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Authors
Abstract(s)
Introdução: A Perturbação do Espetro do Autismo (PEA) é uma doença do
neurodesenvolvimento de etiologia multifatorial e regista uma prevalĂȘncia de 1 em 100
pessoas, segundo a Organização Mundial de SaĂșde. Nas Ășltimas dĂ©cadas observou-se um
aumento do nĂșmero de grĂĄvidas com algum tipo de doença crĂłnica, estando as doenças
autoimunes entre as doenças preexistentes mais comuns na gravidez. Os mecanismos de
inflamação crónica sistémica, associados às doenças autoimunes, podem resultar no
aumento de doenças inflamatĂłrias na geração seguinte, com possĂveis consequĂȘncias no
neurodesenvolvimento da descendĂȘncia.
Objetivos: Nesta dissertação pretende-se explorar a associação entre as doenças
autoimunes maternas e o risco de desenvolvimento de PEA, sendo ainda relevante
compreender os mecanismos envolvidos nesta associação e quais as terapĂȘuticas futuras,
de forma a reduzir a PEA na descendĂȘncia, de mĂŁes portadoras de doenças autoimunes.
MĂ©todos: Procedeu-se Ă pesquisa, entre junho e novembro de 2022, de artigos
cientĂficos, utilizando como motor de pesquisa, a Pubmed e as seguintes palavras-chave:
âautismâ, âautoimmune diseasesâ, âmaternal immune activationâ, âpregnancyâ,
âmaternal autoantibodiesâ. Foram tambĂ©m usados como complemento websites, livros de
referĂȘncia mĂ©dica e guidelines nacionais e internacionais.
Resultados: A teoria de ativação imune materna (AIM) é uma hipótese que procura
explicar a relação entre um estado inflamatório crónico durante a gravidez e o
desenvolvimento de perturbaçÔes do neurodesenvolvimento na descendĂȘncia. Segundo
esta, triggers durante a gravidez, como, as doenças autoimunes, tĂȘm a capacidade de
desencadear uma resposta inflamatĂłria, envolvendo citocinas como a IL-17A e IL-6, o que
pode levar a uma resposta imunolĂłgica materna exacerbada e prejudicial para o feto.
Embora ainda nĂŁo sejam conhecidos os mecanismos exatos, acredita-se que a AIM seja
responsĂĄvel por provocar alteraçÔes na microglia e desencadear nesta uma possĂvel
resposta inflamatĂłria excessiva, o que pode resultar em danos no desenvolvimento
cerebral do feto. No que diz respeito Ă terapĂȘutica disponĂvel, Ă© necessĂĄrio o
desenvolvimento de estratĂ©gias terapĂȘuticas eficazes preventivas da PEA.
ConclusĂŁo: ApĂłs anĂĄlise de diversos artigos, foi constatado que existe uma forte
associação entre doenças autoimunes maternas e o desenvolvimento de perturbaçÔes do
neurodesenvolvimento na descendĂȘncia, em especial a PEA.
Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder of multifactorial etiology with a prevalence of 1 in 100 people, according to the World Health Organization. In recent decades, an increase in the number of pregnant women with some type of chronic disease has been observed, with autoimmune diseases being among the most common pre-existing diseases in pregnancy. The mechanisms of chronic systemic inflammation, associated with autoimmune diseases, may result in increased inflammatory diseases in the next generation, with possible consequences on neurodevelopment of the offspring. Objectives: This dissertation aims to explore the association between maternal autoimmune diseases and the risk of developing ASD, as well as to understand the mechanisms involved in this association and future therapies to reduce ASD in the offspring of mothers with autoimmune diseases. Methods: Between June and November 2022, scientific articles were searched using Pubmed as a search engine and the following keywords: "autism", "autoimmune diseases", "maternal immune activation", "pregnancy", "maternal autoantibodies". Websites, medical reference books, and national and international guidelines were also used as a complement. Results: The maternal immune activation theory (MIA) is a hypothesis that seeks to explain the relationship between a chronic inflammatory state during pregnancy and the development of neurodevelopmental disorders in the offspring. According to this, triggers during pregnancy, such as autoimmune diseases, can trigger an inflammatory response, involving cytokines such as IL-17A and IL-6, which can lead to an exacerbated maternal immune response that is harmful to the fetus. Although the exact mechanisms are not yet known, it is believed that MIA is responsible for causing changes in microglia and triggering in them a possible excessive inflammatory response, which may result in damage to the developing brain of the fetus. As far as available therapeutics are concerned, the development of effective preventive therapeutic strategies for ASD is needed. Conclusion: After reviewing several articles, it was found that there is a strong association between maternal autoimmune diseases and the development of neurodevelopmental disorders in the offspring, especially ASD.
Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder of multifactorial etiology with a prevalence of 1 in 100 people, according to the World Health Organization. In recent decades, an increase in the number of pregnant women with some type of chronic disease has been observed, with autoimmune diseases being among the most common pre-existing diseases in pregnancy. The mechanisms of chronic systemic inflammation, associated with autoimmune diseases, may result in increased inflammatory diseases in the next generation, with possible consequences on neurodevelopment of the offspring. Objectives: This dissertation aims to explore the association between maternal autoimmune diseases and the risk of developing ASD, as well as to understand the mechanisms involved in this association and future therapies to reduce ASD in the offspring of mothers with autoimmune diseases. Methods: Between June and November 2022, scientific articles were searched using Pubmed as a search engine and the following keywords: "autism", "autoimmune diseases", "maternal immune activation", "pregnancy", "maternal autoantibodies". Websites, medical reference books, and national and international guidelines were also used as a complement. Results: The maternal immune activation theory (MIA) is a hypothesis that seeks to explain the relationship between a chronic inflammatory state during pregnancy and the development of neurodevelopmental disorders in the offspring. According to this, triggers during pregnancy, such as autoimmune diseases, can trigger an inflammatory response, involving cytokines such as IL-17A and IL-6, which can lead to an exacerbated maternal immune response that is harmful to the fetus. Although the exact mechanisms are not yet known, it is believed that MIA is responsible for causing changes in microglia and triggering in them a possible excessive inflammatory response, which may result in damage to the developing brain of the fetus. As far as available therapeutics are concerned, the development of effective preventive therapeutic strategies for ASD is needed. Conclusion: After reviewing several articles, it was found that there is a strong association between maternal autoimmune diseases and the development of neurodevelopmental disorders in the offspring, especially ASD.
Description
Keywords
Ativação Imune Materna Autismo DescendĂȘncia Doenças Autoimunes Gravidez