Denny Kerina J, Jeanes Angela, Fathe Kristin, Finnell Richard H, Taylor Stephen M, Woodruff Trent M
School of Biomedical Sciences, The University of Queensland, St Lucia, Brisbane, Australia.
Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia.
Birth Defects Res A Clin Mol Teratol. 2013 Sep;97(9):602-609. doi: 10.1002/bdra.23177.
Periconceptional supplementation with folic acid has led to a significant worldwide reduction in the incidence of neural tube defects (NTDs). However, despite increasing awareness of the benefits of folic acid supplementation and the implementation of food fortification programs in many countries, NTDs continue to be a leading cause of perinatal morbidity and mortality worldwide. Furthermore, there exists a significant subgroup of women who appear to be resistant to the protective effects of folic acid supplementation. The following review addresses emerging clinical and experimental evidence for a role of the immune system in the etiopathogenesis of NTDs, with the aim of developing novel preventative strategies to further reduce the incidence of NTD-affected pregnancies. In particular, recent studies demonstrating novel roles and interactions between innate immune factors such as the complement cascade, neurulation, and folate metabolism are explored.
受孕前补充叶酸已使全球神经管缺陷（NTDs）的发病率显著降低。然而，尽管许多国家对补充叶酸的益处的认识不断提高，并且实施了食品强化计划，但NTDs仍然是全球围产期发病和死亡的主要原因。此外，有相当一部分女性似乎对补充叶酸的保护作用具有抗性。以下综述阐述了免疫系统在NTDs发病机制中作用的新出现的临床和实验证据，旨在制定新的预防策略以进一步降低受NTD影响的妊娠发生率。特别是，探讨了近期关于补体级联反应、神经形成和叶酸代谢等先天免疫因子之间新作用和相互作用的研究。
