Maternal-Fetal Exchange

母胎交换
  • 文章类型: Journal Article
    母胎微嵌合是一种令人着迷的现象,其中母体细胞在怀孕和母乳喂养期间迁移到后代的组织。这些细胞主要由白细胞和干细胞组成。值得注意的是,这些母体细胞在后代中具有功能潜力,并在塑造其免疫系统发育中发挥重要作用。T淋巴细胞,主要存在于后代的各种组织中的细胞群,已被确定为源自母体微嵌合的主要细胞类型。这些T淋巴细胞不仅发挥效应功能,而且影响胸腺中后代T淋巴细胞的发育和淋巴结中B淋巴细胞的成熟。此外,母体白细胞的迁移也促进了免疫记忆的跨代转移。还观察到母体微嵌合体可以解决后代的免疫缺陷。这篇综述文章的重点是研究母体微嵌合状态内运输的母体细胞对后代免疫系统发育的影响。以及阐明通过胎盘和母乳迁移到后代的母体细胞的效应子功能。
    Maternal-fetal microchimerism is a fascinating phenomenon in which maternal cells migrate to the tissues of the offspring during both pregnancy and breastfeeding. These cells primarily consist of leukocytes and stem cells. Remarkably, these maternal cells possess functional potential in the offspring and play a significant role in shaping their immune system development. T lymphocytes, a cell population mainly found in various tissues of the offspring, have been identified as the major cell type derived from maternal microchimerism. These T lymphocytes not only exert effector functions but also influence the development of the offspring\'s T lymphocytes in the thymus and the maturation of B lymphocytes in the lymph nodes. Furthermore, the migration of maternal leukocytes also facilitates the transfer of immune memory across generations. Maternal microchimerism has also been observed to address immunodeficiencies in the offspring. This review article focuses on investigating the impact of maternal cells transported within maternal microchimerism on the immune system development of the offspring, as well as elucidating the effector functions of maternal cells that migrate through the placenta and breast milk to reach the offspring.
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  • 文章类型: Journal Article
    胞吞作用代表一类受调节的主动转运机制。这些包括网格蛋白依赖和独立的机制,以及液相微胞饮作用和巨细胞作用,每个都表现出不同程度的特异性和能力。总的来说,这些机制促进货物内化进入细胞囊泡。妊娠是一种这样的生理状态,在该状态期间内吞作用可能起关键作用。成功的妊娠需要母体和胎儿细胞在母胎界面上持续的交流,以确保对半同种异体胎儿的免疫耐受,同时提供足够的保护,防止病原体感染。如病毒和细菌。它还需要通过母胎界面运输营养物质,但限制潜在有害的化学物质和药物,以允许胎儿发育。在这种情况下,红细胞增多症,一种特定形式的内吞作用,在免疫耐受和感染预防中起着至关重要的作用。胞吞作用也被认为在母胎界面的营养和毒素处理中起重要作用。虽然它的机制仍然不太了解。对内吞作用及其机制的全面了解不仅可以增强我们对母胎相互作用的认识,而且对于确定妊娠病理的发病机理并为治疗干预提供新的途径也是必不可少的。
    Endocytosis represents a category of regulated active transport mechanisms. These encompass clathrin-dependent and -independent mechanisms, as well as fluid phase micropinocytosis and macropinocytosis, each demonstrating varying degrees of specificity and capacity. Collectively, these mechanisms facilitate the internalization of cargo into cellular vesicles. Pregnancy is one such physiological state during which endocytosis may play critical roles. A successful pregnancy necessitates ongoing communication between maternal and fetal cells at the maternal-fetal interface to ensure immunologic tolerance for the semi-allogenic fetus whilst providing adequate protection against infection from pathogens, such as viruses and bacteria. It also requires transport of nutrients across the maternal-fetal interface, but restriction of potentially harmful chemicals and drugs to allow fetal development. In this context, trogocytosis, a specific form of endocytosis, plays a crucial role in immunological tolerance and infection prevention. Endocytosis is also thought to play a significant role in nutrient and toxin handling at the maternal-fetal interface, though its mechanisms remain less understood. A comprehensive understanding of endocytosis and its mechanisms not only enhances our knowledge of maternal-fetal interactions but is also essential for identifying the pathogenesis of pregnancy pathologies and providing new avenues for therapeutic intervention.
