通过病原体的经胎盘通过胎儿的先天性感染可导致严重的发病率和死亡率。即使没有传染给胎儿,胎盘本身的感染与妊娠并发症有关,包括妊娠丢失和早产。胎盘巨噬细胞,也称为Hofbauer细胞(HBC),是位于胎盘中的胎儿源性巨噬细胞,可能参与对胎盘感染的反应和对发育中的胎儿的保护。由于HBCs是绒毛胎盘中唯一的免疫细胞,它们代表了控制感染和预防胎儿发育的最后机会之一。
本综述的目的是提供有关妊娠感染期间HBC反应的文献的系统概述。包括对病毒的反应,细菌,和寄生虫病原体。
PubMed和Scopus于5月20日被搜索,2021年,发布日期没有限制,以确定在感染背景下研究胎盘巨噬细胞/Hofbauer细胞的所有论文。使用了以下搜索策略:(hofbauer*或\“hofbauer细胞\”或\“hofbauer细胞\”或\“胎盘巨噬细胞\”或\“胎盘巨噬细胞\”)和[感染*或病毒或细菌*或寄生虫*或病原体*或LPS\“聚(i:c)”或弓质*或microb*或HIV)]。
确定了86项研究进行综述。这包括那些研究妊娠合并母体感染的胎盘中的HBC,以及研究HBC对病原体或病原体相关分子模式(PAMP)的反应的体外研究。HBCs可以被多种病原体感染,HBC增生是常见的观察结果。HBCs通过改变其转录对病原体感染和PAMPs作出反应,翻译和分泌谱。共培养研究表明,它们可以复制病原体并将其传播到其他细胞。在其他情况下,它们可以通过多种机制消除病原体,包括吞噬作用,细胞因子介导的病原体消除,巨噬细胞胞外陷阱的释放和HBC抗体介导的中和。HBC反应在妊娠期间不同,并且可能受预先存在的免疫的影响。临床信息,包括感染时的胎龄,样本的胎龄,大多数研究缺少样本收集模式和妊娠结局.
Congenital infection of the fetus via trans-placental passage of pathogens can result in severe morbidity and mortality. Even without transmission to the fetus, infection of the placenta itself is associated with pregnancy complications including pregnancy loss and preterm birth. Placental macrophages, also termed Hofbauer cells (HBCs), are fetal-origin macrophages residing in the placenta that are likely involved in responding to placental infection and protection of the developing fetus. As HBCs are the only immune cell present in the villous placenta, they represent one of the final opportunities for control of infection and prevention of passage to the developing fetus.
The objective of this review was to provide a systematic overview of the literature regarding HBC responses during infection in pregnancy, including responses to viral, bacterial, and parasitic pathogens.
PubMed and Scopus were searched on May 20th, 2021, with no limit on publication date, to identify all papers that have studied placental macrophages/Hofbauer cells in the context of infection. The following search strategy was utilized: (hofbauer* OR \"hofbauer cells\" OR \"hofbauer cell\" OR \"placental macrophage\" OR \"placental macrophages\") AND [infect* OR virus OR viral OR bacteri* OR parasite* OR pathogen* OR LPS OR \"poly(i:c)\" OR toxoplasm* OR microb* OR HIV)].
86 studies were identified for review. This included those that investigated HBCs in placentas from pregnancies complicated by maternal infection and in vitro studies investigating HBC responses to pathogens or Pathogen-Associated Molecular Patterns (PAMPs). HBCs can be infected by a variety of pathogens, and HBC hyperplasia was a common observation. HBCs respond to pathogen infection and PAMPs by altering their transcriptional, translational and secretion profiles. Co-culture investigations demonstrate that they can replicate and transmit pathogens to other cells. In other cases, they may eliminate the pathogen through a variety of mechanisms including phagocytosis, cytokine-mediated pathogen elimination, release of macrophage extracellular traps and HBC-antibody-mediated neutralization. HBC responses differ across gestation and may be influenced by pre-existing immunity. Clinical information, including gestational age at infection, gestational age of the samples, mode of sample collection and pregnancy outcome were missing for the majority of studies.