Four Pathways Involving Innate Immunity in the Pathogenesis of Preeclampsia.
Four Pathways Involving Innate Immunity in the Pathogenesis of Preeclampsia.
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DOI：
10.3389/fcvm.2015.00020
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发表时间：
2015
影响因子：
3.6
通讯作者：
Mitchell BM
中科院分区：
文献类型：
--
作者：
Bounds KR;Newell-Rogers MK;Mitchell BM
母体先天免疫系统在正常妊娠和妊娠高血压疾病包括子痫前期（PE）中都起着重要作用。我们提出了四种途径，涉及过度的先天免疫，导致大多数形式的PE。预先存在的内皮功能障碍加上妊娠导致过度的先天免疫反应，导致广泛的炎症、胎盘和肾脏功能障碍、血管收缩和PE。滋养细胞侵袭浅、螺旋动脉重构不足和/或胎盘灌注不足导致的胎盘功能障碍引发先天免疫反应，导致过度炎症、内皮和肾功能障碍以及PE。先天免疫系统由于预先存在或获得性感染而增强，再加上父系胎盘和半异体胎儿的存在，导致过度的先天免疫反应，表现为PE。最后，孕妇对妊娠的异常和过度的免疫反应会导致广泛的炎症、器官功能障碍和PE。我们讨论了先天免疫在这些情况中的潜在作用，以及它们的重叠，以及如何靶向先天免疫系统可能导致PE的治疗。
The maternal innate immune system plays an important role both in normal pregnancy as well as hypertensive disorders of pregnancy including preeclampsia (PE). We propose four pathways that involve excessive innate immunity that lead to most forms of PE. Pre-existing endothelial dysfunction plus pregnancy leads to an excessive innate immune response resulting in widespread inflammation, placental and renal dysfunction, vasoconstriction, and PE. Placental dysfunction due to shallow trophoblast invasion, inadequate spiral artery remodeling, and/or low placental perfusion initiates an innate immune response leading to excessive inflammation, endothelial and renal dysfunction, and PE. A heightened innate immune system due to pre-existing or acquired infections plus the presence of a paternally derived placenta and semi-allogeneic fetus cause an excessive innate immune response which manifests as PE. Lastly, an abnormal and excessive maternal immune response to pregnancy leads to widespread inflammation, organ dysfunction, and PE. We discuss the potential role of innate immunity in each of these scenarios, as well as the overlap, and how targeting the innate immune system might lead to therapies for the treatment of PE.