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实验性先天性弓形虫病。II. 孕鼠阴道感染后弓形虫病向胎盘和胎儿的传播。

Experimental congenital toxoplasmosis. II. Transmission of toxoplasmosis to the placenta and fetus following vaginal infection in the pregnant mouse.

作者信息

COWEN D, WOLF A

出版信息

J Exp Med. 1950 Nov 1;92(5):403-16. doi: 10.1084/jem.92.5.403.

Abstract

Pregnant mice infected with Toxoplasma by the vaginal route have been found to transmit toxoplasmosis to the placentas and fetuses in utero. The microorganism entered the blood stream of the mother from primary foci of infection in the vaginal wall and produced disseminated lesions in the labyrinth of the allantoic placenta at the same time as other peripheral maternal tissues were involved. Placental lesions were observed in mice infected with Toxoplasma by vagina between the 3rd and the 9th day of pregnancy. They consisted of microscopic foci of degeneration, without inflammation, in the syncytial trophoblast, and parasites undergoing multiplication were readily identified in them. Here Toxoplasma gained access to the fetal circulation. Following the vaginal instillation of Toxoplasma on the 8th day of pregnancy, subinoculation of test animals revealed the parasites in the maternal peripheral and placental blood on the 13th day and later, while the first histopathologic changes in the placenta were found on the 17th day. Toxoplasma could be demonstrated in suspensions of fetal tissues on and after the 17th day by the injection of normal test animals. However, no lesions of toxoplasmosis, or Toxoplasma, were found in histologic sections of fetuses 11 to 21 days old removed at autopsy from vaginally infected mothers. It is concluded that before birth the parasites were confined to the fetal blood. The experiments provide the first direct histological demonstration of placental toxoplasmosis. The possible bearing of the experimental disease on human placental and fetal toxoplasmosis is briefly considered. It is probable that a maternal parasitemia during the latter part of pregnancy, whatever the portal of entry may be, is an essential factor in the pathogenesis of human congenital toxoplasmosis and that this occurs shortly after exposure to Toxoplasma rather than in a later chronic stage of the infection. The suggestion is offered that some instances of spontaneous abortion or fetal death in man, as in the mouse, may be due to inapparent toxoplasmosis.

摘要

经阴道途径感染弓形虫的怀孕小鼠已被发现会在子宫内将弓形虫病传播给胎盘和胎儿。微生物从阴道壁的原发性感染灶进入母体血流,并在尿囊胎盘迷路中产生播散性病变,与此同时其他母体外周组织也受到累及。在怀孕第3天至第9天经阴道感染弓形虫的小鼠中观察到了胎盘病变。病变表现为合体滋养层内微小的变性灶,无炎症反应,且在其中很容易识别出正在增殖的寄生虫。在此处弓形虫进入了胎儿循环。在怀孕第8天经阴道接种弓形虫后,对实验动物进行再次接种发现,在第13天及之后母体外周血和胎盘血中存在寄生虫,而胎盘的首次组织病理学变化在第17天被发现。在第17天及之后,通过注射正常实验动物,可在胎儿组织悬液中检测到弓形虫。然而,从经阴道感染的母体尸检取出的11至21日龄胎儿的组织学切片中未发现弓形虫病病变或弓形虫。得出的结论是,在出生前寄生虫局限于胎儿血液中。这些实验首次提供了胎盘弓形虫病的直接组织学证据。简要考虑了实验性疾病对人类胎盘和胎儿弓形虫病可能产生的影响。很可能在妊娠后期的母体寄生虫血症,无论其进入途径如何,都是人类先天性弓形虫病发病机制中的一个关键因素,并且这种情况在接触弓形虫后不久就会发生,而不是在感染的后期慢性阶段。有人提出,人类中某些自然流产或胎儿死亡的情况,如同在小鼠中一样,可能是由于隐性弓形虫病所致。

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