Peyer’s patches

Peyer 的补丁
  • 文章类型: Journal Article
    塑造先天淋巴细胞(ILC)反应的转录组特征已经被很好地表征,然而,调节其发育和活性的转录后机制仍然知之甚少。我们证明肠道固有层的ILC组表达microRNA-142(miR-142)的成熟形式,进化保守的microRNA家族,在免疫系统中具有几种非冗余的调节作用。种系Mir142缺失改变了肠道ILC组成,导致缺乏T-bet种群,并且包括CCR6LTi样ILC3在内的ILC3亚群的细胞数量和表型存在明显缺陷。在先天免疫细胞驱动的结肠炎模型中,这些作用与病理降低相关。此外,Mir142-/-小鼠表现出肠相关淋巴组织的发育缺陷,包括完全没有成熟的Peyer\的补丁。ILC3s(RorcΔMir142)中Mir142的条件缺失支持这些microRNA在建立或维持肠相关组织中LTi样ILC3s的细胞性和功能中的细胞内在作用。RNAseq分析揭示了这些细胞中miR-142微小RNA可能调控的几个靶基因和生物学途径。最后,ILC3中缺乏Mir142导致IL-17A产生升高。这些数据拓宽了我们对miR-142microRNA的免疫系统作用的理解,鉴定这些分子是ILC3和肠粘膜免疫的关键转录后调节因子。
    The transcriptomic signatures that shape responses of innate lymphoid cells (ILCs) have been well characterised, however post-transcriptional mechanisms which regulate their development and activity remain poorly understood. We demonstrate that ILC groups of the intestinal lamina propria express mature forms of microRNA-142 (miR-142), an evolutionarily conserved microRNA family with several non-redundant regulatory roles within the immune system. Germline Mir142 deletion alters intestinal ILC compositions, resulting in the absence of T-bet+ populations and significant defects in the cellularity and phenotypes of ILC3 subsets including CCR6+ LTi-like ILC3s. These effects were associated with decreased pathology in an innate-immune cell driven model of colitis. Furthermore, Mir142-/- mice demonstrate defective development of gut-associated lymphoid tissues, including a complete absence of mature Peyer\'s patches. Conditional deletion of Mir142 in ILC3s (RorcΔMir142) supported cell-intrinsic roles for these microRNAs in establishing or maintaining cellularity and functions of LTi-like ILC3s in intestinal associated tissues. RNAseq analysis revealed several target genes and biological pathways potentially regulated by miR-142 microRNAs in these cells. Finally, lack of Mir142 in ILC3 led to elevated IL-17A production. These data broaden our understanding of immune system roles of miR-142 microRNAs, identifying these molecules as critical post-transcriptional regulators of ILC3s and intestinal mucosal immunity.
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  • 文章类型: Journal Article
    Peyer的补丁(PP),含有大量的B和T细胞,在诱导肠道关键免疫反应中起关键作用。PP被定义为聚集的淋巴滤泡,由多个淋巴滤泡(LFs)组成,这些淋巴滤泡可能以协同方式相互作用。LFs被认为是球形的;然而,他们的结构特征还没有完全理解。为了阐明PPs结构随着个体生长的变化,我们从2周龄、4周龄和10周龄的小鼠收获的整个PPs产生连续的2D切片,并使用软件进行3D分析,阿米拉.尽管在整个实验过程中,PP中LFs的数量没有变化,LFs的体积和表面积显著增加,表明PPs中的LFs通过招募免疫细胞不断发展,即使在断奶后。为了应对断奶后肠道环境的急剧变化,在4周龄和10周龄(但非2周龄)观察到LFs中生发中心(GC)的发育.此外,GCs逐渐开始形成远离LFs的中心,并靠近出口淋巴管发育的肌肉层。重要的是,每个LF连接到相邻的LF;即使在断奶前未激活的PPs中也观察到这一特征。这些结果表明,PPs可能具有增强免疫功能的独特组织和结构,允许LFs中的细胞自由进入相邻的LFs,并在断奶后刺激后从PPs平稳地离开到外周。
    Peyer\'s patches (PPs), which contain an abundance of B and T cells, play a key role in inducing pivotal immune responses in the intestinal tract. PPs are defined as aggregated lymph follicles, which consist of multiple lymph follicles (LFs) that may interact with each other in a synergistic manner. LFs are thought to be spherical in shape; however, the characteristics of their structure are not fully understood. To elucidate changes in the structure of PPs as individuals grow, we generated serial 2D sections from entire PPs harvested from mice at 2, 4, and 10 weeks of age and performed a 3D analysis using a software, Amira. Although the number of LFs in PPs was not changed throughout the experiment, the volume and surface area of LFs increased significantly, indicating that LFs in PPs develop continuously by recruiting immune cells, even after weaning. In response to the dramatic changes in the intestinal environment after weaning, the development of germinal centers (GCs) in LFs was observed at 4 and 10 weeks (but not 2 weeks) of age. In addition, GCs gradually began to form away from the center of LFs and close to the muscle layer where export lymphatic vessels develop. Importantly, each LF was joined to the adjacent LF; this feature was observed even in preweaning nonactivated PPs. These results suggest that PPs may have a unique organization and structure that enhance immune functions, allowing cells in LFs to have free access to adjacent LFs and egress smoothly from PPs to the periphery upon stimulation after weaning.
