Goldman A S, Ham Pong A J, Goldblum R M
Adv Pediatr. 1985;32:71-100.
During the intrauterine period, the human immunologic system develops through a complex but orderly series of events. The functional capacity of the system remains incomplete, not only during prenatal life but also through much of infancy. Many of the factors not produced by the fetus or infant are provided by the mother. Systemic immunity is augmented by specific IgG antibodies from the placenta and mucosal immunity by a wide array of defense agents from human milk including sIgA antibodies, lactoferrin, lysozyme, other soluble factors with antimicrobial properties, and specifically adapted leukocytes. It appears that the defense of the infant and the maternal contribution to that defense are geared to protect principally by noninflammatory mechanisms. Although much has been discovered about the ontogeny of the human immunologic system and the maternal contributions to this immunity, much remains to be learned about the molecular controls of the system, the fate of the transported maternal factors, feedback mechanisms between the immunologic systems of the mother and infant and the precise effects of maternal factors upon the infant. Answers to these questions may lead to the development of immunizing agents which are better suited to the infant, mucosal immunogens fashioned to stimulate the production of protective SIgA antibodies in human milk, the provision of defense factors for serious infections in young infants, and ways to enhance the maturation of the immunologic system of the infant when that is desirable.
在子宫内时期，人类免疫系统通过一系列复杂但有序的事件发展。该系统的功能能力不仅在产前时期，而且在婴儿期的大部分时间内都不完全。许多胎儿或婴儿自身无法产生的因素由母亲提供。胎盘来源的特异性IgG抗体增强全身免疫，母乳中的多种防御因子增强黏膜免疫，这些因子包括分泌型IgA抗体、乳铁蛋白、溶菌酶、其他具有抗菌特性的可溶性因子以及经过特殊适应性变化的白细胞。看来婴儿的防御以及母亲对这种防御的贡献主要是通过非炎症机制来实现保护作用。尽管关于人类免疫系统的个体发育以及母亲对这种免疫的贡献已经有了很多发现，但关于该系统的分子调控、转运而来的母体因子的命运、母婴免疫系统之间的反馈机制以及母体因子对婴儿的确切影响，仍有许多有待了解。对这些问题的解答可能会促成更适合婴儿的免疫制剂的研发、旨在刺激母乳中产生保护性分泌型IgA抗体的黏膜免疫原的研制、为幼儿严重感染提供防御因子，以及在需要时促进婴儿免疫系统成熟的方法。
