Department of Global Health, University of Washington, Seattle, Washington, USA.
Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA.
Immunol Rev. 2022 Jul;308(1):123-148. doi: 10.1111/imr.13078. Epub 2022 Apr 4.
Pregnant women infected with pathogenic respiratory viruses, such as influenza A viruses (IAV) and coronaviruses, are at higher risk for mortality, hospitalization, preterm birth, and stillbirth. Several factors are likely to contribute to the susceptibility of pregnant individuals to severe lung disease including changes in pulmonary physiology, immune defenses, and effector functions of some immune cells. Pregnancy is also a physiologic state characterized by higher levels of multiple hormones that may impact the effector functions of immune cells, such as progesterone, estrogen, human chorionic gonadotropin, prolactin, and relaxin. Each of these hormones acts to support a tolerogenic immune state of pregnancy, which helps prevent fetal rejection, but may also contribute to an impaired antiviral response. In this review, we address the unique role of adaptive and innate immune cells in the control of pathogenic respiratory viruses and how pregnancy and specific hormones can impact their effector actions. We highlight viruses with sex-specific differences in infection outcomes and why pregnancy hormones may contribute to fetal protection but aid the virus at the expense of the mother's health.
感染病原性呼吸道病毒（如甲型流感病毒和冠状病毒）的孕妇，其死亡率、住院率、早产率和死产率更高。一些因素可能导致孕妇易患严重肺部疾病，包括肺生理学变化、免疫防御和一些免疫细胞的效应功能。妊娠也是一种以多种激素水平升高为特征的生理状态，这些激素可能影响免疫细胞的效应功能，如孕激素、雌激素、人绒毛膜促性腺激素、催乳素和松弛素。这些激素中的每一种都作用于支持妊娠的免疫耐受状态，这有助于防止胎儿排斥，但也可能导致抗病毒反应受损。在这篇综述中，我们将讨论适应性和先天免疫细胞在控制病原性呼吸道病毒方面的独特作用，以及妊娠和特定激素如何影响它们的效应作用。我们强调了感染结果存在性别的病毒差异，以及妊娠激素为何可能有助于胎儿保护，但却以牺牲母亲健康为代价帮助病毒。