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  • 文章类型: Journal Article
    Nefecon,布地奈德的靶向释放胶囊制剂被批准用于减少原发性免疫球蛋白A肾病成人的蛋白尿,目标是在肠粘膜水平的Peyer斑块中过量产生半乳糖缺乏的免疫球蛋白1型。为了研究Nefecon胶囊的商业配方是否可靠地将布地奈德释放到远端回肠,用试验胶囊进行了人体研究,再现了Nefecon胶囊的延迟释放功能。咖啡因包含在测试胶囊中作为胶囊在肠道中打开的标记,因为它在从口服给药的剂型释放后迅速出现在唾液中。首次在唾液中测量咖啡因时,使用黑色氧化铁磁共振成像来确定胶囊在肠道中的位置,并直接观察胶囊内容物在肠道中的分散。体外溶出结果证实,试验胶囊具有与奈菲康胶囊相同的延迟释放特性。在12名人类志愿者中有10名,囊被证明在回肠远端打开;在其他两个受试者中,它刚刚经过回盲部。这些结果与在其他公开的靶向肠道的延迟释放制剂的成像研究中看到的高度可变性相比是有利的。测试胶囊被证明能够可靠地将其内容物输送到远端回肠,Peyer贴片浓度最高的区域。
    Nefecon, a targeted-release capsule formulation of budesonide approved for the reduction of proteinuria in adults with primary immunoglobulin A nephropathy, targets overproduction of galactose-deficient immunoglobulin A type 1 in the Peyer\'s patches at the gut mucosal level. To investigate whether the commercial formulation of Nefecon capsules reliably releases budesonide to the distal ileum, a human study was conducted with test capsules reproducing the delayed-release function of Nefecon capsules. Caffeine was included in the test capsules as a marker for capsule opening in the gut since it appears rapidly in saliva after release from orally administered dosage forms. Magnetic resonance imaging with black iron oxide was used to determine the capsule\'s position in the gut at the time caffeine was first measured in saliva and additionally to directly visualize dispersion of the capsule contents in the gut. In vitro dissolution results confirmed that the test capsules had the same delayed-release characteristics as Nefecon capsules. In 10 of 12 human volunteers, the capsule was demonstrated to open in the distal ileum; in the other two subjects, it opened just past the ileocecal junction. These results compared favorably with the high degree of variability seen in other published imaging studies of delayed-release formulations targeting the gut. The test capsules were shown to reliably deliver their contents to the distal ileum, the region with the highest concentration of Peyer\'s patches.
