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母体免疫激活与中枢神经系统疾病的异常大脑发育。

Maternal immune activation and abnormal brain development across CNS disorders.

机构信息

Roche Pharma Research and Early Development, Roche Innovation Centre Basel, Grenzacherstrasse 124, 4070 Basel, Switzerland.

Brain Ischemia &Regeneration Group, Department of Biomedicine, University Hospital, Hebelstrasse 20, 4031 Basel, Switzerland.

出版信息

Nat Rev Neurol. 2014 Nov;10(11):643-60. doi: 10.1038/nrneurol.2014.187. Epub 2014 Oct 14.

Abstract

Epidemiological studies have shown a clear association between maternal infection and schizophrenia or autism in the progeny. Animal models have revealed maternal immune activation (mIA) to be a profound risk factor for neurochemical and behavioural abnormalities in the offspring. Microglial priming has been proposed as a major consequence of mIA, and represents a critical link in a causal chain that leads to the wide spectrum of neuronal dysfunctions and behavioural phenotypes observed in the juvenile, adult or aged offspring. Such diversity of phenotypic outcomes in the mIA model are mirrored by recent clinical evidence suggesting that infectious exposure during pregnancy is also associated with epilepsy and, to a lesser extent, cerebral palsy in children. Preclinical research also suggests that mIA might precipitate the development of Alzheimer and Parkinson diseases. Here, we summarize and critically review the emerging evidence that mIA is a shared environmental risk factor across CNS disorders that varies as a function of interactions between genetic and additional environmental factors. We also review ongoing clinical trials targeting immune pathways affected by mIA that may play a part in disease manifestation. In addition, future directions and outstanding questions are discussed, including potential symptomatic, disease-modifying and preventive treatment strategies.

摘要

流行病学研究表明,母体感染与后代的精神分裂症或自闭症之间存在明显关联。动物模型表明,母体免疫激活(mIA)是后代神经化学和行为异常的一个重要危险因素。小胶质细胞激活被认为是 mIA 的主要后果之一,并且是导致在幼年、成年或老年后代中观察到的广泛神经元功能障碍和行为表型的因果链中的关键环节。mIA 模型中如此多样化的表型结果反映了最近的临床证据,表明怀孕期间的感染暴露也与儿童癫痫以及在较小程度上的脑瘫有关。临床前研究还表明,mIA 可能会引发阿尔茨海默病和帕金森病的发展。在这里,我们总结并批判性地回顾了新出现的证据,即 mIA 是跨中枢神经系统疾病的共同环境风险因素,其变化取决于遗传和其他环境因素之间的相互作用。我们还回顾了针对受 mIA 影响的免疫途径的正在进行的临床试验,这些试验可能在疾病表现中发挥作用。此外,还讨论了未来的方向和悬而未决的问题,包括潜在的症状、疾病修饰和预防治疗策略。

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