Harrison C J, Caruso N
Department of Pediatrics, Medical Microbiology and Immunology, Creighton University, Omaha, NE 68178, USA.
J Med Virol. 2000 Feb;60(2):230-6.
Immunologic causes for poor outcome of pregnancy complicated by primary cytomegalovirus (CMV) infection are only partially understood. Maternal and pup tumor necrosis factor (TNF) and natural killer cell (NK)-like activity associated with primary gestational CMV infection initiated in either the first or third trimester equivalent in the inbred guinea pig model were investigated. Poor pregnancy outcome defined as fetal resorptions, premature delivery, stillbirths, and intrauterine growth retardation occurred with infection at either gestational time. Induction of TNF and NK activity by CMV infection during pregnancy correlated with resorptions in early pregnancy infection and with premature labor in late pregnancy infection. Stillbirths occurred with CMV infection at either time. Regardless of the gestational time of CMV acquisition, poor outcome correlated with higher maternal NK and TNF responses during the first weeks after maternal virus acquisition. Furthermore, CMV infected dams with loss of >/= 50% of conceptus had higher TNF responses than infected dams with < 50% conceptus loss. Likewise, pups born in litters from CMV-infected dams with resorptions and/or premature labor also had enhanced NK activity and TNF response to CMV compared with pups born to dams not having resorptions or premature labor. TNF responses in the delivered pups of infected dams were higher than from pups of uninfected dams regardless of litter outcome, whereas pup NK responses were enhanced only in pups from litters of dams with premature labor or resorptions. Enhanced NK and TNF activity appear to be associated with premature delivery and other poor outcomes of pregnancy.
妊娠合并原发性巨细胞病毒(CMV)感染结局不良的免疫原因仅得到部分理解。在近交豚鼠模型中,研究了与孕早期或孕晚期开始的原发性妊娠CMV感染相关的母鼠和幼崽肿瘤坏死因子(TNF)及自然杀伤细胞(NK)样活性。妊娠结局不良定义为胎儿吸收、早产、死产和宫内生长受限,在任何一个妊娠期感染时都会出现。孕期CMV感染诱导的TNF和NK活性与孕早期感染时的吸收以及孕晚期感染时的早产相关。在任何一个时期发生CMV感染都会出现死产。无论CMV感染发生在哪个妊娠期,不良结局都与母体病毒感染后最初几周内较高的母体NK和TNF反应相关。此外,胚胎损失≥50%的CMV感染母鼠比胚胎损失<50%的感染母鼠有更高的TNF反应。同样,与未出现吸收和/或早产的母鼠所生幼崽相比,有吸收和/或早产的CMV感染母鼠所生一窝幼崽中的幼崽对CMV的NK活性和TNF反应也增强。无论产仔结局如何,感染母鼠所生幼崽的TNF反应都高于未感染母鼠所生幼崽,而幼崽的NK反应仅在有早产或吸收的母鼠所生一窝幼崽中的幼崽中增强。增强的NK和TNF活性似乎与早产及其他妊娠不良结局有关。