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  • 文章类型: Journal Article
    特异性肠道IgA反应的诱导和调节关键取决于树突状细胞亚群和它们在Peyer斑块(PP)中激活的T细胞。我们发现,以霍乱毒素(CT)作为佐剂的口服免疫导致PPDC亚群的组成和定位的迁移依赖性变化,上皮下穹顶中CD103-cDC2s和LysoDCs的数量增加,以及在T细胞区(TZ)中表达CD101的CD103cDC2s,而口服OVA耐受与更大量的TZcDC1s和pTregs相关。在缺乏CD103cDC2s的huCD207DTA小鼠中,在CT佐剂免疫后观察到IgA反应降低,而口服OVA耐受在cDC1缺陷型Batf3-/-小鼠中效率低下。使用卵清蛋白(OVA)TCR转基因CD4T细胞过继转移模型,我们发现,共转移的内源性WTCD4T细胞可以通过分泌IL-10阻碍OVA特异性IgA反应的诱导。CT可以克服这种阻断作用,显然通过对外周诱导的Tregs(pTreg)的调节作用,同时促进滤泡辅助性T细胞(Tfh)的扩增。数据支持一个模型,其中cDC1诱导的pTreg通常抑制任何给定抗原的PP反应,并且CT的口服佐剂效应取决于通过诱导CD103cDC2s促进Tfh反应。
    Induction and regulation of specific intestinal immunoglobulin (Ig)A responses critically depend on dendritic cell (DC) subsets and the T cells they activate in the Peyer\'s patches (PP). We found that oral immunization with cholera toxin (CT) as an adjuvant resulted in migration-dependent changes in the composition and localization of PP DC subsets with increased numbers of cluster of differentiation (CD)103- conventional DC (cDC)2s and lysozyme-expressing DC (LysoDCs) in the subepithelial dome and of CD103+ cDC2s that expressed CD101 in the T cell zones, while oral ovalbumin (OVA) tolerization was instead associated with greater accumulation of cDC1s and peripherally induced regulatory T cells (pTregs) in this area. Decreased IgA responses were observed after CT-adjuvanted immunization in huCD207DTA mice lacking CD103+ cDC2s, while oral OVA tolerization was inefficient in cDC1-deficient Batf3-/- mice. Using OVA transgenic T cell receptor CD4 T cell adoptive transfer models, we found that co-transferred endogenous wildtype CD4 T cells can hinder the induction of OVA-specific IgA responses through secretion of interleukin-10. CT could overcome this blocking effect, apparently through a modulating effect on pTregs while promoting an expansion of follicular helper T cells. The data support a model where cDC1-induced pTreg normally suppresses PP responses for any given antigen and where CT\'s oral adjuvanticity effect is dependent on promoting follicular helper T cell responses through induction of CD103+ cDC2s.
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  • 文章类型: Case Reports
    背景:肠套叠是儿科患者最常见的急性腹部疾病之一,如果不及时治疗,它可能导致肠坏死甚至死亡。该病的病因不明,可能与多种因素有关,MMR疫苗接种后,仅有有限的小肠坏死报告继发于异常的Peyer淋巴结增生。
    方法:在本报告中,我们介绍了两名因肠套叠继发的Peyer淋巴结异常增殖的婴儿,最终导致MMR疫苗接种后小肠坏死.
    结论:肠坏死和感染性休克是婴儿死亡的最常见原因,早期发现和管理至关重要。
    BACKGROUND: Intussusception is one of the most common acute abdominal conditions in pediatric patients, and if left untreated, it may result in intestinal necrosis and even death. The etiology of the disease is unknown and may be related to a variety of factors, and there are only limited reports of small bowel necrosis secondary to abnormal Peyer\'s node hyperplasia after MMR vaccination.
    METHODS: In this report, we present two infants who had an abnormal proliferation of Peyer\'s nodes secondary to intussusception eventually leading to small bowel necrosis after MMR vaccination.
    CONCLUSIONS: Intestinal necrosis and infectious shock are the most common causes of infant mortality, and early detection and management are critical.
