Department of Nutrition, Federal University of Pelotas (UFPel), Pelotas,
Translational Research Group in Autism Spectrum Disorder (GETTEA), Clinical Hospital of Porto Alegre, Porto Alegre,
Neuroimmunomodulation. 2018;25(5-6):271-279. doi: 10.1159/000491821. Epub 2018 Aug 21.
BACKGROUND/AIMS: Perinatal exposure to infections during critical developmental periods is a promising area of study in autism spectrum disorder (ASD). Epidemiological data has highlighted this relationship, pointing out significant correlations between perinatal exposure to pathogens and the occurrence of ASD. The aim of this review is to critically examine the present state of the art on intracellular pathogenic infection during pregnancy and postnatally, pointing out possible correlations with the development of ASD.
We reviewed and collected studies concerning potential associations between intracellular pathogens like viral, bacterial, and parasite infection and the risk of ASD.
We included 14 publications, considering bacterial and/or viral infection that demonstrated the potential to trigger ASD. Nine case-control studies were included and 5 of them reported an association between infections and ASD. One of the 2 cohorts investigated demonstrated that maternal infection increased the risk of ASD in the offspring. Three cross-sectional studies demonstrated that ASD patients presented with chronic infections and active neuroinflammatory processes. Most of the reports suggest inflammatory response as a common factor, and interleukin 6 appears to be a key-player in this process.
The immune responses generated by organisms that cause perinatal maternal infection, i.e., bacteria, viruses, or parasites, have been associated with the development of autism in offspring. Physiological changes transmitted from the mother during chronic or acute inflammation should be further investigated so that modulatory preventive measures can be developed.
背景/目的：围产期在关键发育时期暴露于感染是自闭症谱系障碍（ASD）的一个有前途的研究领域。流行病学数据强调了这种关系，指出围产期病原体暴露与 ASD 的发生之间存在显著相关性。本综述的目的是批判性地检查怀孕期间和产后细胞内病原体感染的最新研究现状，并指出与 ASD 发展的可能相关性。
我们回顾和收集了关于细胞内病原体（如病毒、细菌和寄生虫感染）与 ASD 风险之间潜在关联的研究。
我们纳入了 14 篇出版物，考虑了细菌和/或病毒感染，这些感染有可能引发 ASD。纳入了 9 项病例对照研究，其中 5 项研究报告了感染与 ASD 之间的关联。2 项队列研究中的 1 项表明，母体感染会增加后代患 ASD 的风险。3 项横断面研究表明，ASD 患者存在慢性感染和活跃的神经炎症过程。大多数报告表明炎症反应是一个共同因素，白细胞介素 6 似乎是该过程中的关键因素。
引起围产期母体感染的病原体（即细菌、病毒或寄生虫）产生的免疫反应与后代自闭症的发展有关。应该进一步研究从母亲在慢性或急性炎症期间传递的生理变化，以便制定调节性预防措施。
