生物谷：经过数年的研究，中美医学家首次证明胎儿具有自主免疫应答能力。国际医学界认为，这改变了国际医学界50多年来认为胎儿不具有同成人一样具有精细免疫应答能力的观点，并为妊娠期的早期疫苗接种提供了理论依据，这将对全球公共卫生领域产生极为重要的影响。
在今年6月，江西省人民医院留美归国学者王朝东和美国哥伦比亚大学内科系的米勒（RachelMiller）教授在美国的国际著名医学研究专业期刊《临床研究杂志》发表了题为《针对流感疫苗的子宫内抗原特异性免疫应答》的论文。这一研究取得了重大理论突破：它在国际上首次证实了人体在胚胎发育的早期阶段，就可以对母体环境中的诸多抗原、过敏原和病原体产生主动免疫应答，且产生免疫记忆。
王朝东介绍，这一结论是通过在两年时间内对126名欧美裔孕妇进行研究得出的，它证实了在胎儿发育至28－30周期间，通过对研究对象注射流感疫苗等方式，可以帮助胎儿获得相应的免疫能力。这一研究将对公共卫生领域产生极为重要的影响，改变了以往国际医学界不提倡给孕妇注射疫苗的普遍观点。
鉴于成果的重要性，英、美国际顶尖科学杂志《自然》《科学》，已经在其官方网站的科技新闻显要位置报道和评价了这一重要研究成果。国际医学专家据此认为，胎儿在早期发育阶段免疫系统尚未成熟，母体所接触的环境因素可以“塑造”胎儿的免疫系统，并影响其出生后及成年期的免疫应答能力和方式。这一理论为众多免疫相关性疾病，如过敏、哮喘、自身免疫病及肿瘤等的早期发病机制研究，开辟了全新的研究方向；同时，将有助于在公共卫生领域将免疫接种时间提前至胎儿时期，更为困扰全球的甲肝、乙肝和流感等流行性疾病的预防开辟了新的研究方向。
目前，中美医学界将继续开展相关研究。王朝东表示，将联合国内外医学研究机构，开展与此相关的多中心、大样本、大人群的可行性和安全性研究，并希望将研究成果早日推广到临床及公共卫生预防领域。（引自新华网）
原始出处:
J. Clin. Invest. 117:1637-1646 (2007). doi:10.1172/JCI29466.
Copyright ©2007 by the American Society for Clinical Investigation
Antigen-specific immune responses to influenza vaccine in utero
Deepa Rastogi1, Chaodong Wang2, Xia Mao3, Cynthia Lendor3, Paul B. Rothman4 and Rachel L. Miller3
1Children’s Hospital at Montefiore, Albert Einstein College of Medicine, New York, New York, USA. 2Department of Neurology, Jiangxi Provincial People’s Hospital, Nanchang, People’s Republic of China. 3Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA. 4Department of Internal Medicine, University of Iowa, Iowa City, Iowa, USA.
Address correspondence to: Rachel L. Miller, PH8C, Columbia University College of Physicians and Surgeons, 630 W. 168th Street, New York, New York 10032, USA. Phone: (212) 305-7759; Fax: (212) 305-2277; E-mail: rlm14@columbia.edu .
Received for publication June 21, 2006, and accepted in revised form April 9, 2007.
Initial immune responses to allergens may occur before birth, thereby modulating the subsequent development of atopy. This paradigm remains controversial, however, due to the inability to identify antigen-specific T cells in cord blood. The advent of MHC tetramers has revolutionized the detection of antigen-specific T cells. Tetramer staining of cord blood after CMV infection has demonstrated that effective CD8+ antigen-specific immune responses can follow intrauterine viral infections. We hypothesized that sensitization to antigens occurs in utero in humans. We studied cord blood B and T cell immune responses following vaccination against influenza during pregnancy. Anti-Fluzone and anti-matrix protein IgM antibodies were detected in 38.5% (27 of 70) and 40.0% (28 of 70), respectively, of cord blood specimens. Using MHC tetramers, HA-specific CD4+ T cells were detected among 25.0% (3 of 12) and 42.9% (6 of 14) of cord blood specimens possessing DRB1*0101 and DRB1*0401 HLA types, respectively, and were detected even when the DRB1 HLA type was inherited from the father. Matrix protein–specific CD8+ T cells were detected among 10.0% (2 of 20) of HLA-A*0201+ newborns. These results suggest that B and T cell immune responses occur in the fetus following vaccination against influenza and have important implications for determining when immune responses to environmental exposures begin.