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  • 文章类型: Journal Article
    丁基亲热蛋白样2(BTNL2)是一种T细胞抑制分子,与未知的结合伴侣相互作用,以调节许多炎症和自身免疫性疾病中的免疫反应。在这项研究中,我们发现,BTNL2对T细胞活化和效应功能的抑制作用可以通过其N末端IgV结构域(BTNL2IgV1)单独执行。基于涉及免疫球蛋白超家族成员的已知受体-配体界面,BTNL2IgV1上关键残基的结构指导突变表明,BTNL2与其推定受体使用非规范结合界面。高亲和力BTNL2IgV1探针显示,在溃疡性结肠炎的诱导型模型中,重度结肠炎伴随着在Peyer's斑块中选择性富集表达BTNL2受体的效应记忆性CD4+和CD8+T细胞.腹膜内施用BTNL2IgV1导致DSS诱导的结肠炎的进展显着延迟,并且还显示Peyer's斑块中表达BTNL2受体的T细胞的活化降低。因此,这项研究表明,在Peyer's斑块中表达BTNL2受体的T细胞参与了疾病的发病机制,并且可以作为溃疡性结肠炎的新治疗靶点,可由BTNL2IgV1调节。
    Butyrophilin-like 2 (BTNL2) is a T cell inhibitory molecule that interacts with unknown binding partners to modulate the immune response in a number of inflammatory and autoimmune diseases. In this study, we found that the inhibitory effects of BTNL2 on T cell activation and effector functions can be executed by its N-terminal IgV domain (BTNL2 IgV1) alone. Structure-guided mutation of key residues on BTNL2 IgV1 based on known receptor-ligand interfaces involving immunoglobulin superfamily members revealed that BTNL2 uses a non-canonical binding interface with its putative receptor. A high avidity BTNL2 IgV1 probe revealed that in an inducible model of ulcerative colitis, severe colitis was accompanied by a selective enrichment of BTNL2-receptor expressing effector-memory CD4+ and CD8+ T cells in the Peyer\'s patches. Intraperitoneal administration of BTNL2 IgV1 resulted in a significant delay in the progression of DSS-induced colitis and also showed reduced activation of the BTNL2-receptor-expressing T cells in the Peyer\'s patches. Thus, this study demonstrates that the BTNL2-receptor-expressing T cells in the Peyer\'s patches participate in the disease pathogenesis and can serve as a novel therapeutic target in ulcerative colitis, which can be modulated by BTNL2 IgV1.
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  • 文章类型: Journal Article
    这项研究评估了鸡蛋脂质成分在诱导对蛋清(EW)蛋白过敏致敏中的影响,使用口服无佐剂诱导过敏的小鼠模型。鸡蛋甘油三酯(TG)和磷脂(PL),和更高程度的整个鸡蛋脂质分数(EL),诱导对EW蛋白的过敏,其特征是EW特异性IgG1增加。EL也增加EW特异性IgE。给小鼠施用EW和EL的混合物增加了Il33,Il25和Tslp的肠道表达,IL-33和IL-6的分泌,第2组固有淋巴细胞的扩增,Gata3,Il4和Il13的调节,树突状细胞(DC)的激活和驱动Th2分化的DC分子的表达。TG促进蛋白质通过肠上皮的吸收,增强局部Th2反应,而PL则倾向于将抗原递送到Peyer's贴片。卵蛋白吸收位点的这种差异调节决定了TG和PL的不同行为。蛋黄脂质还在体外诱导肠道人细胞上Th2诱导的先天性反应的激活,并通过激活卵过敏受试者中的DC来增强适应性Th2功能。
    This study evaluates the influence of egg lipid fractions in the induction of allergic sensitization to egg white (EW) proteins, using a mouse model of orally adjuvant-free induced allergy. Egg triglycerides (TG) and phospholipids (PL), and to a higher extent the whole egg lipid fraction (EL), induced allergy to EW proteins characterized by increased EW-specific IgG1. EL also increased EW-specific IgE. The administration to mice of a mixture of EW and EL increased the intestinal expression of Il33, Il25, and Tslp, the secretion of IL-33 and IL-6, the expansion of group 2 innate lymphoid cells, the regulation of Gata3, Il4 and Il13, dendritic cell (DC) activation and expression of DC molecules that drive Th2 differentiation. TG promoted the absorption of proteins through the intestinal epithelium, enhancing local Th2 responses, while PL favoured the delivery of antigens to the Peyer\'s Patches. This differential modulation of the site of absorption of egg proteins determined the different behaviour of TG and PL. Egg yolk lipids also induced activation of Th2-inducing innate responses on intestinal human cells in vitro and enhanced adaptive Th2 functions through the activation of DCs in egg-allergic subjects.
