The Protective Role of Maternal Immunization in Early Life

Frontiers in Pediatrics

Reem Elfeky¹  Gianluca Terrin²  Marzia Duse²  Mario De Curtis²  Giulia Brindisi²  Anna Maria Zicari²  Bianca Cinicola³  Maria Giulia Conti⁴  Ane Fernandez Salinas⁵  Eva Piano Mortari⁶  Rita Carsetti⁷  Viviana Moschese⁸  Mayla Sgrulletti⁹ 

[1] Department of Clinical Immunology, Royal Free Hospital, London, United Kingdom;Infection, Immunity & Inflammation Department, Institute of Child Health, University College London (UCL), London, United Kingdom;Department of Maternal and Child Health and Urological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy;Department of Maternal and Child Health and Urological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy;Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy;Department of Maternal and Child Health and Urological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy;Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy;Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy;Diagnostic Immunology Research Unit, Multimodal Medicine Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy;Diagnostic Immunology Research Unit, Multimodal Medicine Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy;Diagnostic Immunology Research Unit, Multimodal Medicine Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy;Microbiology and Diagnostic Immunology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy;Pediatric Immunopathology and Allergology Unit, University of Rome Tor Vergata, Policlinico Tor Vergata, Rome, Italy;Department Saint Camillus International University of Health and Medical Sciences, Rome, Italy;Pediatric Immunopathology and Allergology Unit, University of Rome Tor Vergata, Policlinico Tor Vergata, Rome, Italy;Ph.D. Program in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy;

关键词: maternal immunization;    vaccination;    pregnancy;    immune system;    neonate;   

DOI  :  10.3389/fped.2021.638871

来源: Frontiers

【 摘 要 】

With birth, the newborn is transferred from a quasi-sterile environment to the outside world. At this time, the neonatal immune system is inexperienced and continuously subject to a process of development as it encounters different antigenic stimuli after birth. It is initially characterized by a bias toward T helper 2 phenotype, reduced T helper 1, and cytotoxic responses to microbial stimuli, low levels of memory, and effector T and B cells and a high production of suppressive T regulatory cells. The aim of this setting, during fetal life, is to maintain an anti-inflammatory state and immune-tolerance. Maternal antibodies are transferred during pregnancy through the placenta and, in the first weeks of life of the newborn, they represent a powerful tool for protection. Thus, optimization of vaccination in pregnancy represents an important strategy to reduce the burden of neonatal infections and sepsis. Beneficial effects of maternal immunization are universally recognized, although the optimal timing of vaccination in pregnancy remains to be defined. Interestingly, the dynamic exchange that takes place at the fetal-maternal interface allows the transfer not only of antibodies, but also of maternal antigen presenting cells, probably in order to stimulate the developing fetal immune system in a harmless way. There are still controversial effects related to maternal immunization including the so called “immunology blunting,” i.e., a dampened antibody production following infant's vaccination in those infants who received placentally transferred maternal immunity. However, clinical relevance of this phenomenon is still not clear. This review will provide an overview of the evolution of the immune system in early life and discuss the benefits of maternal vaccination. Current maternal vaccination policies and their rationale will be summarized on the road to promising approaches to enhance immunity in the neonate.

【 授权许可】

CC BY