Maternal Antibodies

Ann Kari Lefvert, Department of Medicine and Immunological Research Laboratory, Karolinska Hospital, Stockholm, Sweden

The fundamental rule of the immune system is to protect against the numerous potential pathogens which are present in the environment. The memory of earlier invasions of pathogens allows the immune system to mount an early and vigorous response when invaded for the second time. Newborn and young are particularly susceptible to infection as the development of the immune system is incomplete and little is committed to immunological memory. To offset this vulnerability the mammalian young benefits from the mother's experience and the newborn is protected from certain diseases by maternal antibodies that are transferred in utero and via the breast milk.

The transferred maternal antibodies can also lead to overt disease in the fetus and newborn child. Examples of this are isoimmunizations and neonatal disease caused by transfer of autoantibodies from mothers having an antibody-mediated autoimmune disease.

There is, however, not only the passive transfer of immunity and the memory of the individual, there is also the memory of the tribe. Early signals reaching the developing immune system strongly influences the functional status of the adult immune network. Such signals are maternal antibodies, self antigens and external antigens that are present during a critical period. A strong analogy is found in the development of the nervous system. The initial system is genetically programmed and the connectance greater than in the corresponding adult system. The final structure and function depends on the selective enhancement and stabilization of some pathways caused by external stimuli. An imprint of the environment is thus integrated into the initial system. Thus, in individuals with the same basic repertoire, the presence of different self antigens, different maternal immunoglobulins and external antigens will drive the immune system into different functional states. The most important functional effect of this prenatal and neonatal priming is the transfer to the child of maternal immunoglobulins representing the mother's immunological memory, thus making the child's immune system ready to react early and vigorously when meeting a pathogen for the first time.

Evidence for the effect of maternal immunity on the immunological competence of the offspring comes from experiments involving foreign as well as self antigens and antibodies. In the case of foreign antigens both enhanced antibody responses and specific hyporesponsiveness have been reported in the progeny of mothers making an immune response during pregnancy. The same fundamentally different effects can be caused by maternal antibodies. In contrast, only relative protection against autoimmunity rather than susceptibility to disease has been described in the very few studies made of the offspring of mothers with autoimmune diseases.

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