Biomaterial Database

Smallpox infections during pregnancy, lessons on pathogenesis from nonpregnant animal models of infection. 2003

Daniel E Hassett

The Scripps Research Institute CVN-9, 10550 North Torrey Pines Road, La Jolla, CA 92037, USA. dhassett@scripps.edu

Both vaccinated and unvaccinated women during pregnancy who contract variola virus, the causative agent of smallpox, suffer much higher mortality rates than nonpregnants. Furthermore, acute maternal smallpox leads to spontaneous abortion, premature termination of pregnancy and early postnatal infant mortality. The mechanisms governing the abortifacient activity of smallpox, as well as the enhanced susceptibility of gestating women to lethal disease, have remained largely unexamined. Experimental poxvirus infections in nonpregnant small animal models have revealed that T helper type 1 (TH1) cytokines promote efficient resolution of these infections whereas type 2 (TH2) cytokines enhance viral pathogenesis. These data, combined with recent understanding of how the immune system is modulated by pregnancy, may offer important clues as to the increased pathogenesis of variola in pregnant women. The aim of this review is to bring together the current literature on the effects of poxvirus infections in nonpregnant hosts, as well as the effects of pregnancy on the immune system, in order to develop unifying concepts that may provide insight into the pathogenesis of variola during pregnancy and why prior vaccination with vaccinia virus the live anti-variola vaccine offers less protection to pregnant women and their unborn children.

UI	MeSH Term	Description	Entries
D011212	Poxviridae	A family of double-stranded DNA viruses infecting mammals (including humans), birds and insects. There are two subfamilies: CHORDOPOXVIRINAE, poxviruses of vertebrates, and ENTOMOPOXVIRINAE, poxviruses of insects.	Poxviruses
D011247	Pregnancy	The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.	Gestation,Pregnancies
D011251	Pregnancy Complications, Infectious	The co-occurrence of pregnancy and an INFECTION. The infection may precede or follow FERTILIZATION.	Complications, Infectious Pregnancy,Infectious Pregnancy Complications,Maternal Sepsis,Pregnancy, Infectious Complications,Sepsis during Pregnancy,Sepsis in Pregnancy,Infectious Pregnancy Complication,Pregnancy Complication, Infectious,Sepsis in Pregnancies,Sepsis, Maternal
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818	Animals	Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA.	Animal,Metazoa,Animalia
D012899	Smallpox	An acute, highly contagious, often fatal infectious disease caused by an orthopoxvirus characterized by a biphasic febrile course and distinctive progressive skin eruptions. Vaccination has succeeded in eradicating smallpox worldwide. (Dorland, 28th ed)	Alastrim,Variola,Variola Minor,Minor, Variola,Minors, Variola,Variola Minors,Variolas
D012900	Smallpox Vaccine	A VACCINIA VIRUS vaccine used for immunization against SMALLPOX. It is now recommended only for laboratory workers exposed to SMALLPOX VIRUS. Certain countries continue to vaccinate those in the military service. Rare complications most often associated with older generation smallpox vaccines include VACCINIA, secondary bacterial infections, and ENCEPHALOMYELITIS. Because MONKEYPOX VIRUS and SMALLPOX VIRUS are both ORTHOPOXVIRUS and are closely related smallpox vaccines provide effective CROSS-PROTECTION against MPOX (MONKEYPOX) (https://www.cdc.gov/poxvirus/monkeypox/clinicians/smallpox-vaccine.html).	Monkey Pox Vaccine,Monkeypox Vaccine,Monkeypox and Smallpox Vaccine,Mpox Vaccine,Mpox and Smallpox Vaccine,Small Pox Vaccine,Smallpox and Monkeypox Vaccine,Smallpox and Mpox Vaccine,Vaccinia Vaccine,Vaccine, Monkey Pox,Vaccine, Monkeypox,Vaccine, Mpox,Vaccine, Small Pox,Vaccine, Smallpox,Vaccine, Vaccinia
D016207	Cytokines	Non-antibody proteins secreted by inflammatory leukocytes and some non-leukocytic cells, that act as intercellular mediators. They differ from classical hormones in that they are produced by a number of tissue or cell types rather than by specialized glands. They generally act locally in a paracrine or autocrine rather than endocrine manner.	Cytokine
D051379	Mice	The common name for the genus Mus.	Mice, House,Mus,Mus musculus,Mice, Laboratory,Mouse,Mouse, House,Mouse, Laboratory,Mouse, Swiss,Mus domesticus,Mus musculus domesticus,Swiss Mice,House Mice,House Mouse,Laboratory Mice,Laboratory Mouse,Mice, Swiss,Swiss Mouse,domesticus, Mus musculus