Infection and immunity at the maternal-placental-fetal interface: Focus on HIV-1

• Published in: Placenta (Eastbourne) 1998, Vol.19, p.103-124
• Main Authors: Nahmias, André, Abramowsky, Carlos, Dobronyi, Istvan, Ibegbu, Chris, Henderson, Sheryl
• Format: Article
• Language: English
• ISSN: 0143-4004; 1532-3102
• DOI: 10.1016/S0143-4004(98)80036-2

The various methodological approaches, developed earlier by placentologists, are being applied to experimental and pathological studies of infection and the placenta (cf., Panigel and Nahmias, 1994). These approaches, as applied by workers from various disciplines, have provided new information discussed in this overview and by others in this symposium. Their application, together with concepts largely derived from evolutionary principles related to survival of microorganisms and of the human placenta/fetus (hence of our species), have led us to propose new areas of investigation regarding the maternal and fetal interface: o 1. the interactions between exogenous HIV-1 and the endogenous retroviruses of the placenta, embryo, and fetus; 2. tolerance in the antibody response of the fetus/newborn to polysaccharides of microorganisms which might have homology to placental/fetal/neonatal/polysaccharides, leading to the possibility that the passage of such maternal antibodies might lead to bad pregnancy and neonatal outcomes; 3. the mechanisms responsible for the downregulation of maternal lymphocytes and their Th1 cytokines in intervillous blood, and how this downregulation may be overcome by various infectious agents; and 4. the possible role of a very old and potent anti-infectious agent molecule, nitric oxide, in defending the placenta, whether in the intervillous space and/or in Hofbauer cells, how and where the NO is produced, and the resultant effects of differing concentrations of NO and the infectious organisms in protection or pathogenesis. Further basic studies in these areas should hopefully result in some novel practical approaches to prevent, not only the direct deleterious effects of various infectious agents, but also possibly their indirect immune mediated ill-effects on pregnancy outcomes, such as abortion, premature delivery, and birth defects.