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Entwicklung des Immunsystems von Fetus und Neugeborenem

  • E. P. Zilow
  • G. Zilow

Zusammenfassung

Eine wichtige Aufgabe des Immunsystems ist die Abwehr von Krankheitserregern. Mit Beginn der Geburt und manchmal bereits pränatal in utero wird der Mensch mit einer Vielzahl von Mikroorganismen konfrontiert. Diese Mikroorganismen unterscheiden sich in Struktur, Biochemie und ihrer Fähigkeit den Wirt zu besiedeln oder gefährliche Infektionen hervorzurufen. Bei einem Teil der Mikroorganismen besteht eine Symbiose mit dem Wirt. Die normale Bakterienflora z.B. auf Schleimhaut und Haut befindet sich in einem dynamischen, aber stabilen Gleichgewicht und verursacht keine Erkrankung. Dieses Gleichgewicht kann gestört werden und harmlose Mikroorganismen werden pathogen. Diese Störungen können sein: Schädigung der Haut oder Schleimhaut durch Verletzungen (z.B. Durchtrennung der Nabelschnur) oder Ischämie (v. a. des Darmes), Öffnen oder Überbrücken der äußeren Barrieren durch Insertion von Fremdkörpern (venöse Zugänge, Magensonden, endotracheale Intubation), oder Schwächung der Immunabwehr (physiologisch durch Unreife). Sind Bakterien oder Viren über die mechanische Barriere hinweg ins Körperinnere eingedrungen, stehen dem Wirtsorganismus weitere Abwehrmechanismen zur Verfügung. Sie stellen die angeborenen (unspezifischen) sowie die erworbenen (spezifischen) Bestandteile der Immunabwehr dar, die beide sowohl durch humorale als auch zelluläre Kompartimente vermittelt werden (Tabelle 1).