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  • 文章类型: Journal Article
    子宫内基因编辑(IUGE)是一种在出生前或出生后不久引起病理的遗传性疾病的潜在治疗方法。对腺相关病毒(AAV)载体和Cas9内切核酸酶的预先存在的免疫可能限制出生后的基因编辑。致耐受性的胎儿免疫系统使对IUGE的胎儿免疫屏障最小化。然而,母体免疫限制胎儿基因编辑的能力仍然是一个问题。我们调查了先前存在的对AAV或Cas9的母体免疫力是否会损害IUGE。使用荧光报告小鼠和代谢性肝病小鼠模型的组合,我们证明了母体抗AAVIgG抗体以母体滴度依赖性方式有效地从dam转移到胎儿并受损IUGE。相比之下,母体细胞免疫无效地转移到胎儿,对Cas9的母体细胞免疫和体液免疫均不损害IUGE。使用从中期至晚期妊娠收集的人脐带和母体血液样本,我们证明,与足月相比,妊娠中期抗AAVIgG的母婴传播效率低下,提示母体免疫屏障与临床IUGE在妊娠中期的相关性较小。这些发现支持IUGE的免疫学优势,并为未来的临床试验提供母体术前测试方案和排除标准。
    In utero gene editing (IUGE) is a potential treatment for inherited diseases that cause pathology before or soon after birth. Preexisting immunity to adeno-associated virus (AAV) vectors and Cas9 endonuclease may limit postnatal gene editing. The tolerogenic fetal immune system minimizes a fetal immune barrier to IUGE. However, the ability of maternal immunity to limit fetal gene editing remains a question. We investigated whether preexisting maternal immunity to AAV or Cas9 impairs IUGE. Using a combination of fluorescent reporter mice and a murine model of a metabolic liver disease, we demonstrated that maternal anti-AAV IgG antibodies were efficiently transferred from dam to fetus and impaired IUGE in a maternal titer-dependent fashion. By contrast, maternal cellular immunity was inefficiently transferred to the fetus, and neither maternal cellular nor humoral immunity to Cas9 impaired IUGE. Using human umbilical cord and maternal blood samples collected from mid- to late-gestation pregnancies, we demonstrated that maternal-fetal transmission of anti-AAV IgG was inefficient in midgestation compared with term, suggesting that the maternal immune barrier to clinical IUGE would be less relevant at midgestation. These findings support immunologic advantages for IUGE and inform maternal preprocedural testing protocols and exclusion criteria for future clinical trials.
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  • 文章类型: Journal Article
    哺乳动物的繁殖依赖于精确的母胎交流,其中免疫修饰促进对半同种异体胚胎的耐受性。细胞外囊泡(EV),包括外泌体和微泡,已经成为关键的调解人,安全地运输像microRNAs这样的分子。电动汽车影响不同的生殖阶段,从配子成熟到着床,并影响妊娠失败等病理。在胚胎-母体对话中,电动汽车显著影响输卵管相互作用,基因表达,和胚胎-子宫内膜界面,对于成功植入至关重要。关于电动汽车吸收的关键查询仍然存在,货物交付,和驱动交流的特定生物分子。他们在诊断方面的潜力,治疗学,了解环境对生育率的影响预示着一个令人兴奋的未来,依靠合作努力,实现生殖健康领域的变革。
    Mammalian reproduction relies on precise maternal-fetal communication, wherein immune modifications foster tolerance toward the semi-allogeneic embryo. Extracellular vesicles (EVs), including exosomes and microvesicles, have emerged as crucial mediators, transporting molecules like microRNAs securely. EVs influence various reproductive stages, from gamete maturation to implantation, and impact pathologies like pregnancy loss. In the embryo-maternal dialogue, EVs notably affect oviductal interactions, gene expression, and the embryo-endometrial interface, crucial for successful implantation. Key queries persist about EV uptake, cargo delivery, and the specific biomolecules driving communication. Their potential in diagnostics, therapeutics, and understanding environmental impacts on fertility signals an exciting future, reliant on collaborative efforts for transformative strides in reproductive health.
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  • 文章类型: Journal Article
    器官和功能的胎儿发育容易受到母体炎症的干扰,这可能会增加出生后对疾病的易感性。因为尚不清楚胎盘和胎儿对急性肺部炎症的反应,我们描述了在24小时内母体和胎儿器官中母体肺脂多糖暴露的反应,成像和综合分析。与母体器官不同,产生强烈的炎症免疫反应,胎盘上调免疫调节基因,特别是IL-6信号传导抑制子Sock3。同样,我们在胎儿肝脏中没有观察到免疫反应,而是显示新陈代谢的变化,包括含有二十二碳六烯酸的脂质增加,对胎儿大脑发育至关重要.母体肝脏和血浆显示相似的代谢改变,可能增加二十二碳六烯酸对母亲和胎儿的生物利用度。因此,我们的综合时间分析表明,母亲的全身性炎症会导致胎儿的代谢紊乱.
