Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Department of Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Int J Mol Sci. 2021 Mar 13;22(6):2921. doi: 10.3390/ijms22062921.
As most recently demonstrated by the SARS-CoV-2 pandemic, congenital and perinatal infections are of significant concern to the pregnant population as compared to the general population. These outcomes can range from no apparent impact all the way to spontaneous abortion or fetal infection with long term developmental consequences. While some pathogens have developed mechanisms to cross the placenta and directly infect the fetus, other pathogens lead to an upregulation in maternal or placental inflammation that can indirectly cause harm. The placenta is a temporary, yet critical organ that serves multiple important functions during gestation including facilitation of fetal nutrition, oxygenation, and prevention of fetal infection in utero. Here, we review trophoblast cell immunology and the molecular mechanisms utilized to protect the fetus from infection. Lastly, we discuss consequences in the placenta when these protections fail and the histopathologic result following infection.
如最近由 SARS-CoV-2 大流行所表明的那样，先天性和围产期感染对孕妇群体而言，比一般人群更值得关注。这些后果的范围从没有明显影响到自然流产或胎儿感染以及长期发育后果。虽然一些病原体已经开发出了穿过胎盘并直接感染胎儿的机制，但其他病原体导致母体或胎盘炎症的上调，这可能会间接造成伤害。胎盘是一种临时的、至关重要的器官，在妊娠期间发挥着多种重要功能，包括促进胎儿营养、氧气供应和防止胎儿宫内感染。在这里，我们回顾滋养层细胞免疫学以及用于保护胎儿免受感染的分子机制。最后，我们讨论了当这些保护措施失败时胎盘的后果以及感染后的组织病理学结果。
