Maturation of the Immune System in the Fetus, and the Implications for Congenital CMV

Publication date: Available online 16 March 2019Source: Best Practice & Research Clinical Obstetrics & GynaecologyAuthor(s): Erez Rechavi, Raz SomechAbstractCongenital Cytomegalovirus (CMV) infection is the most prevalent and most consequential of all congenital infections, affecting roughly 0.6% of all live births worldwide. Timing of maternal infection and maternal immune status largely determine the likelihood of a symptomatic infection. However, recent studies suggest that the fetal immune system, long perceived as naïve and immature, may also play a role in deciding the outcome of congenital CMV infection. Here, we review the development of the four immune cells most pertinent to CMV control in the human fetus. αβT cells, B cells, Natural Killer (NK) cells and γδT cells are all present, mature and partially functional in-utero, and are capable of mounting some form of response to congenital CMV. Whether this response is negligible, effective or harmful remains an open question. Expanding our knowledge of normal and abnormal immune development could provide clinicians with more accurate tools for the detection, monitoring and treatment of congenitally infected fetuses.

Source: Best Practice and Research Clinical Obstetrics and Gynaecology - March 16, 2019 Category: OBGYN Source Type: research