Bachinsky Elmira, Guyer Lauren, Patel Riddhi, Amoah Stephen K, Ortega Diana, Robinson Shenandoah, Helmbrecht Hawley, Jantzie Lauren L
Neonatal-Perinatal Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Neonatal-Perinatal Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Neurosciences Intensive Care Nursery (NICN), Johns Hopkins Children's Center, USA.
Semin Perinatol. 2025 Sep 13:152143. doi: 10.1016/j.semperi.2025.152143.
The placenta serves as an essential communicative organ between a mother and fetus throughout gestation. The placenta is critical in the development and maintenance of pregnancy while serving as a hub for immune signaling. In the context of an ever-changing microenvironment, the placenta responds dynamically to infection, inflammation, and other potentially harmful exposures. As in chorioamnionitis and preterm birth, a placental inflammatory response can impart harm to the developing fetal brain and facilitate the presentation of perinatal brain injury. Through various functional and structural disruptions, including changes to neural networks and complex neural immune interactions, neurodevelopmental disorders can manifest. In this review, we utilize chorioamnionitis as a platform for understanding immune signaling and inflammatory cell communication along the maternal-placental-fetal axis. We delineate how immune dysfunction changes neurodevelopment and explore cellular and molecular mechanisms associated with adverse clinical outcomes after birth. Together with discussion of unique inflammatory pathophysiology and triggers of perinatal brain injury, we explore avenues for neuroimmunomodulation, novel biomarker discovery, and precision medicine approaches for clinical practice.
在整个妊娠期，胎盘是母亲与胎儿之间至关重要的交流器官。胎盘在妊娠的发育和维持过程中起着关键作用，同时也是免疫信号传导的枢纽。在不断变化的微环境中，胎盘会对感染、炎症及其他潜在有害暴露做出动态反应。如在绒毛膜羊膜炎和早产中，胎盘炎症反应会对发育中的胎儿大脑造成损害，并促使围产期脑损伤的出现。通过各种功能和结构破坏，包括神经网络的变化和复杂的神经免疫相互作用，神经发育障碍可能会显现出来。在本综述中，我们利用绒毛膜羊膜炎作为一个平台，来理解沿母-胎-胎盘轴的免疫信号传导和炎症细胞通讯。我们阐述免疫功能障碍如何改变神经发育，并探索与出生后不良临床结局相关的细胞和分子机制。在讨论围产期脑损伤独特的炎症病理生理学和触发因素的同时，我们还探索了神经免疫调节的途径、新型生物标志物的发现以及临床实践中的精准医学方法。
