Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA; Department of Obstetrics and Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, USA.
Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA, USA; The Research Center Aggeu Magalhães (CPqAM)/Oswaldo Cruz Foundation (Fiocruz), Recife, Brazil.
Lancet. 2016 Apr 9;387(10027):1587-1590. doi: 10.1016/S0140-6736(16)00650-4. Epub 2016 Mar 4.
The mechanism by which the Zika virus can cause fetal microcephaly is not known. Reports indicate that Zika is able to evade the normal immunoprotective responses of the placenta. Microcephaly has genetic causes, some associated with maternal exposures including radiation, tobacco smoke, alcohol, and viruses. Two hypotheses regarding the role of the placenta are possible: one is that the placenta directly conveys the Zika virus to the early embryo or fetus. Alternatively, the placenta itself might be mounting a response to the exposure; this response might be contributing to or causing the brain defect. This distinction is crucial to the diagnosis of fetuses at risk and the design of therapeutic strategies to prevent Zika-induced teratogenesis.
寨卡病毒导致胎儿小头畸形的机制尚不清楚。有报道表明,寨卡病毒能够逃避胎盘的正常免疫保护反应。小头畸形有遗传原因,有些与母体暴露有关,包括辐射、烟草烟雾、酒精和病毒。关于胎盘作用的两种假说可能成立:一种是胎盘将寨卡病毒直接传递给早期胚胎或胎儿。另一种是胎盘本身对暴露做出反应;这种反应可能导致或引起脑部缺陷。这种区别对于诊断有风险的胎儿和设计预防寨卡病毒致畸的治疗策略至关重要。