Immune-metabolic adaptations in pregnancy: A potential stepping-stone to sepsis.

Autor:	Sharma S; Project Sepsis, Systems Immunity Research Institute, Cardiff University, Cardiff, CF14 4XN, UK; Department of Obstetrics & Gynaecology, University Hospital of Wales, Cardiff, CF14 4XW, UK. Electronic address: SharmaS44@cardiff.ac.uk., Rodrigues PRS; Project Sepsis, Systems Immunity Research Institute, Cardiff University, Cardiff, CF14 4XN, UK., Zaher S; Project Sepsis, Systems Immunity Research Institute, Cardiff University, Cardiff, CF14 4XN, UK; Department of Obstetrics & Gynaecology, University Hospital of Wales, Cardiff, CF14 4XW, UK., Davies LC; Project Sepsis, Systems Immunity Research Institute, Cardiff University, Cardiff, CF14 4XN, UK; Biomedical Sciences Unit, Swansea University Medical School, Singleton Park, Swansea, SA2 8PP, UK., Ghazal P; Project Sepsis, Systems Immunity Research Institute, Cardiff University, Cardiff, CF14 4XN, UK. Electronic address: ghazalp@cardiff.ac.uk.
Jazyk:	angličtina
Zdroj:	EBioMedicine [EBioMedicine] 2022 Dec; Vol. 86, pp. 104337. Date of Electronic Publication: 2022 Dec 02.
DOI:	10.1016/j.ebiom.2022.104337
Abstrakt:	Physiological shifts during pregnancy predispose women to a higher risk of developing sepsis resulting from a maladapted host-response to infection. Insightful studies have delineated subtle point-changes to the immune system during pregnancy. Here, we present an overlay of these point-changes, asking what changes and when, at a physiological, cellular, and molecular systems-level in the context of sepsis. We identify distinct immune phases in pregnancy delineated by placental hormone-driven changes in homeostasis setpoints of the immune and metabolic systems that subtly mirrors changes observed in sepsis. We propose that pregnancy immune-metabolic setpoint changes impact feedback thresholds that increase risk for a maladapted host-response to infection and thus act as a stepping-stone to sepsis. Defining maternal immune-metabolic setpoint changes is not only vital for tailoring the right diagnostic tools for early management of maternal sepsis but will facilitate an unravelling of the pathophysiological pathways that predispose an individual to sepsis. Competing Interests: Declaration of interests P.G is a member of the development board for Sepsis Trust UK with no cash incentive. (Copyright © 2022. Published by Elsevier B.V.)
Databáze:	MEDLINE
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