Modern concepts of the mechanisms of congenital cytomegalovirus infection development

Abstract

The review presents modern information of domestic and foreign authors about possible pathogenetic mechanisms of the virus effect on the fetus in the case of cytomegalovirus infection in pregnant women. Immunosuppressive changes, which are a feature of the physiological course of pregnancy, create favorable conditions for the development of active cytomegalovirus infection. The virus’s ability to infect a wide range of cells in vivo and trigger a set of molecular mechanisms causes changes in placental cell differentiation, which plays a key role in transplant transmission. The processes of formation of chronic placental insufficiency, which leads to hypoxia of the fetus and to delay of intrauterine development, are separately highlighted. The literary data on non-specific metabolic changes of the mother and placental activation of proinflammatory cytokines (TNF-α, IL-1β, IL2, IL-6 and IL-8), which occur in cytomegalovirus infection and are of significant importance in formation of hypoxia of the fetus have been analyzed.In addition, the role of individual cells in preventing intrauterine infection is examined, namely the deciduous macrophages with antiviral activity, the deciduous natural killers and their activated toll-like receptors. The article also discusses the genetic predisposition to the development of manifest forms of EID, including the relationship of polymorphism of TLR2 and Arg753Gln genes with an increased risk of intrauterine infection of the fetus CMV.Characteristic properties of the virus are pronounced genetic diversity, the ability to life-long persistence in various human organs and tissues (secretory glands, lymphatic cells, kidneys, etc.) and replication without cell damage, as well as suppressing cellular immunity. The article describes the issues of genotyping of virus and the relationship of some genotypes with certain organ pathology in newborns.