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  • 文章类型: Journal Article
    淋巴组织诱导(LTi)细胞,先天淋巴细胞(ILC)的一个子集,在次级淋巴组织的形成中起着至关重要的作用。然而,该ILC子集的发展和功能的调节仍然难以捉摸。在这项研究中,我们报道了转录因子T细胞因子1(TCF-1),就像GATA3一样,对于非LTiILC子集的开发是不可或缺的。虽然LTi细胞仍然存在于TCF-1缺陷小鼠中,Peyer斑块(PPs)的器官发生,但不是淋巴结,在这些小鼠中受损。来自不同组织的LTi细胞具有不同的基因表达模式,TCF-1特异性调节PPLTi细胞中淋巴毒素的表达。机械上,TCF-1可以直接和/或间接调节Lta,包括通过促进GATA3的表达。因此,TCF-1-GATA3轴,在T细胞发育过程中起着重要作用,还关键地调节非LTi细胞的发育和LTi细胞的组织特异性功能。
    Lymphoid tissue inducer (LTi) cells, a subset of innate lymphoid cells (ILCs), play an essential role in the formation of secondary lymphoid tissues. However, the regulation of the development and functions of this ILC subset is still elusive. In this study, we report that the transcription factor T cell factor 1 (TCF-1), just as GATA3, is indispensable for the development of non-LTi ILC subsets. While LTi cells are still present in TCF-1-deficient mice, the organogenesis of Peyer\'s patches (PPs), but not of lymph nodes, is impaired in these mice. LTi cells from different tissues have distinct gene expression patterns, and TCF-1 regulates the expression of lymphotoxin specifically in PP LTi cells. Mechanistically, TCF-1 may directly and/or indirectly regulate Lta, including through promoting the expression of GATA3. Thus, the TCF-1-GATA3 axis, which plays an important role during T cell development, also critically regulates the development of non-LTi cells and tissue-specific functions of LTi cells.
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  • 文章类型: Journal Article
    背景:常见的具有异常粘膜免疫的原发性肾小球肾炎是IgA肾病(IgAN)。滤泡辅助性T细胞(TFH)在调节B细胞分化中至关重要。派尔斑块(PPs)是IgA+成浆细胞分化的主要位点。
    目的:我们的研究旨在探讨TFH细胞在IgA肾病病因中的潜在作用。
    方法:在IgAN小鼠模型的PPs中,TFH细胞的比例,B220+IgA+,B220+IgM+,和B220-IgA+淋巴细胞进行评估。然后,我们使用Westernblot评估PPs中Bcl-6,Blip-1和IL-21蛋白的表达,并使用RT-PCR评估IL-21和TGF-1mRNA的表达。TFH细胞与脾细胞共培养以测定TFH细胞上IL-21的程度和活化标记物CD69的比例。将来自患有IgAN的儿童的幼稚B细胞(CD27-IgD+)与TFH细胞相关细胞因子一起培养。检测上清液以评估半乳糖缺陷型IgA1(Gd-IgA1)的排泄。
    结果:IgAN小鼠在TFH细胞上的IL-21和CD69程度明显高于对照组,以及更高百分比的B220+IgA+,B220+IgM+,B220+IgA+,PPs中的TGF-1、IL-21mRNA和Bcl-6、IL-21蛋白。上清液和IgAN阳性儿童血清中的Gd-IgA1水平明显高于健康对照组(P<0.05)。PPs提供微环境以诱导分泌IgA的成浆细胞的产生。
    结论:TFH细胞可能是诱导B细胞分化为分泌IgA的浆母细胞并产生Gd-IgA1的关键调节剂,在IgAN的发病中起重要作用。它可能是未来新的治疗靶点。
    BACKGROUND: Common primary glomerulonephritis with aberrant mucosal immunity is IgA nephropathy (IgAN). T follicular helper (TFH) cells are essential in regulating B cell differentiation. Peyer\'s patches (PPs) are the main site where IgA+ plasmablasts differentiate.
    OBJECTIVE: Our study aimed to investigate the TFH cell\'s potential contribution to the etiology of IgA nephropathy.
    METHODS: In PPs from IgAN mouse models, the ratio of the TFH cell, B220+IgA+, B220+IgM+, and B220-IgA+ lymphocytes were assessed. Then, we used Western blot to assess the expression of Bcl-6, Blimp- 1, and IL-21 proteins in PPs and used RTPCR to assess the expression of IL-21 and TGF-β1 mRNA. TFH cells coculture with spleen cells to measure the degree of IL-21 and the ratio of activation marker CD69 on the TFH cells. Naive B cells (CD27-IgD+) from children suffering from IgAN were cultured with TFH cell-related cytokines. The supernatant was detected to assess the excretion of galactose-deficient IgA1 (Gd-IgA1).
