Pathogens and the placental fortress

Curr Opin Microbiol. 2012 Feb;15(1):36-43. doi: 10.1016/j.mib.2011.11.006. Epub 2011 Dec 12.


Placental infections are major causes of maternal and fetal disease. This review introduces a new paradigm for placental infections based on current knowledge of placental defenses and how this barrier can be breached. Transmission of pathogens from mother to fetus can occur at two sites of direct contact between maternal cells and specialized fetal cells (trophoblasts) in the human placenta: firstly, maternal immune and endothelial cells juxtaposed to extravillous trophoblasts in the uterine implantation site and secondly, maternal blood surrounding the syncytiotrophoblast (SYN). Recent findings suggest that the primary vulnerability is in the implantation site. We explore evidence that the placental SYN evolved as a defense against pathogens, and that inflammation-mediated spontaneous abortion may benefit mother and pathogen.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Abortion, Septic / immunology
  • Abortion, Septic / microbiology
  • Abortion, Septic / parasitology
  • Bacterial Infections / immunology*
  • Bacterial Infections / microbiology
  • Bacterial Infections / pathology
  • Female
  • Humans
  • Placenta / immunology*
  • Placenta / microbiology
  • Placenta / parasitology
  • Pregnancy
  • Pregnancy Complications, Infectious / immunology*
  • Pregnancy Complications, Infectious / microbiology*
  • Pregnancy Complications, Infectious / parasitology
  • Pregnancy Complications, Parasitic / immunology*
  • Pregnancy Complications, Parasitic / parasitology*
  • Protozoan Infections / immunology*
  • Protozoan Infections / parasitology
  • Protozoan Infections / pathology
  • Trophoblasts / immunology