Ben-Hur Herzl, Gurevich Pavel, Elhayany Asher, Avinoach Ilana, Schneider David F, Zusman Itshak
Laboratory of Experimental Medicine, Park Rabin, The Hebrew University of Jerusalem, Rehovot, Israel.
Int J Mol Med. 2005 Sep;16(3):401-7.
We studied the effect of ascending infections of the birth canal on the transport of maternal immunoglobulins (Igs) through the placental barrier in humans. The study was performed on 41 human placentas obtained from embryos (n=21) and fetuses (n=20) who had died from different causes, including those connected with ascending infections of the birth canal, and seven placentas obtained after normal delivery at term. Different morphological and immunohistochemical methods were used. The transfer of Igs through the placental barrier is a complex process that involves tissues (trophoblast, stroma of the trophoblastic villi, and capillaries), cells (monocytes and erythroblasts) and molecular components (at least six types of transfer receptors and biologically active components). We found that the intensification of transfer of different types of maternal Igs (IgG, IgA, IgM) is accompanied by certain morphological and functional changes in the placental barrier. In normal development without infection, the transfer of IgG is steady and the process most intensive, while the transfer of IgA was evaluated in 75% of the cases, and of IgM in only 10%. Inflammation of the birth canal was accompanied by an increase in the transport of IgG in early embryogenesis, which was maintained throughout intrauterine development. In cases with moderate infection, transfer of IgG and IgA was found in all cases studied, while transfer of IgM was seen in 45% of the cases. In cases with massive infection, transfer of all three types of Igs was seen, the most intensive being of IgG and the least of IgM. Ascending infection of the birth canal changes dramatically the transport of Igs through the placenta and can be dangerous and even fatal for the embryo or fetus.
我们研究了产道上行感染对母体免疫球蛋白(Ig)通过人类胎盘屏障转运的影响。该研究对41份人类胎盘进行,这些胎盘取自因不同原因死亡的胚胎(n = 21)和胎儿(n = 20),包括与产道上行感染相关的病例,以及7份足月正常分娩后获得的胎盘。使用了不同的形态学和免疫组织化学方法。Ig通过胎盘屏障的转运是一个复杂的过程,涉及组织(滋养层、滋养层绒毛基质和毛细血管)、细胞(单核细胞和成红细胞)以及分子成分(至少六种转运受体和生物活性成分)。我们发现,不同类型母体Ig(IgG、IgA、IgM)转运的增强伴随着胎盘屏障某些形态和功能的变化。在无感染的正常发育过程中,IgG的转运稳定且最为强烈,而IgA的转运在75%的病例中可检测到,IgM的转运仅在10%的病例中可检测到。产道炎症在早期胚胎发育过程中伴随着IgG转运增加,并在整个子宫内发育过程中持续存在。在中度感染的病例中,所有研究病例均发现了IgG和IgA的转运,而45%的病例中发现了IgM的转运。在重度感染的病例中,三种类型的Ig均有转运,其中IgG转运最为强烈,IgM转运最少。产道上行感染显著改变了Ig通过胎盘的转运,对胚胎或胎儿可能是危险的,甚至是致命的。