Maternal vaccination to prevent adverse pregnancy outcomes

TY - JOUR

T1 - Maternal vaccination to prevent adverse pregnancy outcomes

T2 - An underutilized molecular immunological intervention?

AU - Giles, Michelle L

AU - Sing Way, Sing

AU - Marchant, Arnaud

AU - Aghaepour, Nima

AU - James, Tomin

AU - Schaltz-Buchholzer, Frederik

AU - Zazara-Giannou, Dimitra

AU - Arck, Petra

AU - Kollmann, Tobias R

N1 - Copyright © 2023. Published by Elsevier Ltd.

PY - 2023/7/1

Y1 - 2023/7/1

N2 - Adverse pregnancy outcomes including maternal mortality, stillbirth, preterm birth, intrauterine growth restriction cause millions of deaths each year. More effective interventions are urgently needed. Maternal immunization could be one such intervention protecting the mother and newborn from infection through its pathogen-specific effects. However, many adverse pregnancy outcomes are not directly linked to the infectious pathogens targeted by existing maternal vaccines but rather are linked to pathological inflammation unfolding during pregnancy. The underlying pathogenesis driving such unfavourable outcomes have only partially been elucidated but appear to relate to altered immune regulation by innate as well as adaptive immune responses, ultimately leading to aberrant maternal immune activation. Maternal immunization, like all immunization, impacts the immune system beyond pathogen-specific immunity. This raises the possibility that maternal vaccination could potentially be utilised as a pathogen-agnostic immune modulatory intervention to redirect abnormal immune trajectories towards a more favourable phenotype providing pregnancy protection. In this review we describe the epidemiological evidence surrounding this hypothesis, along with the mechanistic plausibility and present a possible path forward to accelerate addressing the urgent need of adverse pregnancy outcomes.

AB - Adverse pregnancy outcomes including maternal mortality, stillbirth, preterm birth, intrauterine growth restriction cause millions of deaths each year. More effective interventions are urgently needed. Maternal immunization could be one such intervention protecting the mother and newborn from infection through its pathogen-specific effects. However, many adverse pregnancy outcomes are not directly linked to the infectious pathogens targeted by existing maternal vaccines but rather are linked to pathological inflammation unfolding during pregnancy. The underlying pathogenesis driving such unfavourable outcomes have only partially been elucidated but appear to relate to altered immune regulation by innate as well as adaptive immune responses, ultimately leading to aberrant maternal immune activation. Maternal immunization, like all immunization, impacts the immune system beyond pathogen-specific immunity. This raises the possibility that maternal vaccination could potentially be utilised as a pathogen-agnostic immune modulatory intervention to redirect abnormal immune trajectories towards a more favourable phenotype providing pregnancy protection. In this review we describe the epidemiological evidence surrounding this hypothesis, along with the mechanistic plausibility and present a possible path forward to accelerate addressing the urgent need of adverse pregnancy outcomes.

U2 - 10.1016/j.jmb.2023.168097

DO - 10.1016/j.jmb.2023.168097

M3 - SCORING: Review article

C2 - 37080422

VL - 435

JO - J MOL BIOL

JF - J MOL BIOL

SN - 0022-2836

IS - 13

M1 - 168097

ER -