title: Influenza pathogenicity during pregnancy in women and animal models.
abstract: Pregnant women are at the highest risk to develop severe and even fatal influenza. The high vulnerability of women against influenza A virus infections during pregnancy was repeatedly highlighted during influenza pandemics including the pandemic of this century. In 2009, mortality rates were particularly high among otherwise healthy pregnant women. However, our current understanding of the molecular mechanisms involved in severe disease development during pregnancy is still very limited. In this review, we summarize the knowledge on the clinical observations in influenza A virus-infected pregnant women. In addition, knowledge obtained from few existing experimental infections in pregnant animal models is discussed. Since clinical data do not provide in-depth information on the pathogenesis of severe influenza during pregnancy, adequate animal models are urgently required that mimic clinical findings. Studies in pregnant animal models will allow the dissection of involved molecular disease pathways that are key to improve patient management and care.
authors.affiliation: Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany.|Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Debby
authors.initials: D
authors.lastname: van Riel
authors.affiliation: Institute of Immunology, Medical Center Hamburg Eppendorf, Hamburg, Germany.
authors.forename: Hans-Willi
authors.initials: HW
authors.lastname: Mittrücker
authors.affiliation: Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany.|Department of Obstetrics and Fetal Medicine, Medical Center Hamburg Eppendorf, Hamburg, Germany.
authors.forename: Geraldine
authors.initials: G
authors.lastname: Engels
authors.affiliation: Department of Molecular Pathology, University Hospital Tübingen, Tübingen, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Klingel
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Jena, Jena, Germany.
authors.forename: Udo R
authors.initials: UR
authors.lastname: Markert
authors.affiliation: Heinrich-Pette-Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany. guelsah.gabriel@hpi.uni-hamburg.de.|University of Lübeck, Lübeck, Germany. guelsah.gabriel@hpi.uni-hamburg.de.
authors.forename: Gülsah
authors.initials: G
authors.lastname: Gabriel
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D047109:Fetal Development / Q000276:immunology; D006801:Humans; D007107:Immune System / Q000166:cytology / Q000276:immunology / Q000378:metabolism; D007108:Immune Tolerance; D009980:Influenza A virus; D007251:Influenza, Human / Q000175:diagnosis / Q000209:etiology*; D008168:Lung / Q000276:immunology / Q000378:metabolism / Q000473:pathology / Q000821:virology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious
keywords: Animal models; Influenza; Pathogenesis; Pregnancy