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Literatur

  1. Adinolfi M (1977) Human complement. Onset and site of synthesis during fetal life. Am J Dis Child 131: 1015–1023PubMedGoogle Scholar
  2. Adinolfi M, Beck S (1976) Human complement — C7 and C9 — in fetal and newborn sera. Arch Dis Child 50: 562–564CrossRefGoogle Scholar
  3. Adinolfi M, Gardner B, Wood CBS (1968) Ontogenesis of two components of human complement b 1E and b 1A globulins. Nature 219: 189–191PubMedCrossRefGoogle Scholar
  4. Adinolfi M (1980) Levels of two components of complement (C4 and C3) in human fetal and newborn sera. Dev Med Child Neurol 12: 306–308CrossRefGoogle Scholar
  5. Alford CA, Schaefer J, Blankenship WJ, Straumfjord JV, Cassady G (1967) A correlative immunologic, microbiologic, and clinical approach to the diagnosis of acute and chronic infections in newborn infants. N Engl J Med 277: 437–449PubMedCrossRefGoogle Scholar
  6. Ambruso DR, Altenburger KM, Johnsfon RBJ (1979) Defective oxidative metabolism in newborn neutrophils: Discrepancy between Superoxide anion and hydroxyl radical generation. Pediatrics 64: 722–725PubMedGoogle Scholar
  7. Anderson DC, Hughes BJ, Edwards MS, Buffone GJ, Baker CJ (1983) Impaired chemotaxigenesis by type III group B streptococci in neonatal sera: relationship to diminished concentration of specific anticapsular antibody and abnormalities of serum complement. Pediatr Res 17: 496–502PubMedCrossRefGoogle Scholar
  8. Andersson U, Bird AG, Britton S, Palacios R (1981) Humoral and cellular immunity in humans studied at the cell level from birth to two years of age. Immunol Rev 57: 5–38CrossRefGoogle Scholar
  9. August CS, Berkel AI, Driscoll, S, Merler E (1971) Onset of lymphozyte function in the developing human fetus. Pediatr Res 5: 539–545CrossRefGoogle Scholar
  10. Bach S, Ruddy S, MacLaren AJ (1971) Electrophoretic polymorphism of the fourth component of human complement in paired maternal and fetal plasma. Immunology 21: 869–878PubMedGoogle Scholar
  11. Balla G, Karmazsin L (1983) Evolution of serum C3, IgG, IgA and IgM levels of healty mothers and their mature newborns during the early neonatal period. Acta Paediatr Hung 24(1): 41–51PubMedGoogle Scholar
  12. Ballow M, Fang, Good RA, Day NK (1974) Developmental aspects of complement components in the newborn. Clin Exp Immunol 18: 257–266PubMedGoogle Scholar
  13. Becker ID, Robinson OM, Bazan TS, Lopez-Osuna M, Kretschmer RR (1981) Bactericidal capacity of newborn phagocytes against group B beta-hemolytic streptococci. Infect Immun 34: 535–539PubMedGoogle Scholar
  14. Berger M (1990) Complement deficiency and neutrophil dysfunction as risk factors for bacterial infection in newborns and the role of granulocyte transfusion in therapy. Rev Infect Dis 12: S401–S409PubMedCrossRefGoogle Scholar
  15. Buckley RH, Dees SC, O’Fallon WM (1968) Serum immunoglobulins: I Levels in normal children and in uncomplicated childhood allergy. Pediatrics 41: 600–611PubMedGoogle Scholar
  16. Cates KL, Rowe C, Ballow M (1983) The premature infant as a compromised host. Curr Probl Pediatr 13: 1–63PubMedGoogle Scholar
  17. Chenoweth DE, Hugh TE (1978) Demonstration of specific C5a receptor on intact human polymorphnuclear leukocytes. Proc Natl Acad Sci USA 75: 3343–3349CrossRefGoogle Scholar
  18. Clough JD, Mims LH, Strober W (1971) Deficient IgA antibody responses to arsanilic acid bovine serum albumin (BSA) in neonatally thymectomized rabbits. J Immunol 106: 1624–1629PubMedGoogle Scholar
  19. Christensen RD, Rothstein G (1980) Exhaustion of mature marrow neutrophils in neonates with sepsis. J Pediatr 96: 316–317PubMedCrossRefGoogle Scholar
  20. Christensen RD, Bradley PP, Rothstein G (1981) The leukocyte left shift in clinical and experimental neonatal sepsis. J Pediatr 98: 101–105PubMedCrossRefGoogle Scholar
  21. Colten HR (1976) Biosynthesis of complement. Adv Immunol 22: 67–118PubMedCrossRefGoogle Scholar
  22. Colten HR (1973) Biosynthesis of the fifth component of complement (C5) by human fetal tissues. Clin Immunol Immunopathol 1: 346–352PubMedCrossRefGoogle Scholar
  23. Colten HR (1972) Ontogeny of the human complement system: In vitro biosynthesis of individual complement components of fetal tissues. J Clin Invest 51: 725–730PubMedCrossRefGoogle Scholar
  24. Dosset JH, Williams RC, Quie PG (1969) Studies on interaction of bacteria, serum factors and polymorphnuclear leukocytes in mothers and newborns. Pediatrics 44: 49–57Google Scholar
