Ashley Moffett: New Approaches to Maternal Mortality In Africa

485 views

Published on

Ashley Moffett (Professor of Reproductive Immunology at the Department of Pathology and Centre for Trophoblast Research, University of Cambridge):
How does the mother’s immune system affect the outcome of pregnancy?

Published in: Health & Medicine, Technology
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
485
On SlideShare
0
From Embeds
0
Number of Embeds
74
Actions
Shares
0
Downloads
10
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide
  • Why study immune system?What does it have to do with MM in Africa?
  • Frequency against birth weight – peak frequency between 3 and 4 Kg – falls off either end
  • When look at extremes major problems responsible for a major proportion of maternal and fetal deathsBoth these extremes occur more frequently in sub-Saharan Africa
  • Regulation of birth weight is vital to successful pregnancy. Show you one way this is achieved is by immune system
  • NK cells
  • Different variants of NK receptors in a population – a woman can have any of these depending on her genetic make up
  • Ashley Moffett: New Approaches to Maternal Mortality In Africa

    1. 1. How does the mother’s immune system affect the outcome of pregnancy? Ashley Moffett
    2. 2. The Norwegian Mother-Baby study A cohort consisting of ~800 000 pregnancies
    3. 3. The Norwegian MoBa studyA cohort consisting of ~800 000 pregnancies
    4. 4. The Norwegian MoBa study A cohort consisting of ~800 000 pregnanciesPre-eclampsiaStillbirthPrematurity
    5. 5. The Norwegian MoBa studyA cohort consisting of ~800 000 pregnancies Obstructedlabour Haemorrhage Sepsis
    6. 6. ObstructedlabourWilliam Smellie‘s Sett of Anatomical Tables, 1752
    7. 7. Birth weight and neonatal mortality rate (n=13,730) “Perhaps the most clear-cut example of a human character subject to stabilizing (balancing) selection is birth weight”from Cavalli-Sforza, L.L. &Bodmer, W.F.In The genetics of human populations (Freeman Press, San Francisco, 1971).
    8. 8. NK cells and the success of human pregnancy The maternal-fetal interface
    9. 9. Failure of invasion of extravillous trophoblast cells in pre-eclampsia Moffett
    10. 10. The immune system has evolved to discriminate between self & non-self
    11. 11. Transplantation self label non-self label receptorRecipient immune cell self non-self
    12. 12. Pregnancy MaternalselflabelMaternal immune cell Paternalnon-selflabel self & non-self labels = HLA
    13. 13. Failure of invasion of extravillous trophoblast cells in pre-eclampsia Moffett
    14. 14. Uterine NK cellsPlacenta
    15. 15. Maternal populationNK cells
    16. 16. Paternalnon-selflabels on placenta
    17. 17. NK cells Placenta
    18. 18. NK cells Placenta
    19. 19. NK cells Risk Placenta
    20. 20. HLA-C2
    21. 21. Distribution of Neanderthal HLA-C*0702 allele (group C1) in modern populations 58.7 30.0 18.0 Abi-Rached et al 9.0 (%) Science 2011 0.0 HLA-C*07:02 = C1 group
    22. 22. Inverse correlation in human populations between C2 epitope and KIR A haplotype. Parham 2012. Extending Hiby et al 2004, JEM.
    23. 23. The distributions of birth weight and transfer to neonatal special care units. 1999-2009 Norway (MoBa) 0.45 Birth weight frequency 0.4 Neonate transfer frequency 0.35 0.3 % frequency 0.25 0.2 0.15 0.1 0.05 0 0 1000 2000 3000 4000 5000 6000 7000 8000 Birth weight (grams)

    ×