Document Detail

Smallpox infections during pregnancy, lessons on pathogenesis from nonpregnant animal models of infection.
MedLine Citation:
PMID:  14568674     Owner:  NLM     Status:  MEDLINE    
Both vaccinated and unvaccinated women during pregnancy who contract variola virus, the causative agent of smallpox, suffer much higher mortality rates than nonpregnants. Furthermore, acute maternal smallpox leads to spontaneous abortion, premature termination of pregnancy and early postnatal infant mortality. The mechanisms governing the abortifacient activity of smallpox, as well as the enhanced susceptibility of gestating women to lethal disease, have remained largely unexamined. Experimental poxvirus infections in nonpregnant small animal models have revealed that T helper type 1 (TH1) cytokines promote efficient resolution of these infections whereas type 2 (TH2) cytokines enhance viral pathogenesis. These data, combined with recent understanding of how the immune system is modulated by pregnancy, may offer important clues as to the increased pathogenesis of variola in pregnant women. The aim of this review is to bring together the current literature on the effects of poxvirus infections in nonpregnant hosts, as well as the effects of pregnancy on the immune system, in order to develop unifying concepts that may provide insight into the pathogenesis of variola during pregnancy and why prior vaccination with vaccinia virus the live anti-variola vaccine offers less protection to pregnant women and their unborn children.
Daniel E Hassett
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Journal of reproductive immunology     Volume:  60     ISSN:  0165-0378     ISO Abbreviation:  J. Reprod. Immunol.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-21     Completed Date:  2004-11-16     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8001906     Medline TA:  J Reprod Immunol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  13-24     Citation Subset:  IM    
The Scripps Research Institute CVN-9, 10550 North Torrey Pines Road, La Jolla, CA 92037, USA.
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MeSH Terms
Cytokines / immunology*,  metabolism
Models, Animal
Poxviridae / pathogenicity*
Pregnancy Complications, Infectious / prevention & control,  virology*
Smallpox / prevention & control,  virology*
Smallpox Vaccine / administration & dosage
Grant Support
Reg. No./Substance:
0/Cytokines; 0/Smallpox Vaccine

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