针对胎盘疟疾中 TLR 信号的潜在药物干预措施。
Potential pharmacologic interventions targeting TLR signaling in placental malaria.
机构信息
Directorate of Research and Innovation, Mount Kenya University, P.O. Box 342, 01000, Thika, Kenya; Centre for Malaria Elimination, Mount Kenya University, P.O. Box 342, 01000, Thika, Kenya.
Mothers and Babies Research Centre, Hunter Medical Research Institute, Newcastle, NSW, Australia.
出版信息
Trends Parasitol. 2022 Jul;38(7):513-524. doi: 10.1016/j.pt.2022.04.002. Epub 2022 May 7.
Complications from placental malaria cause poor pregnancy outcomes, including low birthweight, preterm delivery, and stillbirths. Many of these complications are driven by maternal innate proinflammatory responses to the sequestration of Plasmodium falciparum in the placenta. However, recent studies show that, in reaction to maternal innate immune responses that are detrimental to the fetus, the fetus mounts innate immune counter-responses that ameliorate pregnancy outcomes. Such fetal-maternal conflict in placental malaria has potential for pharmacologic modulation for better pregnancy outcomes. Here, we discuss placental malaria pathogenesis, its complications, and the role of innate immunity and fetal-maternal innate immune conflict in placental malaria. Finally, we discuss pharmacologic immunomodulatory strategies and agents with the potential to improve placental malaria outcomes.
胎盘疟疾引起的并发症导致不良妊娠结局，包括低出生体重、早产和死产。这些并发症中的许多是由母体对疟原虫在胎盘内隔离的固有促炎反应引起的。然而，最近的研究表明，为了应对对胎儿有害的母体固有免疫反应，胎儿会产生固有免疫对抗反应，从而改善妊娠结局。胎盘疟疾中这种胎儿-母体的固有免疫冲突具有通过药物调节来改善妊娠结局的潜力。在这里，我们讨论胎盘疟疾的发病机制、其并发症以及固有免疫和胎儿-母体固有免疫冲突在胎盘疟疾中的作用。最后，我们讨论了具有改善胎盘疟疾结局潜力的药物免疫调节策略和药物。
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