The Pathophysiology of Allergy Lecture 514.094 The

77 Pages·2011·5.48 MB·English

by  Pali Gerfried

Lecture 514.094 of the Medical University Vienna Pregnancy and allergies
The Pathophysiology of Allergy Isabella Pali-Schöll
IPA
Lecture 514.094 The Pathophysiology of Allergy
Chapter 12: Allergies in pregnancy, lactation and early
childhood
Isabella Pali-Schöll
Institute of Pathophysiology and Allergy Research (IPA)
Medical University Vienna
[email protected]
Lecture 514.094 of the Medical University Vienna Pregnancy and allergies
The Pathophysiology of Allergy Isabella Pali-Schöll
IPA
Topics
(cid:1) Immunology of pregnancy
(cid:2) Influence factors on allergy development during pregnancy
(cid:3) Influence factors on allergy development around birth
(cid:4) Influence factors on allergy development during lactation
(cid:5)(cid:5) IInnfflluueennccee ffaaccttoorrss oonn aalllleerrggyy ddeevveellooppmmeenntt dduurriinngg bbaabbyyhhoooodd
(cid:6) Management of allergy of mother during pregnancy
Lecture 514.094 of the Medical University Vienna Pregnancy and allergies
The Pathophysiology of Allergy Isabella Pali-Schöll
IPA
(cid:1) Immunology of pregnancy
Pali-Schöll et al. JACI 123:1012-21 (2009)
Lecture 514.094 of the Medical University Vienna Pregnancy and allergies
The Pathophysiology of Allergy Isabella Pali-Schöll
IPA
(cid:1) Immunology of pregnancy
Why is this a topic at all???
(cid:7) The baby/fetus bears molecules
which are foreign to the mother!
www.fertilityc.com
Lecture 514.094 of the Medical University Vienna Pregnancy and allergies
The Pathophysiology of Allergy Isabella Pali-Schöll
IPA
(cid:1) Immunology of pregnancy
Only in the 1950s, Sir Peter Brian Medawar
(Nobel laureate 1960) pointed out that the fetus
contains maternal as well as paternal antigens
(cid:7) should be rejected by mother’s immune system
Medawar PB. Symp Soc Exp Biol 7:320-338 (1953)
Lecture 514.094 of the Medical University Vienna Pregnancy and allergies
The Pathophysiology of Allergy Isabella Pali-Schöll
IPA
(cid:1) Immunology of pregnancy
Hypotheses for survival of the “allogenic transplant” embryo
i. Anatomical barrier between mother and fetus (cid:7) immunological,
physical or physiological barrier blocks maternal immune competent or
cytotoxic molecules and cells
ii. Fetus immunologically undeveloped (cid:7) expresses no paternal antigens
iiiiii.. MMaatteerrnnaall iimmmmuunnee ssyysstteemm iinnaaccttiivvee dduurriinngg pprreeggnnaannccyy
(cid:7) no immune reactions
Desoyeet al. Arch Gyn Obst 245:146-148 (1989)
Lecture 514.094 of the Medical University Vienna Pregnancy and allergies
The Pathophysiology of Allergy Isabella Pali-Schöll
IPA
(cid:1)(cid:1) IImmmmuunnoollooggyy ooff pprreeggnnaannccyy
HHyyppootthheesseess ffoorr ssuurrvviivvaall ooff tthhee ““aallllooggeenniicc ttrraannssppllaanntt”” eemmbbrryyoo
aadd iiiiii.. IImmmmuunnee ssyysstteemm ssuupppprreessssiioonn mmeecchhaanniissmmss
33..aa ccyyttookkiinneess aanndd TThh11//TThh22 eennvviirroonnmmeenntt
33..bb LLIIFF ((lleeuukkaaeemmiiaa iinnhhiibbiittoorryy ffaaccttoorr))
33..cc nnaattuurraall kkiilllleerr cceellllss aanndd mmaaccrroopphhaaggeess
3333....dddd HHHHLLLLAAAA----GGGG
33..ee pprrooggeesstteerroonnee
33..ff aappooppttoossiiss
33..gg ccoommpplleemmeenntt
33..hh bblloocckkiinngg aannttiibbooddiieess
33..ii ttoolleerraannccee
http://homepages.uel.ac.uk/u9400777/
Erlebacher A. Curr Opin Immunol 13:590-593 (2001)
Le Bouteiller P. Nature Medicine 12:991 - 992 (2006)
Lecture 514.094 of the Medical University Vienna Pregnancy and allergies
The Pathophysiology of Allergy Isabella Pali-Schöll
IPA
(cid:1) Immunology of pregnancy
Hypotheses for survival of the “allogenic transplant” embryo
ad iii. Immune system suppression mechanisms
3.a cytokines and Th1/Th2 environment
(cid:7) cytokines act locally
(cid:7) early stages of pregnancy: conceptus and placental tissue provide:
IIFFNN,, IILL,, TTNNFF,, GGMM--CCSSFF (cid:7)(cid:7) mmeecchhaanniissmm ooff aaccttiioonn uunncclleeaarr
Schäfer-SomiS, Animal ReprSci 75:73-94 (2003)
Lippert H. Anatomie. 6. Auflage(1995)
Lecture 514.094 of the Medical University Vienna Pregnancy and allergies
The Pathophysiology of Allergy Isabella Pali-Schöll
IPA
(cid:1) Immunology of pregnancy
Hypotheses for survival of the “allogenic transplant” embryo
ad iii. Immune system suppression mechanisms
3.a cytokines and Th1/Th2 environment
(cid:7) Th2-cytokine environment essential for successful pregnancy:
IL-4, IL-5, IL-6, IL-10, IL-13
SSaaiittoo SS.. JJ RReepprrIImmmmuunnooll 4477:: 8877--110033 ((22000000))
(cid:7) shift but no complete suppression of Th1, as mother and fetus need
to be protected from pathogens
Guilbert LJ. J ReprImmunol 32:105-110 (1996)
(cid:7) not only Th2-cytokines essential, as interleukins 11-18 have been
found during different stages of pregnancy
Chaouat G et al. J ReprImmunol 53:241-256 (2002)
www.shinesa.org.au/go/information-and-resources/choose-
a-topic/pregnancy/stages-of-pregnancy-and-birth
Lecture 514.094 of the Medical University Vienna Pregnancy and allergies
The Pathophysiology of Allergy Isabella Pali-Schöll
IPA
(cid:1) Immunology of pregnancy
Hypotheses for survival of the “allogenic transplant” embryo
ad iii. Immune system suppression mechanisms
3.a cytokines and Th1/Th2 environment
(cid:7) decidual leukocytes and pre-implantation embryo secrete IL-10
Schäfer-SomiS. Animal ReprSci 75:73-94 (2003)
(cid:7)(cid:7) dduurriinngg iimmppllaannttaattiioonn bbllaassttooccyysstt ssuupppprreesssseess iinnffllaammmmaattoorryy rreessppoonnssee
of maternal endometrium by IL-6
Vince GS et al. J ReprImmunol 32:101-104 (1996)
(cid:7) IL-4 for maintenance of pregnancy, suppresses Th1 by inhibiting
IL-12 production by MΦ and DC; constitutively expressed in
amniotic and decidual tissue; critical necessity discussed
Bonney EA. Immunol 103:382-389 (2001)
www.tutorvista.com/content/biology/biology-
iv/reproduction-in-animals/segmentation.php