    RESULTS: IgAN mice developed noticeably increased degrees of IL-21 and CD69 on TFH cells than controls did, as well as higher percentages of B220+IgA+, B220+IgM+, B220+IgA+, TGF- β1, and IL-21 mRNA and Bcl-6, IL-21 proteins in PPs. The Gd-IgA1 level in the supernatant and IgAN- positive children\'s serum were noticeably higher than those of the healthy controls (P < 0.05). PPs provide the microenvironment to induce the production of IgA-secreting plasmablasts.
    CONCLUSIONS: TFH cells may be a key moderator to induce B cell differentiation into IgAsecreting plasmablasts and produce Gd-IgA1, which plays a significant part in IgAN\'s pathogenesis. It could be a new therapeutic target in the future.
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  • 文章类型: Journal Article
    孕妇在怀孕期间感染甲型流感病毒(IAV)会影响子代的免疫规划和发育。从感染流感的母亲出生的后代患神经发育障碍的风险增加,并且对病原体的呼吸道粘膜免疫受损。肠相关淋巴组织(GALT)在体内免疫系统中占很大比例,并在胃肠道(GI)稳态中起重要作用。这包括对来自食物或微生物的抗原的免疫调节,肠道菌群组成,和肠-脑轴信号。因此,在这项研究中,我们调查了母体IAV感染对后代胃肠道粘膜免疫的影响。感染流感的水坝所生的后代的胃肠道没有重大的解剖学变化。相比之下,母体IAV确实影响后代的粘膜免疫,显示不同GALT内免疫细胞谱的区域差异。中性粒细胞,单核细胞/巨噬细胞,在IAV感染的大坝的盲肠补片后代中,CD4和CD8T细胞浸润增加。在Peyer的补丁中,IAV后代中只有活化的CD4+T细胞增加。IL-6基因表达在盲肠斑块中也升高,但在IAV后代的Peyer斑块中没有升高。这些发现表明,母体IAV感染会干扰后代胃肠道的稳态粘膜免疫。这可能会对肺部的肠-脑轴和粘膜免疫产生深远的影响,导致后代在以后的生活中对呼吸道感染和神经系统疾病的易感性增加。妊娠期间甲型流感病毒(IAV)感染与后代肠道相关淋巴组织(GALT)以区域依赖性方式变化相关。在感染水坝的后代的盲肠斑块中,中性粒细胞和单核细胞/巨噬细胞升高。在Peyer的斑块中未观察到先天免疫细胞浸润的这种增加。T细胞在盲肠斑块中也升高,但在Peyer斑块中没有升高。
    Maternal influenza A virus (IAV) infection during pregnancy can affect offspring immune programming and development. Offspring born from influenza-infected mothers are at increased risk of neurodevelopmental disorders and have impaired respiratory mucosal immunity against pathogens. The gut-associated lymphoid tissue (GALT) represents a large proportion of the immune system in the body and plays an important role in gastrointestinal (GI) homeostasis. This includes immune modulation to antigens derived from food or microbes, gut microbiota composition, and gut-brain axis signaling. Therefore, in this study, we investigated the effect of maternal IAV infection on mucosal immunity of the GI tract in the offspring. There were no major anatomical changes to the gastrointestinal tract of offspring born to influenza-infected dams. In contrast, maternal IAV did affect the mucosal immunity of offspring, showing regional differences in immune cell profiles within distinct GALT. Neutrophils, monocytes/macrophages, CD4+ and CD8+ T cells infiltration was increased in the cecal patch offspring from IAV-infected dams. In the Peyer\'s patches, only activated CD4+ T cells were increased in IAV offspring. IL-6 gene expression was also elevated in the cecal patch but not in the Peyer\'s patches of IAV offspring. These findings suggest that maternal IAV infection perturbs homeostatic mucosal immunity in the offspring gastrointestinal tract. This could have profound ramifications on the gut-brain axis and mucosal immunity in the lungs leading to increased susceptibility to respiratory infections and neurological disorders in the offspring later in life.NEW & NOTEWORTHY Influenza A virus (IAV) infection during pregnancy is associated with changes in gut-associated lymphoid tissue (GALT) in the offspring in a region-dependent manner. Neutrophils and monocytes/macrophages were elevated in the cecal patch of offspring from infected dams. This increase in innate immune cell infiltration was not observed in the Peyer\'s patches. T cells were also elevated in the cecal patch but not in the Peyer\'s patches.
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