Vinet É, Pineau C A, Clarke A E, Fombonne É, Platt R W, Bernatsky S
Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Canada Division of Rheumatology, McGill University Health Centre, Montreal, Canada
Division of Rheumatology, McGill University Health Centre, Montreal, Canada.
Lupus. 2014 Oct;23(11):1099-104. doi: 10.1177/0961203314541691. Epub 2014 Jun 26.
Children born to women with systemic lupus erythematosus seem to have a potentially increased risk of neurodevelopmental disorders compared to children born to healthy women. Recent experimental data suggest in utero exposure to maternal antibodies and cytokines as important risk factors for neurodevelopmental disorders. Interestingly, women with systemic lupus erythematosus display high levels of autoantibodies and cytokines, which have been shown, in animal models, to alter fetal brain development and induce behavioral anomalies in offspring. Furthermore, subjects with systemic lupus erythematosus and neurodevelopmental disorders share a common genetic predisposition, which could impair the fetal immune response to in utero immunologic insults. Moreover, systemic lupus erythematosus pregnancies are at increased risk of adverse obstetrical outcomes and medication exposures, which have been implicated as potential risk factors for neurodevelopmental disorders. In this article, we review the current state of knowledge on neurodevelopmental disorders and their potential determinants in systemic lupus erythematosus offspring.
与健康女性所生子女相比,系统性红斑狼疮女性所生子女似乎患神经发育障碍的风险可能更高。最近的实验数据表明,子宫内暴露于母体抗体和细胞因子是神经发育障碍的重要危险因素。有趣的是,系统性红斑狼疮女性体内自身抗体和细胞因子水平较高,在动物模型中,这些物质已被证明会改变胎儿大脑发育并导致后代行为异常。此外,患有系统性红斑狼疮和神经发育障碍的个体具有共同的遗传易感性,这可能会损害胎儿对子宫内免疫损伤的免疫反应。此外,系统性红斑狼疮患者怀孕时出现不良产科结局和接触药物的风险增加,这些因素被认为是神经发育障碍的潜在危险因素。在本文中,我们综述了系统性红斑狼疮后代神经发育障碍及其潜在决定因素的当前知识状况。