will be the majority of individuals ≥65 years old. An estimated 4-to-6-fold increase in rates of ADRD post-2060 will result in widespread societal and economic distress and the complete collapse of already overburdened healthcare systems in developed countries. Preventative measures must be set in place immediately including investments and interventions in public education, social policy, laws, and healthcare.
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Enfermedad de Alzheimer/etiología , Amnesia/etiología , Encéfalo/crecimiento & desarrollo , Disfunción Cognitiva/etiología , Desarrollo Humano/fisiología , Tiempo de Pantalla , Adolescente , Adulto , Anciano , Niño , Humanos , Persona de Mediana Edad , Adulto JovenRESUMEN
Cytokines and their receptors have a vital function in regulating various processes such as immune function, inflammation, haematopoiesis, cell growth and differentiation. The interaction between a cytokine and its specific receptor triggers intracellular signalling cascades that lead to altered gene expression in the target cell and consequent changes in its proliferation, differentiation, or activation. In this review, we highlight the role of the soluble type I cytokine receptor CRLF1 (cytokine receptor-like factor-1) and the Interleukin (IL)-6 cytokine CLCF1 (cardiotrophin-like cytokine factor 1) during development in physiological and pathological conditions with particular emphasis on Crisponi/cold-induced sweating syndrome (CS/CISS) and discuss new insights, challenges and possibilities arising from recent studies.
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Citocinas/metabolismo , Deformidades Congénitas de la Mano/genética , Hiperhidrosis/genética , Receptores de Citocinas/metabolismo , Trismo/congénito , Animales , Muerte Súbita , Modelos Animales de Enfermedad , Facies , Desarrollo Humano , Humanos , Transducción de Señal , Trismo/genéticaRESUMEN
Extensive experimental animal studies and epidemiological observations have shown that environmental influences during early development affect the risk of later pathophysiological processes associated with chronic, especially noncommunicable, disease (NCD). This field is recognized as the developmental origins of health and disease (DOHaD). We discuss the extent to which DOHaD represents the result of the physiological processes of developmental plasticity, which may have potential adverse consequences in terms of NCD risk later, or whether it is the manifestation of pathophysiological processes acting in early life but only becoming apparent as disease later. We argue that the evidence suggests the former, through the operation of conditioning processes induced across the normal range of developmental environments, and we summarize current knowledge of the physiological processes involved. The adaptive pathway to later risk accords with current concepts in evolutionary developmental biology, especially those concerning parental effects. Outside the normal range, effects on development can result in nonadaptive processes, and we review their underlying mechanisms and consequences. New concepts concerning the underlying epigenetic and other mechanisms involved in both disruptive and nondisruptive pathways to disease are reviewed, including the evidence for transgenerational passage of risk from both maternal and paternal lines. These concepts have wider implications for understanding the causes and possible prevention of NCDs such as type 2 diabetes and cardiovascular disease, for broader social policy and for the increasing attention paid in public health to the lifecourse approach to NCD prevention.