  25. Fearon DT, Austen KF (1980) Current concepts in immunology. The alternative pathway of complement — A system for host resistance to microbial infection. N Engl J Med 303: 259–263PubMedCrossRefGoogle Scholar
  26. Fireman P, Zuchowski DA, Taylor PM (1965) Development of human complement system. J Immunol 103: 25–31Google Scholar
  27. Ford CE (1966) Traffic of lymphoid cells in the body. In: Wolstenholme GEW, Porter R (eds) The thymus. Experimental and clinical studies. Ciba Foundation Symposium. Little, Brown Boston, pp 131–152Google Scholar
  28. Gallin JI, Rosenthal ASA (1974) The regulatory role of divalent cations in human granulocyte Chemotaxis — Evidence for an association between calcium and microtubule assembly. J Cell Biol 62: 594–609PubMedCrossRefGoogle Scholar
  29. Gathings WE, Lawton AR, Cooper MD (1977) Immunofluorescent studies of the development of pre-B cells, B lymphocytes and immunoglobulin isotype diversity in humans. Eur J Immunol 7: 804–810PubMedCrossRefGoogle Scholar
  30. Gitlin D, Biasucci A (1969) Development of γG, γA, γM, β1C/β1A, C1-esterase inhibitor, ceruloplasmin, transferrin, hemopexin, haptoglobin, fibrinogen, Plasminogen, αl-antitrypsin, orosomucoid, β-lipoprotein, γ2-macroglobulin and prealbumin in human conceptus. J Clin Invest 48: 1433–1446PubMedCrossRefGoogle Scholar
  31. Hayward AR, Lawton AR (1977) Induction of plasma cell differentiation of human fetal lymphocytes: evidence for functional immaturity of T and B cells. J Immunol 119: 1213–1217PubMedGoogle Scholar
  32. Horwitz MA (1982) Phagocytosis of microorganisms. Rev Infect Dis 4: 104–123PubMedCrossRefGoogle Scholar
  33. Jacobs RF, Wilson CB, Palmer S, Springmeyer SC, Henderson WR, et al. (1985) Factors related to the appearance of alveolar macrophages in the developing lung. Am Rev Respir Dis 131: 548–553PubMedGoogle Scholar
  34. Johnston RB, Altenburger KM, Atkinson AW, Curry RH (1979) Complement in the newborn infant. Pediatrics 65: 781–786Google Scholar
  35. Kadowaki J, Zuelzer WW, Brogh AJ, Thomson RI, Wooley PV, Gruber D (1965) XX/XY chimaerism in congenital immunological deficiency syndrome with thymic alymphoplasia. Lancet 2: 1152–1155PubMedCrossRefGoogle Scholar
  36. Kamps WA, Cooper MD (1982) Microenvironmental studies of pre-B and B cell development in human and mouse fetuses. J Immunol 129: 526–531PubMedGoogle Scholar
  37. Köhler PE (1973) Maturation of the complement system. I. Onset time and site of fetal Clq, C4, C3 and C5 synthesis. J Clin Invest 52: 671–677PubMedCrossRefGoogle Scholar
  38. Kretschmer RR, Stewardson PB, Papierniak CK, Gotoff SP, (1976) Chemotactic and bactericidal capacities of human newborn monocytes. J Immunol 117: 1303–1307Google Scholar
  39. Lawton AR, Asofsky R, Hylton MB, Cooper MD (1972) Suppression of immunoglobulin class synthesis in mice: I. Effects of treatment with antibody to μ chain. J Exp Med 135: 277–297PubMedCrossRefGoogle Scholar
  40. Mease AD, Fisher GW, Hunter KW, Roymann FB (1980) Decreased phytohemagglutinin induced aggregation and C5a induced Chemotaxis of human newborn neutrohils. Pediatr Res 14: 142–146PubMedCrossRefGoogle Scholar
  41. Miles AA (1961) The acute reactions of injury as an antimicrobial defense. In: Thomas L, Uhr JW (eds) International Symposium on injury, inflammation and immunity. Williams & Wilkins, Baltimore, pp 162–182Google Scholar
  42. Miller ME (1971) Chemotactic function in the human neonate: humoral and cellular aspects. Pediatr Res 5: 487–492CrossRefGoogle Scholar
  43. Miller ME (1975) Developmental maturation of human neutrophil motility and its relationship to membrane deformability. In: Bellanti JA, Dayton DH (eds) The phagocytic cell in host resistance. Raven, New York, pp 295–307Google Scholar
  44. Miller ME (1979) Phagocyte function in the neonate: selected aspects. Pediatrics 64: 709–712PubMedGoogle Scholar
  45. Mills EL, Thompson T, Bjorkstein B, Filipovich D, Quie PG (1979) The chemiluminescense response and bactericidal activity of polymorphnuclear leukocytes from newborns and their mothers. Pediatrics 63: 429–434PubMedGoogle Scholar
  46. Miyawaki T, Moriya N, Nagaoki T, Taniguchi N (1981) Maturation of B cell differentiation ability and T cell regulatory function in infancy and childhood. Immunol Rev 57: 61–87PubMedCrossRefGoogle Scholar
  47. Moore MAS, Owen JJT (1967) Stern cell migration in developing lympoid systems. Lancet 2: 658–659CrossRefGoogle Scholar
