Scott J S
Lancet. 1976 Jan 10;1(7950):78-81. doi: 10.1016/s0140-6736(76)90166-5.
Major advances in knowledge of immunological diseases have resulted from observation of transient effects on children borne by women with such diseases. The discoveries that in Graves' disease and myasthenia gravis there are IgG antibodies directed against receptors sites are examples of such developments, while "ikiopathic" thrombocytopenic purpura is now accepted as immunological owing to its behaviour during pregnancy. In some instances observations of transient neonatal forms do not correspond with the disease manifestations in the mother. These discrepancies may be due to surgical removal of an organ vital to the disease process; inactivating damage by the disease to such an organ; presence of a blocking antibody of a molecular type not transferred across the placenta; differing tissue-antigen specificity or differing lymphocyte cooperation based on genetic variation. At present there are unexplained observations of fetal/neonatal effects in relation to diabetes mellitus and systemic lupus erythematosus which suggest that study of immunological parameters might be profitable. Determination of the HLA status of mother/fetus pairs may give rewarding clues. In the elucidation of the diseases now proven as antibody-mediated in the antibodies first discovered often turned out to be irrelevant red herrings.
对患有免疫性疾病的女性所生育子女的短暂影响进行观察，从而在免疫性疾病知识方面取得了重大进展。在格雷夫斯病和重症肌无力中发现存在针对受体部位的IgG抗体就是这类进展的例子，而“特发性”血小板减少性紫癜因其在孕期的表现，现在也被认为是免疫性疾病。在某些情况下，对短暂新生儿形式的观察结果与母亲的疾病表现并不相符。这些差异可能是由于手术切除了对疾病进程至关重要的器官；疾病对该器官造成的失活损伤；存在未通过胎盘转移的分子类型的封闭抗体；基于基因变异的不同组织抗原特异性或不同淋巴细胞协同作用。目前，关于糖尿病和系统性红斑狼疮存在一些无法解释的胎儿/新生儿影响观察结果，这表明对免疫参数的研究可能会有所收获。确定母婴对的HLA状态可能会提供有价值的线索。在阐明目前已被证明是抗体介导的疾病时，最初发现的抗体往往是无关紧要的干扰因素。
