Pediatric Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy.
Clin Infect Dis. 2013 Dec;57 Suppl 4:S193-5. doi: 10.1093/cid/cit586.
Primary cytomegalovirus (CMV) infection during the first half of pregnancy is responsible for the majority of symptomatic congenital infections. Between one-third and one-half of fetuses become infected, and up to one-half of infected fetuses will have neurologic or sensorineural sequelae at birth or later in life. Following favorable results obtained in animal experiments, observational studies have shown beneficial effects after administration of high-titer CMV hyperimmunoglobulin to pregnant women with fetal infection or disease subsequent to primary CMV infection. The mechanisms of action of hyperimmunoglobulin are multiple and not yet fully understood. However, they could reside in 2 major properties: (1) antiviral activities due to high-avidity neutralizing antibodies and (2) immunomodulating activities mostly including downregulation of cytokine-mediated cellular immune responses. A decreased viral pathogenicity occurs as an immediate consequence, whereas reduced placental inflammation and restored function are the long-term effects.
原发性巨细胞病毒（CMV）感染在妊娠前半期是导致大多数有症状先天性感染的主要原因。三分之一到一半的胎儿会受到感染，而感染的胎儿中有一半会在出生时或以后出现神经或感觉神经后遗症。在动物实验中取得良好结果后，观察性研究表明，在原发性 CMV 感染后胎儿感染或疾病的孕妇中，给予高滴度 CMV 免疫球蛋白有治疗效果。免疫球蛋白的作用机制是多方面的，目前尚未完全了解。然而，它们可能存在于 2 个主要特性中：（1）由于高亲和力中和抗体而具有抗病毒活性，以及（2）免疫调节活性，主要包括下调细胞因子介导的细胞免疫反应。作为直接后果，病毒致病性降低，而胎盘炎症减少和功能恢复是长期影响。
