Infections and Brain Development.
Infections and Brain Development.
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DOI：
10.1097/ogx.0000000000000236
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发表时间：
2015-10
影响因子：
6.2
通讯作者：
Burd I
中科院分区：
文献类型：
--
作者：
Cordeiro CN;Tsimis M;Burd I
几个不同的证据支持感染和改变大脑发育之间的联系。母亲感染，如流感和人类免疫缺陷病毒，与自闭症谱系障碍的发展，认知测试分数的差异和双相情感障碍有关;流行病学和回顾性研究都显示了这种关联。几种病毒、细菌和寄生虫疾病与胎儿脑结构异常的改变有关，包括脑钙化和脑积水。感染过程可激活炎症途径，导致释放各种促炎生物标志物和与感染性宫内环境（绒毛膜炎）或脐带（脐带炎）一致的组织学变化。炎性细胞因子的升高与脑瘫、精神分裂症和自闭症相关。动物研究表明，促炎和抗炎细胞因子的平衡对于产前炎症在神经发育中的作用至关重要。最后，绒毛膜炎与脑瘫和其他异常神经发育结果相关。总之，大量的证据支持这一理论，尽管有不同程度的确定性，即在胎儿发育的关键时期发生的母体感染和炎症理论上可以以时间敏感的方式改变大脑结构和功能。
Several different bodies of evidence support a link between infection and altered brain development. Maternal infections, such as influenza and human immunodeficiency virus, have been linked to the development of autism spectrum disorders, differences in cognitive test scores, and bipolar disorder; an association that has been shown in both epidemiologic and retrospective studies. Several viral, bacterial, and parasitic illnesses are associated with alterations in fetal brain structural anomalies including brain calcifications and hydrocephalus. The process of infection can activate inflammatory pathways causing the release of various proinflammatory biomarkers and histological changes consistent with an infectious intrauterine environment (chorioamnionitis) or umbilical cord (funisitis). Elevations in inflammatory cytokines are correlated with cerebral palsy, schizophrenias, and autism. Animal studies indicate that the balance of proinflammatory and anti-inflammatory cytokines is critical to the effect prenatal inflammation plays in neurodevelopment. Finally, chorioamnionitis is associated with cerebral palsy and other abnormal neurodevelopmental outcomes. In conclusion, a plethora of evidence supports, albeit with various degrees of certainty, the theory that maternal infection and inflammation that occur during critical periods of fetal development could theoretically alter brain structure and function in a time-sensitive manner.