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The initiation of cell-mediated immunity can be observed as early as the third month of fetal growth, with active antibody-mediated immunity following approximately one month later.
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
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A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development
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[Neonatal lupus: a fetal-maternal immunisation model?].

Zahir Amoura1, Laurent Arnaud, Alexis Mathian

  • 1Médecine Interne 2, Centre National de Référence Labellisé Lupus, Groupe Hospitalier Pitié-Salpêtrière - Paris. zahir.amoura@psl.aphp.fr

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|December 10, 2013
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Summary

Neonatal lupus, caused by maternal antibodies, can lead to congenital heart block (CHB) in infants. This permanent condition requires intervention in most cases, highlighting the need for further research into prevention and treatment.

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Area of Science:

  • Immunology
  • Cardiology
  • Neonatology

Background:

  • Neonatal lupus arises from maternal autoantibodies (anti-SSA/Ro, anti-SSB/La) crossing the placenta.
  • Key complications include transient skin, hematologic, hepatic, and neurological issues, with congenital heart block (CHB) being the most severe.

Discussion:

  • The pathogenesis of CHB involves maternal autoantibodies binding to cardiomyocyte surface antigens on apoptotic cells.
  • This triggers a macrophage-mediated inflammatory cascade, leading to fibrosis of the cardiac conduction system.

Key Insights:

  • Anti-SSA/Ro antibodies are necessary but not sufficient for CHB development.
  • CHB affects 1-2% of infants born to anti-SSA/Ro-positive mothers, with a 10-17% recurrence risk.
  • CHB is permanent, causing significant morbidity and mortality.

Outlook:

  • Further research is needed to understand the precise mechanisms leading to CHB and to develop preventative strategies.
  • Investigating therapeutic interventions for affected infants is crucial to improve long-term outcomes.