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Prophylactic and treatment strategies. Effective prophylactic and treatment strategies for potential risks of offspring's neuropsychiatric disorders in pregnant women during the COVID-19 pandemic.
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During the Coronavirus disease 2019 (COVID-19) pandemic, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is universally susceptible to all types of populations. In addition to the elderly and children becoming the groups of great concern, pregnant women carrying new lives need to be even more alert to SARS-CoV-2 infection. Studies have...
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... adverse reactions in pregnant women after receiving the COVID-19 vaccine [56], a vaccine with nutritional support seems to be an effective approach. For pregnant women who have already developed psychological problems, appropriate use of drug medication and psychological treatment are recommended and prescribed under the guidance of physicians (Fig. ...
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Mother-to-child transmission of SARS-CoV-2 has been reported since the onset of the COVID-19 pandemic. We conducted a study to summarize evidence on the risk of mother-to-child transmission in the first 30 days after birth in high-income countries and to evaluate the association between preventive measures and the risk of infection for the neonate....
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... Various factors, such as infections, immune challenges, stress, and environmental exposures during pregnancy, can trigger an immune response in the mother (Fig. 5). There are significant concerns regarding the potential impact of maternal infection of COVID-19 on the development of neuropsychiatric disorders in offspring [194][195][196][197]. It remains unclear whether maternal immune activation can affect the vaginal microbiota in pregnant women. ...
The human body harbors a diverse ecosystem of microorganisms, including bacteria, viruses, and fungi, collectively known as the microbiota. Current research is increasingly focusing on the potential association between the microbiota and various neuropsychiatric disorders. The microbiota resides in various parts of the body, such as the oral cavity, nasal passages, lungs, gut, skin, bladder, and vagina. The gut microbiota in the gastrointestinal tract has received particular attention due to its high abundance and its potential role in psychiatric and neurodegenerative disorders. However, the microbiota presents in other body tissues, though less abundant, also plays crucial role in immune system and human homeostasis, thus influencing the development and progression of neuropsychiatric disorders. For example, oral microbiota imbalance and associated periodontitis might increase the risk for neuropsychiatric disorders. Additionally, studies using the postmortem brain samples have detected the widespread presence of oral bacteria in the brains of patients with Alzheimer's disease. This article provides an overview of the emerging role of the host microbiota in neuropsychiatric disorders and discusses future directions, such as underlying biological mechanisms, reliable biomarkers associated with the host microbiota, and microbiota-targeted interventions, for research in this field.
... Despite ongoing debates, it has been generally accepted that SARS-COV-2 can be vertically transmitted during pregnancy (5.3%) and can result in neurological manifestation upon birth (Vivanti et al., 2020;Shook et al., 2022;Vivanti et al., 2022). Although longitudinal cohort studies are still in infancy due to the recent occurrence of the pandemic, emerging data have been pointing out that maternal SARS-COV-2 infection during pregnancy could affect neurodevelopment negatively and even increase the chance of neurodevelopmental and neurologic diagnosis later on (Chevalier and Poillon, 2022;Germano et al., 2022;Shook et al., 2022;Taquet et al., 2022;Wang et al., 2022). Early brain development spanning from prenatal to postnatal is an intricate and sensitive period. ...
Living in a globalized world, viral infections such as CHIKV, SARS-COV-2, and ZIKV have become inevitable to also infect the most vulnerable groups in our society. That poses a danger to these populations including pregnant women since the developing brain is sensitive to maternal stressors including viral infections. Upon maternal infection, the viruses can gain access to the fetus via the maternofetal barrier and even to the fetal brain during which factors such as viral receptor expression, time of infection, and the balance between antiviral immune responses and pro-viral mechanisms contribute to mother-to-fetus transmission and fetal infection. Both the direct pro-viral mechanisms and the resulting dysregulated immune response can cause multi-level impairment in the maternofetal and brain barriers and the developing brain itself leading to dysfunction or even loss of several cell populations. Thus, maternal viral infections can disturb brain development and even predispose to neurodevelopmental disorders. In this review, we discuss the potential contribution of maternal viral infections of three relevant relative recent players in the field: Zika, Chikungunya, and Severe Acute Respiratory Syndrome Coronavirus-2, to the impairment of brain development throughout the entire route.
... These viruses cause brain damage primarily through maternal immune activation(MIA), the activation of the placental and fetal immune systems, and then the activation of the fetal brain immune system (neuroinflammation) [50,51]. SARS-CoV-2 can potentially affect the growth and development of the fetal nervous system through maternal immune activation [52]. The flu did the same; an increased rate of neurological disorders, including schizophrenia, has been reported in adults who were fetuses during the 1957 influenza pandemic [51]. ...
... Maternal immune activation is associated with elevated levels of inflammatory cytokines. Cytokines can pass through the placenta and the blood-brain barrier and impair neural development in the fetus [52]. Neurotoxic properties of Cytokines may be mediated by an increase in reactive oxygens and a decrease in monoamine transport [1]. ...
... Cytokine homeostasis/balance is necessary for a healthy pregnancy [52]. Interleukin-10 is required for the embryo's maintenance and immunological tolerance (the embryo is semi-allogenic). ...
Immunoneuropsychiatry is an emerging field about the interaction between the immune and nervous systems. Infection and infection-related inflammation (in addition to genetics and environmental factors) can act as the etiopathogenesis of neuropsychiatric disorders (NPDs). Exposure to COVID-19 in utero may be a risk factor for developing NPDs in offspring in the future. Maternal immune activation (MIA) and subsequent inflammation can affect fetal brain development. Inflammatory mediators, cytokines, and autoantibodies can pass through the placenta and the compromised blood-brain barrier after MIA, leading to neuroinflammation. Neuroinflammation also affects multiple neurobiological pathways; for example, it decreases the production of the neurotransmitter serotonin. Fetal sex may affect the mother's immune response. Pregnant women with male fetuses have been reported to have decreased maternal and placental humoral responses. This suggests that in pregnancies with a male fetus, fewer antibodies may be transferred to the fetus and contribute to males' increased susceptibility/vulnerability to infectious diseases compared to female infants. Here, we want to discuss maternal COVID-19 infection and its consequences for the fetus, particularly the neurological outcomes and the interaction between fetal sex and possible changes in maternal immune responses.
