Alterações Endócrinas e Imuno-modulação na Gravidez

 

Celestino Neves*, José Luís Medina*, José Luís Delgado†

*Serviço de Endocrinologia, Unidade de Investigação e Desenvolvimento Cardiovascular, Hospital de São João, Porto; †Serviço de Imunologia, Hospital de São João, Porto

 

 

Os sistemas endócrino e imunológico sofrem alterações significativas de modo a proporcionar uma evolução normal da gestação. Nesta revisão são delineadas as principais modificações endócrinas que ocorrem durante a gravidez, salientando-se a importância da adeno e da neuro-hipófise, das paratireóides, das supra-renais e da tireóide na multiplicidade de alterações hormonais, cujo objectivo consiste em proporcionar uma interacção maternofetal, que permita o perfeito desenvolvimento físico e neuropsíquico do feto, num ambiente de imuno-tolerância materna. Também são delineados os principais factores hormonais envolvidos na indução do estado Th2 (T helper tipo 2) durante a gestação, salientando-se a acção das células T, das células NK (Natural Killer), dos macrófagos e das citocinas na imuno-modulação na gravidez.

Palavras-chave: auto-imunidade; sistema endócrino; gravidez; período pós-parto.

 

 

Endocrine Alterations and Imuno-modulation on Pregnancy

The endocrine system and the immune system suffer significant alterations in order to provide a normal evolution of the gestation. This review delineates the main endocrine modifications that occur during the pregnancy, pointing out the importance of the adeno, the neuro-hypophysis, the adrenal glands and the thyroid in the multiplicity of the hormonal alterations, whose objective consists of providing a fetal-maternal relationship, that allows the perfect physical and psychoneurological development of the embryo on an immune tolerance hormone environment. Also mentioned are the main hormonal factors in the induction of the Th2 state during the gestation, pointing out the action of T cells, NK cells, the macrophages and the cytokines on the immune modulation in the pregnancy.

Key words: autoimmunity; endocrine system; pregnancy; post-partum period.

 

 

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Correspondência:

Dr. Celestino Neves

Serviço de Endocrinologia Hospital de São João

Alameda Prof. Hernâni Monteiro

4200-319 Porto

e-mail: celestino.neves@sapo.pt