妊娠寨卡病毒感染对胎儿脑/神经系统发育的影响

The Effects of Zika Virus Infection on Fetal Brain and Nervous System Development during Pregnancy

近年来,南美洲寨卡病毒(Zika virus)流行,同时该地区吉兰-巴雷综合征(Guillain-Barrésyndrome)、新生儿小头畸形发病率明显升高。截至2016年3月,疫情共波及美洲33个国家和地区,超过19万人疑似感染。另外,欧洲、亚洲诸国也均有输入性病例的报道。妊娠寨卡病毒感染与胎儿神经系统发育异常存在着高度的相关性,这已引起了全球范围的密切关注。寨卡病毒影响胎儿神经系统发育的机制可分为直接和间接两条途径:1寨卡病毒可通过血-胎盘屏障,且病毒具有嗜神经性,直接影响胎儿的神经系统发育;2寨卡病毒通过其他介质间接影响胎儿的神经系统发育,如通过胎儿炎症反应介质或免疫交叉反应产生的抗体等。虽然具体机制目前尚未完全明确,但现阶段及时阐明妊娠寨卡病毒感染对胎儿神经系统发育的影响及防控该病毒在中国境内的传播,将具有极为重要的临床意义和长远的社会意义。

In recent years, the Zika virus outbreak is ongoing in South-America, followed by increasing morbidity of neurological disorders, including Guillain-Barré syndrome and congenital microcephaly. By the end of March, 2016, thirty-three countries in America were involved, with suspected cases over 190 000. Besides, imported cases have also been reported in Europe and Asia. The correlation between Zika virus infection during the pregnancy and fetal neurogenesis defects raises global severe concern immediately. The potential mechanism can be divided into two pathways： 1 The blood-placenta barrier may be penetrated by Zika virus and the virus has a characteristic of neurotropism. Subsequently Zika virus can impair neurogenesis directly. 2 Zika virus might disrupt fetal neurogenesis indirectly by other mediators, such as fetal inflammatory cytokines or antibodies in cross-immune response. Although the precise mechanism has not been completely elucidated yet, to review the effects of Zika virus infection in pregnancy on fetal neurogenesis promptly as well as the prevention and control of Zika virus outbreak in our country will have both critical clinical and long-term social significances.