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REVIEW article

Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1503402
This article is part of the Research Topic Tuberculosis: Recent Updates in Basic Research, Drug Discovery and Treatment View all 5 articles

Immune-neuroendocrine Reactivity and Features of Tuberculosis in Pregnancy

Provisionally accepted
Anna Starshinova Anna Starshinova 1,2*Leonid P. Churilov Leonid P. Churilov 1Igor Vladimirovich Kudryavtsev Igor Vladimirovich Kudryavtsev 2,3Artem Rubinstein Artem Rubinstein 3Ekaterina Belyaeva Ekaterina Belyaeva 1Anastasia Kulpina Anastasia Kulpina 1,2Hong Ling Hong Ling 4Min Zhuang Min Zhuang 4Dmitry Kudlay Dmitry Kudlay 5,6,7
  • 1 Saint Petersburg State University, Saint Petersburg, Russia
  • 2 Almazov National Medical Research Centre, Saint Petersburg, Russia
  • 3 Institute of Experimental Medicine (RAS), Saint Petersburg, Russia
  • 4 Harbin Medical University, Harbin, Heilongjiang, China
  • 5 Lomonosov Moscow State University, Moscow, Moscow, Russia
  • 6 I.M. Sechenov First Moscow State Medical University, Moscow, Moscow Oblast, Russia
  • 7 Institute of Immunology (Russia), Moscow, Moscow Oblast, Russia

The final, formatted version of the article will be published soon.

    The combination of tuberculosis and pregnancy always raises questions about therapy, the specialness of management of pregnancy, obstetrics, postpartum period, and lactation; the effect of therapy on fetal development and the peculiarities of the tuberculosis course. Until recently, tuberculosis and pregnancy were considered a rare combination, but with the growing problem of HIV infection and worsening tuberculosis screening among adults, this combination has become quite common. Moreover, cases of congenital tuberculosis in newborns have begun to emerge. In this review, we analyzed features of immunologic and iImmuno-neuroendocrine reactivity in pregnant women that influence for prevalence TB and TB/HIV coinfection. The immuno-neuroendocrine changes characteristic of pregnancy have a multifactorial effect on antituber-culosis immunity and determine the specificity of the course of tuberculosis against the back-ground of pregnancy. These changes contribute to a more severe course of TB than before preg-nancy. The structure of TB clinical forms in women who became ill during pregnancy and in the first year after childbirth is characterized by greater severity, higher frequency of multi-organ lesions, and the percentage of bacterial isolates is significantly higher among women with TB that developed in the postpartum period compared to women who developed it during pregnancy. HIV infection poses a particular threat, exacerbating immune response disorders that affect the effectiveness of treatment and disease progression in general.

    Keywords: Tuberculosis, TB/HIV, coinfection in pregnant women, immune response, Neuroendocrine reactivity

    Received: 28 Sep 2024; Accepted: 13 Jan 2025.

    Copyright: © 2025 Starshinova, Churilov, Kudryavtsev, Rubinstein, Belyaeva, Kulpina, Ling, Zhuang and Kudlay. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Anna Starshinova, Saint Petersburg State University, Saint Petersburg, Russia

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.