C3 pregnancy

Question 1

Name factors associated with miscarriage (8)

Answer 1

Age & past pregnancy 
Genetic factors 
Embryo abnormalities 
Weak cervix
Infection 
Alloimmune reaction 
Autoimmune factors
Womb structure abnormalities

Question 2

Describe preeclampsia

Answer 2

Trophoblasts ~dont invade into maternal tissue - therefore sprial arteries dont undergo full physiological change and hence blood flow to the placenta is reduced

• excessive maternal inflammatory response (~against fetal Ag)
• Have higher CD8 responses against paternal antigens vs healthy pregnant

Question 3

Describe some immune mechanisms that exist to protect the fetus:

Answer 3

Placental barrier
Immune suppression (cytokine shifts, effect of progesterone
Altered HLA antigen expression

Question 4

Pregnancy can

1. increase severity to which infections
2. decrease severity

Answer 4

Increase 
Toxoplasma
Listeria
Leishamania
Plasmodium

Decrease
Psoriasis
Rheumatoid arthritis

Question 5

What ways can infection have direct effects on pregnancy

Answer 5

Interfere w/ physiology & immunology of pregnancy
Damage the placenta
Result in congenital transmission

Question 6

Infection during pregnancy can result in

Answer 6

Can result in congenital infection
Altered immunity to that infection:
- increase susceptibility to new infection
- cause reactivation of latent infection
Neurodevelopmental changes & neuropsychiatric disease

Question 7

How does congenital T. gondii infection affect lifetime response of foetus (into adulthood)

• what cells reduced
• what is promoted
• effect on mother?

Answer 7

alters the lifetime immune response by allowing persistent infection with multiple episodes of reactivation
= reduced lymphocyte responsiveness
- promotes absorption of fetus
- Increased severity of disease in mothers, creates conditions that facilitate congenital transmission

Question 8

Describe reactivation of bradyzoites

• describe life cycle
• what in body is attacked
• this is common with people with what congenital condition/ what does this show about their immune system

Answer 8

Bradyzoites can reactive under certain conditions –> tachyzoites
–> bradyzoites under certain stress conditions
Each time it reactivates - destroys more retina
- Common in people with congenital toxoplasmosis –> shows something diff about their immune system

Question 9

what is the relationship between fetal infection & severity of fetal damage in the 3 trimesters

Answer 9

Inverse relationship
Trimester 1: lower chance of infection however more severe consequences
vs trimer 3

Question 10

Describe consequences of

T. gondii infection in first semester vs 3rd

Answer 10

Infection during 1st trimester disrupts Th2 bias and results in abortion

Infection during 3rd trimester is poorly controlled due to Th2 bias and results in high parasitemia and increased congenital transmission

Question 11

Leishmania has what affect on

1. placental cells
2. spleen cells

Answer 11

1. Decreased IL-4 & IL-10 
Increased TNFa & IFNy 
- infection increases reabsorption of fetus
2. Decreased IFNy 
Increased IL-4, IL-5 & IL-10

Question 12

Infections result in
what type of infection  
1. Toxoplasma gondii
2. Influenza
3. Salmonella

Answer 12

1. Classic Th1-Th2 imbalance 
Congential transmission 
2. Enhanced maternal infection 
No placental infection 
3. Opportunistic maternal infection 
Severe placental infection

Question 13

Define MIA & what does it lead to

- activation results in

Answer 13

Maternal immune activation
leads to psychiatric disorders in offspring
- activation = release of proinflammatory cytokines/ Th17: IL-17
- genetics & second hit required

Question 14

Describe some changes in adult MIA offspring

Answer 14

Changes in peripheral immunity
+ Changes in gut microbiome
= Changes in connection between brain areas:
changes in a disease related circuit
–> changes in immune molecules in the brain & at synapses

~Converges upon the mTOR pathway which leads to synapse formation, growth, translation, survival & autophagy