Opinion in 2014

Colonization of an infant with their microbiota in early life is important for normal development of host metabolism. In this Perspectives article, Cox and Blaser posit that exposure to antibiotics that disrupt either vertical transmission or colonization and maturation of the microbiota in the infant can lead to adverse consequences such as obesity in adulthood.

Transfer from paediatric to adult health-care services for individuals with a disorder of sex development has specific issues that can impede continuity of care. Here, Crouch and Creighton discuss these barriers, and propose that a long-term plan with psychological support at each stage of transition could ensure successful transfer for these patients.

Hyperinsulinaemic androgen excess leads to hirsutism, acne, seborrhoea and irregular menstrual cycles in young women. In this Perspectives article, Ibáñez and colleagues hypothesize that hyperinsuliaemic androgen excess arises owing to increased lipid load in adipose tissue, outline potential diagnostic criteria, and discuss the advantages and disadvantages of different treatment options for girls with this disorder.

The cellular mechanisms whereby stressful life experiences cause biological damage and increase disease risk remain poorly understood. Here, Picard et al. expand upon the metabolic aspects of this process. They propose that mitochondrial allostatic load could underpin the deleterious structural and functional changes that mitochondria undergo in response to elevated glucose levels and stress-related pathophysiology.