    The fetal development of organs and functions is vulnerable to perturbation by maternal inflammation which may increase susceptibility to disorders after birth. Because it is not well understood how the placenta and fetus respond to acute lung- inflammation, we characterize the response to maternal pulmonary lipopolysaccharide exposure across 24 h in maternal and fetal organs using multi-omics, imaging and integrative analyses. Unlike maternal organs, which mount strong inflammatory immune responses, the placenta upregulates immuno-modulatory genes, in particular the IL-6 signaling suppressor Socs3. Similarly, we observe no immune response in the fetal liver, which instead displays metabolic changes, including increases in lipids containing docosahexaenoic acid, crucial for fetal brain development. The maternal liver and plasma display similar metabolic alterations, potentially increasing bioavailability of docosahexaenoic acid for the mother and fetus. Thus, our integrated temporal analysis shows that systemic inflammation in the mother leads to a metabolic perturbation in the fetus.
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  • 文章类型: Journal Article
    这项研究,通过搜索“母体狼疮”等关键词进行“新生儿狼疮”,以及PubMed和Scopus等数据库中的“先天性心脏传导阻滞”,提供了对胎儿和新生儿狼疮的详细叙述回顾。自身抗体如抗Ro/SSA和抗La/SSB可能穿过胎盘并引起新生儿并发症,如先天性心脏传导阻滞(CHB)。管理选择涉及羟氯喹,能够抵消一些不良事件,尽管由于该药物对QTc间期的影响,因此需要谨慎使用。新生儿CHB的高级起搏策略,尤其是在严重的形式,如积水,也进行了评估。这篇综述强调风湿病学家需要跨学科护理,产科医生,和儿科医生,以便在狼疮妊娠中实现最佳的孕产妇和新生儿健康。这种多学科方法旨在改善疾病的结果和管理,减轻母亲和婴儿的负担。
    This study, conducted by searching keywords such as \"maternal lupus\", \"neonatal lupus\", and \"congenital heart block\" in databases including PubMed and Scopus, provides a detailed narrative review on fetal and neonatal lupus. Autoantibodies like anti-Ro/SSA and anti-La/SSB may cross the placenta and cause complications in neonates, such as congenital heart block (CHB). Management options involve hydroxychloroquine, which is able to counteract some of the adverse events, although the drug needs to be used carefully because of its impact on the QTc interval. Advanced pacing strategies for neonates with CHB, especially in severe forms like hydrops, are also assessed. This review emphasizes the need for interdisciplinary care by rheumatologists, obstetricians, and pediatricians in order to achieve the best maternal and neonatal health in lupus pregnancies. This multidisciplinary approach seeks to improve the outcomes and management of the disease, decreasing the burden on mothers and their infants.
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  • 文章类型: Journal Article
    目的:孕妇有严重SARS-CoV-2感染的风险,可能导致产科和新生儿并发症。针对SARS-CoV-2的抗体的胎盘转移可能对新生儿COVID-19具有保护作用,但这仍有待研究。我们旨在确定未接种疫苗的孕妇人群中SARS-CoV-2抗体的血清阳性率,并确定这些抗体的胎盘转移。
    方法:共有1197名未接种疫苗的妇女,其研究前SARS-CoV-2感染状况大多未知,在大流行的第一年,在交付时测试了SARS-CoV-2刺突蛋白IgG抗体。如果母亲是血清阳性,则收集脐带样品并评估血清阳性。产妇特征,我们从病历中提取了妊娠和新生儿结局以及SARS-CoV-2感染数据.
    结果:在258名女性中检测到特异性IgG(21.6%)。在81.3%的病例中观察到明显的胎盘转移到新生儿。在第二和第三三个月,母亲感染了这种疾病,症状越严重,IgG经胎盘转移至新生儿的可能性越大。
    结论:在大流行的第一年,大约五分之一的女性在分娩时检测到抗SARS-CoV-2刺突蛋白IgG抗体,这些抗体明显转移到胎儿。这项研究提供了进一步的证据,以更好地了解SARS-CoV-2IgG抗体从母亲到新生儿的胎盘转移的动力学,这对于改进疫苗接种策略是必要的。
    OBJECTIVE: Pregnant women are at risk of severe SARS-CoV-2 infection, potentially leading to obstetric and neonatal complications. Placental transfer of antibodies directed to SARS-CoV-2 may be protective against neonatal COVID-19, but this remains to be studied. We aimed to determine the seroprevalence of SARS-CoV-2 antibodies in a population of unvaccinated pregnant women and to determine the placental transfer of these antibodies.
