Infection in the Developing Brain: The Role of Unique Systemic Immune Vulnerabilities.
Infection in the Developing Brain: The Role of Unique Systemic Immune Vulnerabilities.
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DOI：
10.3389/fneur.2021.805643
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发表时间：
2021
影响因子：
3.4
通讯作者：
Rohlwink UK
中科院分区：
文献类型：
--
作者：
Singh G;Tucker EW;Rohlwink UK
中枢神经系统（CNS）感染仍然是儿科疾病的主要负担，由于发育中的大脑损伤，与显著的长期发病率相关。儿童易受各种CNS感染病因的影响，部分原因是其外周免疫系统的脆弱性。与成人相比，幼儿已知先天性和适应性免疫细胞的数量和功能减少，免疫介质的产生较差，对炎症刺激的反应受损，抗体活性降低。这不仅对它们对病原体入侵的反应有影响，而且对开发适当的疫苗和疫苗接种策略也有影响。此外，儿科免疫特征随着其更广泛的生理和激素景观的发展而在儿童期到青春期的跨度中演变。除了固有的脆弱性外，儿童还受到影响其感染易感性的外部因素的影响，包括母亲的免疫力和接触以及营养。在这篇综述中，我们总结了目前的证据，整个儿童的免疫特征，使儿童在中枢神经系统感染的风险，并介绍了通过调节作用，大脑对免疫反应的中枢神经系统的联系。这份手稿奠定了基础，从我们探索的具体感染和炎症的中枢神经系统和后果，成熟的大脑在第二部分的这一系列审查。
Central nervous system (CNS) infections remain a major burden of pediatric disease associated with significant long-term morbidity due to injury to the developing brain. Children are susceptible to various etiologies of CNS infection partly because of vulnerabilities in their peripheral immune system. Young children are known to have reduced numbers and functionality of innate and adaptive immune cells, poorer production of immune mediators, impaired responses to inflammatory stimuli and depressed antibody activity in comparison to adults. This has implications not only for their response to pathogen invasion, but also for the development of appropriate vaccines and vaccination strategies. Further, pediatric immune characteristics evolve across the span of childhood into adolescence as their broader physiological and hormonal landscape develop. In addition to intrinsic vulnerabilities, children are subject to external factors that impact their susceptibility to infections, including maternal immunity and exposure, and nutrition. In this review we summarize the current evidence for immune characteristics across childhood that render children at risk for CNS infection and introduce the link with the CNS through the modulatory role that the brain has on the immune response. This manuscript lays the foundation from which we explore the specifics of infection and inflammation within the CNS and the consequences to the maturing brain in part two of this review series.
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