Neonatal Immunity (Contemporary Immunology) - Hardcover

Bona, Constantin

Hardcover

ISBN 10: 158829319X ISBN 13: 9781588293190

Publisher: Humana, 2004

Synopsis

A critical review of the classic, as wells as most recent-and quite seminal-findings concerning the phenotypic and molecular characteristics of both fetal and neonatal B and T cells, the cells that mediate antibody and cellular immune responses in newborns and infants. Dr. Bona shows how the antibody response of neonates is modulated by maternal antibodies and how, in certain cases, this can cause transient or life-threatening neonatal autoimmune disease. He also describes the characteristics of neonatal tolerance induced by foreign allo- and self-antigens, which are the basis for understanding impaired infant immune response and which provide a rationale for the development of efficient neonatal vaccines. By making clear the characteristics and differences between the immune system and the immune responses of both newborns and infants, compared to those of adults, Dr. Bona offers insights and challenging hypotheses that promise to help overcome the poor responses of neonates to various antigens.

About this title

From the Back Cover

New advances in cellular immunology, molecular biology, recombinant DNA and proteins, and the function of cytokines and chemokines have revolutionized the study of neonatal immune responsiveness. In Neonatal Immunity, Constantin Bona, MD, critically reviews the classic, as well as most recent-and quite seminal-findings concerning the phenotypic and molecular characteristics of both fetal and neonatal B and T cells, the cells that mediate antibody and cellular immune responses in newborns and infants. Dr. Bona shows how the antibody response of neonates is modulated by maternal antibodies and how, in certain cases, this can cause transient or life-threatening neonatal autoimmune disease. He also describes the characteristics of neonatal tolerance induced by foreign allo- and self-antigens, which are the basis for understanding impaired infant immune response and which provide a rationale for the development of efficient neonatal vaccines. By making clear the characteristics and differences between the immune system and the immune responses of both newborns and infants, compared to those of adults, Dr. Bona offers insights and challenging hypotheses that promise to help overcome the poor responses of neonates to various antigens.
Authoritative and forward-looking, Neonatal Immunity critically reviews what we know of the neonatal immune response today, and how this is dramatically opening new therapeutic horizons in such areas as infant vaccination, stem cells, gene therapy, and transplantation.

Reviews

During the past 50 years, the field of neonatal immunology has been influenced by such dogmas as "The neonatal age is a window of time when tolerance develops," and "Neonatal immune cells are unresponsive because they are immature." Yet, many questions have been left unanswered: What type of antigen induces immunologic tolerance instead of immunity in neonates? Are neonatal immune cells truly immature? How does neonatal immunity differ from adult immunity? How can safe and effective vaccines for neonates be created? Constantin Bona addresses some of these questions in this book. After an introduction outlining the elements of the immune system, Bona devotes a remarkable chapter to the ontogeny and development of immune cells. The central point of this chapter is that all cells that mediate innate and adaptive immunity originate from the hematopoietic stem cell and develop through a multistep process involving various cytokines and signaling pathways. The idea that hematopoietic stem cells derive only from the yolk sac is refuted by observations that these cells also originate within the embryo. This is true not only for humans but also for other mammals, fish, birds, and amphibians. The reader will welcome two figures that skillfully summarize this valuable chapter. Neonatal B and T cells then take the stage. There are subtle differences in the signaling pathways between neonatal and adult B and T cells, whereas the expression of the antigen receptor and costimulatory molecules is similar in neonatal and adult cells. The sequential activation of B-cell precursors during fetal and neonatal life is antigen-independent and genetically programmed by an "internal clock." Mature and functional B and T cells are present in the fetuses and infants of many mammals, but their repertoire of antigen receptors is more restricted than it is in adults. In a section on the effects of maternal antibodies on infants, Bona cautions that such antibodies are beneficial in conferring passive immunity but interfere with active immunization of infants. Maternal transfer of autoantibodies can also cause severe autoimmune diseases in infants. DNA immunization of newborns circumvents the inhibitory effect of maternal antibodies on cellular and humoral responses. Frequent references to the idiotypic network in the regulation of responses of B and T cells in neonates, and to DNA immunization as a successful vaccine tool, reflect the direct interest and expertise of the author. Although there is evidence to the contrary, Bona describes the cytokine network in neonates by supporting the thesis that T cells in newborn humans and mice are biased to synthesize cytokines produced by type 2 helper T cells. It is interesting to note Bona's acknowledgment of functional type 1 helper T cells in neonatal lymphoid organs. The cytokine microenvironment and the antigen dose and delivery also influence how neonatal T lymphocytes generate effector and memory functions of cytotoxic T lymphocytes. A chapter on neonatal tolerance discusses basic notions of clonal deletion, anergy, and suppression of B and T cells. Bona concludes with a detailed review of existing prophylactic and therapeutic vaccines for neonates. This book is written for immunologists; it is up to date, and the references are comprehensive. Minor shortcomings include imprecise writing, which makes for difficult reading in a few instances; the number of figures and summary charts, which could be greater; and the language used in many sections, which is too specialized for a general audience, although helpful summary sentences recapitulate the main messages. Notwithstanding these minor limitations, I recommend this book as an excellent source of both old and cutting-edge information on neonatal immunity. Marcella Sarzotti, Ph.D.
Copyright © 2005 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Edition details

• Publisher: Humana
• Publication date: 2004
• Language: English
• ISBN 10: 158829319X
• ISBN 13: 9781588293190
• Binding: Hardcover
• Number of pages: 401