Fouda Genevieve G, Martinez David R, Swamy Geeta K, Permar Sallie R
Human Vaccine Institute, Duke University Medical Center, Durham, NC, 27710.
Department of Pediatrics, Duke University Medical Center, Durham, NC, 27710.
Immunohorizons. 2018 Jan 1;2(1):14-25. doi: 10.4049/immunohorizons.1700057.
Pediatric vaccines have significantly reduced infectious disease-related infant mortality, but as protective immunity often require several infant vaccine doses; maternally-acquired antibodies are critical to protect infants during the first months of life. Consequently, immunization of pregnant women is an important strategy not only to protect mothers from infection, but also to provide immunity to young infants. Nevertheless, maternal immunization can also negatively impact early life immunity. In fact, maternal antibodies can interfere with the development of infant immune responses, though it is unclear if such interference is clinically significant. Moreover, the transplacental transfer of maternal immunoglobulin therapeutics can be harmful to the fetus. Thus, the risk/benefit of maternal immunization for both the mother and the fetus should be carefully weighed. In addition, it is critical to fully understand the mechanisms by which IgG is transferred across the placenta in order to develop optimal maternal and infant immunization strategies.
儿科疫苗显著降低了与传染病相关的婴儿死亡率,但由于保护性免疫通常需要多剂婴儿疫苗;母体获得的抗体对于在生命的最初几个月保护婴儿至关重要。因此,孕妇免疫不仅是保护母亲免受感染的重要策略,也是为幼儿提供免疫力的重要策略。然而,母体免疫也可能对早期生命免疫产生负面影响。事实上,母体抗体可能会干扰婴儿免疫反应的发展,尽管尚不清楚这种干扰在临床上是否具有显著意义。此外,母体免疫球蛋白治疗剂的胎盘转运可能对胎儿有害。因此,应仔细权衡母体免疫对母亲和胎儿的风险/益处。此外,充分了解IgG跨胎盘转运的机制对于制定最佳的母婴免疫策略至关重要。