  48. Notarangelo LD, Chirico G, Chiara A et al. (1984) Activity of classical and alternative pathways of complement in preterm and small for gestational age infants. Pediatr Res 18: 281–285PubMedCrossRefGoogle Scholar
  49. Olding LB, Oldstone MBA (1976) Thymus-derived peripheral lymphocytes from human newborns inhibit division of their mothers lymphocytes. J Immunol 116: 682–686PubMedGoogle Scholar
  50. Pahwa S, Pahwa R, Grimes E, Smithwick E (1977) Cellular and humoral components of monocyte and neutrophil Chemotaxis in cord blood. Pediatr Res 11: 677–680PubMedCrossRefGoogle Scholar
  51. Propp RP, Alper CA (1968) C3 synthesis in the human fetus and lack of transplacental passage. Science 162: 611–612CrossRefGoogle Scholar
  52. Ragunathan R, Miller ME, Evere HS, Leake RD (1982) Phagocyte Chemotaxis in the perinatal period. J Clin Immunol 2: 242–245CrossRefGoogle Scholar
  53. Root RK, Cohen MS (1981) The microbicidal mechanisms of human neutrophils and eosinophils. Rev Infect Dis 3: 565–598PubMedCrossRefGoogle Scholar
  54. Ruddy S, Klemperer MR, Rosen FS et al. (1970) Hereditary deficiency of the second component of complement (C2) in man: correlation of C2 haemolytic activity with immunochemical measurements of C2 protein. Immunology 18: 943–954PubMedGoogle Scholar
  55. Sacchi F, Rondini G, Mingrat G (1982) Different maturation of neutrophil Chemotaxis in term and premature newborn infants. J Pediatr 101: 273–274PubMedCrossRefGoogle Scholar
  56. Schuit KE, DeBiasio R (1980) Kinetics of phagocyte response to group B streptococcal infection in newborn rats. Infect Immun 28: 319–324PubMedGoogle Scholar
  57. Seligmann B, Gallin E, Martin D et al. (1980) Interaction of chemotactic factors with human polymorphnuclear leukocytes: studies using a membrane potential sensitive cyanine dye. J Membr Biol 52: 257–272PubMedCrossRefGoogle Scholar
  58. Shigeoka AO, Santos JI, Hill HR (1979) Functional analysis of neutrophil granulocytes from healthy, infected and stressed neonates. J Pediatr 95: 454–460PubMedCrossRefGoogle Scholar
  59. Shigeoka AO, Charette RP, Wyman ML, Hill HR (1981) Defective oxidative responses of neutrophils from stressed neonates. J Pediatr 98: 392–398PubMedCrossRefGoogle Scholar
  60. Synderman R, Pike MC (1984) Chemoattractant receptors on phagocytic cells. Ann Rev Immunol 2: 257–281CrossRefGoogle Scholar
  61. Speer CP, Ambruso DR, Grimsley S, Johnston RB (1985) Oxydative metabolism in cord blood monocytes and monocyte derived macrophages. Infect Immun 50: 919–921PubMedGoogle Scholar
  62. Spitzer RE (1977) The Complement system. Pediatr Clin North Am 24: 341–364PubMedGoogle Scholar
  63. Stroobant J, Harris MC, Cody CS (1983) Diminished bactericidal capacity for group B streptococci of neutrophils from children with chronic granulomatous disease. Infect Immun 39: 966–969PubMedGoogle Scholar
  64. Tosato G, Magrath IT, Koski IR, Dooley NJ, Blaese RM (1980) B cell differentiation and immunoregulatory T cell function in human cord blood lymphocytes. J Clin Invest 66: 383–388PubMedCrossRefGoogle Scholar
  65. White JR, Naccache PH, Molski TPF (1983) Direct demonstration of increased intracellular concentration of free calcium in rabbit and human neutrophils following stimulation by chemotactic factors. Biochem Biophys Res Commun 113: 44–50PubMedCrossRefGoogle Scholar
  66. Williams LT, Snyderman R, Pike MC (1977) Specific receptor sites for chemotactic peptides on human polymorphnuclear leukocytes. Proc Natl Acad Sci USA 74: 1204–1208PubMedCrossRefGoogle Scholar
  67. Wilson CB (1984) Lung antimicrobial defenses in the newborn. Semin Respir Med 6: 149–156CrossRefGoogle Scholar
  68. Wilson CB, Weaver WM (1985) Comparative susceptibility of group B streptococci and Staphyllococcus aureus to killing by oxygen metabolites. J Infect Dis 152: 323–329PubMedCrossRefGoogle Scholar
  69. Wu LYF, Lawton AR, Cooper MD (1973) Differentiation capacity of cultured B lymphocytes from immunodeficient patients. J Clin Invest 52: 3180–3189PubMedCrossRefGoogle Scholar
  70. Zach TL, Hostetter MK (1989) Biochemical abnormalities of the third complement in neonates. Pediatr Res 26: 116–120PubMedCrossRefGoogle Scholar
  71. Zilow G, Zilow EP, Burger R, Linderkamp O (1993) Complement activation in newborn infants with early onset infection. Pediatr Res 34: 199–203PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1994

Authors and Affiliations

  • E. P. Zilow
  • G. Zilow

There are no affiliations available

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