Department of Women's Health, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
Department of Obstetrics and Fetal Therapy, Leiden University Medical Center, Leiden, The Netherlands.
Ultrasound Obstet Gynecol. 2022 Aug;60(2):167-175. doi: 10.1002/uog.24891.
The neonatal Fc receptor (FcRn) plays an important role in the transfer of the immunoglobulin G isotype (IgG) from the mother to the fetus. FcRn expressed on endothelial cells also binds to IgG and albumin, regulating the circulating half-lives of these proteins. Alloimmune and autoimmune IgG antibodies have been implicated in various perinatal immune-mediated diseases. FcRn-mediated placental transfer of pathogenic antibodies can result in cell and tissue injury in the fetus and neonate, with devastating outcomes. Thus, blockade of FcRn may be an effective treatment strategy in managing these conditions and could additionally reduce the concentration of pathogenic antibodies in the maternal circulation by preventing IgG recycling. In this review, we discuss the biology of FcRn, the rationale and considerations for development of FcRn-blocking agents, and their potential clinical applications in various perinatal immune-mediated diseases. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
新生儿 Fc 受体（FcRn）在免疫球蛋白 G 同种型（IgG）从母体向胎儿的转移中发挥重要作用。内皮细胞上表达的 FcRn 也与 IgG 和白蛋白结合，调节这些蛋白质的循环半衰期。同种免疫和自身免疫 IgG 抗体与各种围产期免疫介导的疾病有关。FcRn 介导的致病性抗体向胎盘的转移可导致胎儿和新生儿的细胞和组织损伤，产生毁灭性的后果。因此，阻断 FcRn 可能是治疗这些疾病的有效策略，并且通过防止 IgG 再循环，还可以降低母体循环中致病性抗体的浓度。在这篇综述中，我们讨论了 FcRn 的生物学、开发 FcRn 阻断剂的原理和考虑因素，以及它们在各种围产期免疫介导疾病中的潜在临床应用。