    METHODS: A total of 1197 unvaccinated women with mostly unknown pre-study SARS-CoV-2 infection status, were tested at delivery for SARS-CoV-2 spike protein IgG antibodies during the first year of the pandemic. Umbilical cord samples were collected and assessed for seropositivity if the mother was seropositive. Maternal characteristics, pregnancy and neonatal outcomes and data on SARS-CoV-2 infection were extracted from medical records.
    RESULTS: Specific IgG were detected in 258 women (21.6%). A significant placental transfer to the newborn was observed in 81.3% of cases. The earlier in the 2nd and 3rd trimesters that the mother had contracted the disease and the more symptomatic she was, the greater the likelihood of transplacental transfer of IgG to her newborn.
    CONCLUSIONS: Approximately one in five women had detectable anti-SARS-CoV-2 spike protein IgG antibodies at delivery during the first year of the pandemic, and these antibodies were significantly transferred to their fetuses. This research provides further evidence to better understand the dynamics of the placental transfer of SARS-CoV-2 IgG antibodies from mothers to their newborns, which is necessary to improve vaccination strategies.
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  • 文章类型: Journal Article
    我们旨在确定孕妇的SARS-CoV-2抗体血清阳性,以及SARS-CoV-2特异性抗体相对于SARS-CoV-2血清阳性母带对中疟疾抗体的胎盘转移效率。这项横断面研究是在阿克拉进行的,加纳,2022年3月至5月通过ELISA测量母体和脐带血浆中针对SARS-CoV-2(核蛋白和刺突受体结合域)和疟疾抗原(环子孢子蛋白和裂殖子孢子表面蛋白3)的抗原特异性IgG抗体。使用商业试剂盒测试来自接种疫苗和未接种疫苗的孕妇的血浆中和抗体。在接受测试的未接种疫苗的孕妇中,产前诊所的58.12%和分娩病房的55.56%的SARS-CoV-2核蛋白和RBD抗体均为血清阳性。脐带样本中的抗SARS-CoV-2抗体与母体抗体水平相关(N抗原rs=0.7155,p<0.001;RBDrs=0.8693,p<0.001)。SARS-CoV-2核蛋白抗体的胎盘转移与环子孢子蛋白抗体相当(p=0.9999),但均高于裂殖子孢子表面蛋白3抗体的转移速率(p<0.001)。阿克拉孕妇的SARS-CoV-2IgG血清阳性率很高,接种疫苗的妇女中SARS-CoV-2RBD特异性IgG的增加。抗SARS-CoV-2和疟疾抗体的胎盘转移是有效的,支持母亲接种疫苗,作为保护婴儿免受SARS-CoV-2感染的策略。
    We aimed to determine SARS-CoV-2 antibody seropositivity among pregnant women and the transplacental transfer efficiency of SARS-CoV-2-specific antibodies relative to malaria antibodies among SARS-CoV-2 seropositive mother-cord pairs. This cross-sectional study was conducted in Accra, Ghana, from March to May 2022. Antigen- specific IgG antibodies against SARS-CoV-2 (nucleoprotein and spike-receptor binding domain) and malarial antigens (circumsporozoite protein and merozoite surface protein 3) in maternal and cord plasma were measured by ELISA. Plasma from both vaccinated and unvaccinated pregnant women were tested for neutralizing antibodies using commercial kit. Of the unvaccinated pregnant women tested, 58.12% at antenatal clinics and 55.56% at the delivery wards were seropositive for both SARS-CoV-2 nucleoprotein and RBD antibodies. Anti-SARS-CoV-2 antibodies in cord samples correlated with maternal antibody levels (N antigen rs = 0.7155, p < 0.001; RBD rs = 0.8693, p < 0.001). Transplacental transfer of SARS-CoV-2 nucleoprotein antibodies was comparable to circumsporozoite protein antibodies (p = 0.9999) but both were higher than transfer rates of merozoite surface protein 3 antibodies (p < 0.001). SARS-CoV-2 IgG seropositivity among pregnant women in Accra is high with a boost of SARS-CoV-2 RBD-specific IgG in vaccinated women. Transplacental transfer of anti-SARS-CoV-2 and malarial antibodies was efficient, supporting vaccination of mothers as a strategy to protect infants against SARS-CoV-2.
