Maternal immune activation and abnormal brain development across CNS disorders

Nat Rev Neurol. 2014 Nov;10(11):643-60. doi: 10.1038/nrneurol.2014.187. Epub 2014 Oct 14.

Abstract

Epidemiological studies have shown a clear association between maternal infection and schizophrenia or autism in the progeny. Animal models have revealed maternal immune activation (mIA) to be a profound risk factor for neurochemical and behavioural abnormalities in the offspring. Microglial priming has been proposed as a major consequence of mIA, and represents a critical link in a causal chain that leads to the wide spectrum of neuronal dysfunctions and behavioural phenotypes observed in the juvenile, adult or aged offspring. Such diversity of phenotypic outcomes in the mIA model are mirrored by recent clinical evidence suggesting that infectious exposure during pregnancy is also associated with epilepsy and, to a lesser extent, cerebral palsy in children. Preclinical research also suggests that mIA might precipitate the development of Alzheimer and Parkinson diseases. Here, we summarize and critically review the emerging evidence that mIA is a shared environmental risk factor across CNS disorders that varies as a function of interactions between genetic and additional environmental factors. We also review ongoing clinical trials targeting immune pathways affected by mIA that may play a part in disease manifestation. In addition, future directions and outstanding questions are discussed, including potential symptomatic, disease-modifying and preventive treatment strategies.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alzheimer Disease / epidemiology
  • Alzheimer Disease / immunology
  • Animals
  • Brain / embryology*
  • Brain / immunology
  • Central Nervous System Diseases / epidemiology*
  • Central Nervous System Diseases / immunology
  • Cerebral Palsy / epidemiology
  • Cerebral Palsy / immunology
  • Child Development Disorders, Pervasive / epidemiology
  • Child Development Disorders, Pervasive / immunology
  • Female
  • Humans
  • Parkinson Disease / epidemiology
  • Parkinson Disease / immunology
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology*
  • Pregnancy Complications, Infectious / immunology
  • Prenatal Exposure Delayed Effects / epidemiology*
  • Prenatal Exposure Delayed Effects / immunology
  • Schizophrenia / epidemiology
  • Schizophrenia / immunology