人在生理条件和感染期间的围产期免疫。

IF 2.4 Q1 PEDIATRICS Molecular and cellular pediatrics Pub Date : 2017-12-01 Epub Date: 2017-04-21 DOI:10.1186/s40348-017-0070-1
Gijs T J van Well, Leonie A Daalderop, Tim Wolfs, Boris W Kramer
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引用次数: 55

摘要

长期以来,人们认为宫内环境是无菌的。然而,在胎儿时期已经存在几种传染性威胁。这篇综述的重点是产前暴露于微生物和相关炎症刺激的产后免疫后果。胎儿和新生儿的先天免疫系统和适应性免疫系统都不成熟,这使他们极易受到感染。有充分证据表明,产前感染是早产的主要原因。此外,产前炎症和新生儿不良结局之间的关联已经得到了很好的证实。妊娠期间肺、胃肠道和皮肤暴露于羊水,是妊娠期间感染和随后炎症的可能目标。我们发现大量的研究集中在产前感染和宿主反应上。宫内感染和胎儿免疫反应得到了很好的研究,我们描述了对不同微生物挑战的细胞、细胞因子和体液反应的临床数据。然而,与出生后免疫效应(包括免疫麻痹和/或过度免疫激活)的联系被证明要复杂得多。我们发现产前感染或炎症与众所周知的新生儿疾病,如呼吸窘迫综合征、支气管肺发育不良和坏死性小肠结肠炎有关。尽管有这些数据,产前撞击和产后免疫结果之间的直接联系还不能毫无争议地建立起来。然而,我们确实确定了几个未解决的主题,并提出了进一步研究的问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Human perinatal immunity in physiological conditions and during infection.

The intrauterine environment was long considered sterile. However, several infectious threats are already present during fetal life. This review focuses on the postnatal immunological consequences of prenatal exposure to microorganisms and related inflammatory stimuli. Both the innate and adaptive immune systems of the fetus and neonate are immature, which makes them highly susceptible to infections. There is good evidence that prenatal infections are a primary cause of preterm births. Additionally, the association between antenatal inflammation and adverse neonatal outcomes has been well established. The lung, gastrointestinal tract, and skin are exposed to amniotic fluid during pregnancy and are probable targets of infection and subsequent inflammation during pregnancy. We found a large number of studies focusing on prenatal infection and the host response. Intrauterine infection and fetal immune responses are well studied, and we describe clinical data on cellular, cytokine, and humoral responses to different microbial challenges. The link to postnatal immunological effects including immune paralysis and/or excessive immune activation, however, turned out to be much more complicated. We found studies relating prenatal infectious or inflammatory hits to well-known neonatal diseases such as respiratory distress syndrome, bronchopulmonary dysplasia, and necrotizing enterocolitis. Despite these data, a direct link between prenatal hits and postnatal immunological outcome could not be undisputedly established. We did however identify several unresolved topics and propose questions for further research.

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