... In addition, another metaanalysis study has reported that preventing or safely treating maternal infections could reduce the incidence of ASD by 12% to 17% [24]. Moreover, the infection of coronavirus disease 2019 (COVID-19) during pregnancy is associated with MIA and can result in the risk of ASD onset by alteration of maternal and fetal immune responses [9,11,25,26]. Therefore, a thorough understanding of the role of inflammation and oxidative stress in the pathogenesis of ASD has also gained significance. ...
... In addition, another meta-analysis study has reported that preventing or safely treating maternal infections could reduce the incidence of ASD by 12% to 17% [24]. Moreover, the infection of coronavirus disease 2019 (COVID- 19) during pregnancy is associated with MIA and can result in the risk of ASD onset by alteration of maternal and fetal immune responses [9,11,25,26]. Therefore, a thorough understanding of the role of inflammation and oxidative stress in the pathogenesis of ASD has also gained significance. ...
Autism spectrum disorder (ASD) is a neurodevelopmental disorder (NDD) characterized by impairments in social communication, repetitive behaviors, restricted interests, and hyperesthesia/hypesthesia caused by genetic and/or environmental factors. In recent years, inflammation and oxidative stress have been implicated in the pathogenesis of ASD. In this review, we discuss the inflammation and oxidative stress in the pathophysiology of ASD, particularly focusing on maternal immune activation (MIA). MIA is a one of the common environmental risk factors for the onset of ASD during pregnancy. It induces an immune reaction in the pregnant mother’s body, resulting in further inflammation and oxidative stress in the placenta and fetal brain. These negative factors cause neurodevelopmental impairments in the developing fetal brain and subsequently cause behavioral symptoms in the offspring. In addition, we also discuss the effects of anti-inflammatory drugs and antioxidants in basic studies on animals and clinical studies of ASD. Our review provides the latest findings and new insights into the involvements of inflammation and oxidative stress in the pathogenesis of ASD.
... Epidemiological data suggest that maternal immune activation (MIA), such as maternal infection, might be associated with the risk of neuropsychiatric disorders, such as schizophrenia and ASD in offspring [110,111]. During the coronavirus disease 2019 (COVID-19) pandemic, an increasing number of pregnant women have become infected with COVID-19 worldwide, and MIA induced by COVID-19 infection has been suggested as a risk factor for schizophrenia and ASD [112][113][114]. A cohort study shows that severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) exposure in utero may be associated with neurodevelopmental sequelae in some offspring [115]. ...
Cognitive impairment has been observed in patients with various psychiatric disorders, including schizophrenia, major depressive disorder (MDD), and bipolar disorder (BD). Although modern therapeutic drugs can improve certain symptoms (i.e., psychosis, depression) in these patients, these drugs have not been found to improve cognitive impairment. The N-methyl-D-aspartate receptor antagonist (R,S)-ketamine has attracted attention as a rapidly acting antidepressant. In addition to its robust antidepressant effects, (R,S)-ketamine has been suggested to improve cognitive impairment in patients with MDD and BD, despite causing cognitive impairment in healthy control subjects. (R,S)-ketamine is a racemic mixture of equal amounts of (R)-ketamine (or arketamine) and (S)-ketamine (or esketamine). Arketamine has been found to have more potent antidepressant-like actions than esketamine in rodents. Interestingly, arketamine, but not esketamine, has been suggested to improve phencyclidine-induced cognitive deficits in mice. Furthermore, arketamine has been suggested to ameliorate cognitive deficits in rodent offspring after maternal immune activation. In the current article, it is proposed that arketamine has therapeutic potential for treating cognitive impairment in patients with psychiatric disorders. Additionally, the potential role of the gut–microbiome–brain axis in cognitive impairment in psychiatric disorders is discussed.
... Pregnant women infected with SARS-CoV-2 can impart brain damage and post-birth psychiatric disorders in their offspring (37). SARS-CoV-2 can affect the development of the fetal nervous system directly or indirectly (38). ...
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - 2019 (COVID-19) has led to a worldwide public health concern. In addition to immediate impacts on human health and well-being, COVID-19 can result in unfortunate and long-term health consequences for future generations. In particular, pregnant women and developing fetuses in low-income settings could be prone to a higher risk of undernutrition, often due to an inadequate supply of food and nutrition during a pandemic outbreak like COVID-19. Such situations can subsequently lead to an increased risk of undesirable health consequences, such as non-communicable diseases, including obesity, metabolic syndrome, hypertension, and type 2 diabetes, in individuals born to exposed mothers via fetal programming. Moreover, COVID-19 infection or related stress during pregnancy can induce long-term programming outcomes on neuroendocrinological systems in offspring after birth. However, the long-lasting consequences of the transplacental transmission of COVID-19 in offspring are currently unknown. Here we hypothesize that a COVID-19 pandemic triggers intrauterine programming outcomes in offspring due to multiple maternal factors (e.g., nutrition deficiency, stress, infection, inflammation) during pregnancy. Thus, it is crucial to establish an integrated lifetime health information system for individuals born in or around the COVID-19 pandemic to identify those at risk of adverse pre-and postnatal nutritional programming. This approach will assist in designing specific dietary or other nutritional interventions to minimize the potential undesirable outcomes in those nutritionally programmed individuals.
