Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Front Immunol. 2020 May 15;11:899. doi: 10.3389/fimmu.2020.00899. eCollection 2020.
Many functions of the immune system are impaired in neonates, allowing vulnerability to serious bacterial, viral and fungal infections which would otherwise not be pathogenic to mature individuals. This vulnerability is exacerbated in compromised newborns such as premature neonates and those who have undergone surgery or who require care in an intensive care unit. Higher susceptibility of preterm neonates to infections is associated with delayed immune system maturation, with deficiencies present in both the innate and adaptive immune components. Here, we review recent insights into early life immunity, and highlight features associated with compromised newborns, given the challenges of studying neonatal immunity in compromised neonates due to the transient nature of this period of life, and logistical and ethical obstacles posed by undertaking studies newborns and infants. Finally, we highlight how the unique immunological characteristics of the premature host play key roles in the pathogenesis of diseases that are unique to this population, including necrotizing enterocolitis and the associated sequalae of lung and brain injury.
新生儿的免疫系统有许多功能受损，容易受到严重细菌、病毒和真菌感染的影响，而这些感染在成熟个体中通常不会致病。这种易感性在有潜在健康问题的新生儿中更为严重，如早产儿和接受过手术或需要在重症监护病房中护理的新生儿。早产儿更容易感染的原因是免疫系统成熟延迟，先天和适应性免疫成分均存在缺陷。在这里，我们综述了近期对生命早期免疫的认识，并强调了与有潜在健康问题的新生儿相关的特征，因为研究有潜在健康问题的新生儿的免疫需要考虑到生命这一阶段的短暂性，以及对新生儿和婴儿进行研究所带来的实际和伦理障碍。最后，我们强调了早产宿主独特的免疫特征如何在该人群特有的疾病发病机制中发挥关键作用，包括坏死性小肠结肠炎和与之相关的肺和脑损伤的后遗症。
