Endocrine Factors Determining Immune Polarization during Perinatal Transition

Barna Vásárhelyi; Tivadar Tulassay

doi:10.1055/s-0043-114666

Klinische Pädiatrie, Table of Contents

Klin Padiatr 2017; 229(05): 261-266
DOI: 10.1055/s-0043-114666

Review

Endocrine Factors Determining Immune Polarization during Perinatal Transition

Endokrine Faktoren und Immunpolarisierung während der perinatalen Adaptationsperiode

Barna Vásárhelyi

¹Semmelweis Egyetem, Department of Laboratory Medicine, Budapest, Hungary

,

Tivadar Tulassay

²Semmelweis Egyetem, Ist Department of Pediatrics, Budapest, Hungary

› Author Affiliations

Abstract

In utero the skewness of the adaptive immune system towards Th2 (‘antiinflammatory’) direction and low of Th1/Th2 cell ratio defend the fetus against rejection by the maternal immune system. Th2 dominance at birth is also of importance as it prevents uncontrolled inflammatory processes during parturition. This condition should change rapidly after birth. In an extrauterine milieu that is inherent with exposure to microorganisms, Th1 (‘proinflammatory’) polarization (i. e. increased Th1 cytokine production along with high Th1/Th2 ratio) are required to maintain an efficient immune response. After birth, maternal hormone supplies including estrogen, progesterone, testosterone, and antiinflammatory prostaglandins cease abruptly. As these hormones have an immune modulatory action favoring Th2, and inhibiting Th1 polarization, their low level supports the strengthening of Th1-type immunity. During parturition a dramatic but transient increase of several hormones (oxytocin, thyorid hormones, and catecholamines) occurs. Again, the net effect of high hormone levels favors Th2 activation, followed by Th1 polarization when hormonal levels reach their postnatal levels. The perinatal change of these components results in the quick cessation of Th1 inhibition and supports the maturation of adaptive immunity to provide an effective response against extrauterine microorganisms.

Zusammenfassung

Der Fötus wird im intrauterinen Leben durch die Th2-(antiinflammatorische) Polarisierung des adaptiven Immunsystems und die Verminderung des Th1/Th2-Verhältnisses vor der Rejektion des maternalen Immunsystems geschützt. Die Th2 Dominanz ist dabei bei der Geburt besonders wichtig, da sie einen nicht-kontrollierten Entzündungsprozess verhindert. Kurz nach der Geburt ändert sich diese Konstellation. Im extrauterinen Milieu wird die effektive Immunantwort durch die Th1 Polarisierung (d. h. erhöhte Produktion Th1 Zytokine und eine Verschiebung des Th1/Th2 Verhältnisses) ermöglicht. Während der Geburt werden transitorisch einige Hormone (z. B. Oxytocin, Thyroid Hormone, Katecholamine) in Exzess produziert. Die mütterliche, Th2-fördernde Hormon-Versorgung (z. B. Oestrogen, Progesterone, Testosterone, anti-inflammatorische Prostaglandine) lässt unmittelbar nach der Geburt nach. Sobald die Hormonspiegel das postnatale Niveau erreichen, haben diese Prozesse eine Th2-Aktivation gefolgt von einer Th1 Polarisierung zur Folge. Die perinatale Adaptation führt dann zu einem schnellen Ende der Th1 Inhibition und unterstützt die Reifung der adaptiven Immunität, die einen wirksamen Schutz gegen extrauterine Mikroorganismen ermöglicht.

Key words

immune system - perinatal adaptation - Th1/Th2 polarization - endocrine systems

Schlüsselwörter

perinatale Adaptation - Immunsystem - Th1/Th2-Verhältniss - endokrine Regulation

Full Text

References

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