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  • 文章类型: Journal Article
    正常怀孕是一个矛盾而复杂的生理过程。尽管胎儿携带从父系遗传的人类白细胞抗原(HLA),它不会引起母体免疫排斥。作为免疫学原理的唯一例外,母胎免疫耐受一直是生殖免疫学研究的热点.在怀孕早期,胎儿绒毛外滋养层细胞(EVT)侵入蜕膜组织,并与母体蜕膜免疫细胞(DIC)和蜕膜基质细胞(DSC)直接接触,以建立复杂的母胎串扰。本研究回顾了前人的研究成果,重点探讨了基于母胎串扰的母胎耐受的建立和维持机制。对母胎耐受性的认识不仅可以提高对正常妊娠的认识,还可以为复发性自然流产提供新的治疗策略。先兆子痫,和早产。
    UNASSIGNED: Normal pregnancy is a contradictory and complicated physiological process. Although the fetus carries the human leukocyte antigen (HLA) inherited from the paternal line, it does not cause maternal immune rejection. As the only exception to immunological principles, maternal-fetal immune tolerance has been a reproductive immunology focus. In early pregnancy, fetal extravillous trophoblast cells (EVTs) invade decidual tissues and come into direct contact with maternal decidual immune cells (DICs) and decidual stromal cells (DSCs) to establish a sophisticated maternal-fetal crosstalk. This study reviews previous research results and focuses on the establishment and maintenance mechanism of maternal-fetal tolerance based on maternal-fetal crosstalk. Insights into maternal-fetal tolerance will not only improve understanding of normal pregnancy but will also contribute to novel therapeutic strategies for recurrent spontaneous abortion, pre-eclampsia, and premature birth.
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  • 文章类型: Journal Article
    在人类怀孕期间,给予母亲的二甲双胍穿过胎盘,导致二甲双胍暴露于胎儿。然而,二甲双胍暴露对胎儿的影响知之甚少,也很难在人类中研究。怀孕绵羊是研究胎儿生理学的强大的大型动物模型。这项研究的目的是确定在人类剂量等效浓度下母体给药的二甲双胍是否穿过绵羊胎盘并在胎儿循环中平衡。为了测试这个,妊娠母羊通过连续静脉输注或在饮用水中补充二甲双胍给药。两种给药途径都将母体二甲双胍浓度增加到约10µM的人体剂量当量浓度,然而,即使在母体给药3~4天后,二甲双胍在胎儿中的表达也可以忽略不计.在子叶和肉梗组织中,主要二甲双胍摄取转运体有机阳离子转运体1(OCT1)的表达水平<胎儿肝脏中表达水平的1%,具有丰富表达的组织。其他假定的摄取转运蛋白OCT2和OCT3以及外排转运蛋白多药和毒素挤出(MATE)1和MATE2的表达更为丰富。这些结果证明绵羊胎盘对于母体二甲双胍给药是不可渗透的。这可能是由于绵羊与人胎盘中母体和脐带循环之间的解剖学差异和血液间距离增加限制了胎盘二甲双胍的转运。
    In human pregnancy, metformin administered to the mother crosses the placenta resulting in metformin exposure to the fetus. However, the effects of metformin exposure on the fetus are poorly understood and difficult to study in humans. Pregnant sheep are a powerful large animal model for studying fetal physiology. The objective of this study was to determine if maternally administered metformin at human dose-equivalent concentrations crosses the ovine placenta and equilibrates in the fetal circulation. To test this, metformin was administered to the pregnant ewe via continuous intravenous infusion or supplementation in the drinking water. Both administration routes increased maternal metformin concentrations to human dose-equivalent concentrations of ~ 10 µM, yet metformin was negligible in the fetus even after 3-4 days of maternal administration. In cotyledon and caruncle tissue, expression levels of the major metformin uptake transporter organic cation transporter 1 (OCT1) were < 1% of expression levels in the fetal liver, a tissue with abundant expression. Expression of other putative uptake transporters OCT2 and OCT3, and efflux transporters multidrug and toxin extrusion (MATE)1 and MATE2were more abundant. These results demonstrate that the ovine placenta is impermeable to maternal metformin administration. This is likely due to anatomical differences and increased interhaemal distance between the maternal and umbilical circulations in the ovine versus human placenta limiting placental metformin transport.
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