Journal of Molecular Oncology Research: Efficacy and safety of pemetrexed and cisplatin chemotherapy as first line in advanced stage of lung adenocarcinoma.
Journal of Molecular Oncology Research is an open-access journal that publishes & accepts all types of articles that comes under the scope of the journal. APJOT published an article on the titled Efficacy and safety of pemetrexed and cisplatin chemotherapy as first line in advanced stage of lung adenocarcinoma.
The incipient human maternal-fetal bond is established during the sacrosanct period of gestation. Not exclusively a site for fetal development, the uterine cavity also acts as a haven for protection against potentially life-threatening infections. A number of innate proteins with antimicrobial activity such as α- defensins, lactoferrin, and phospholipase A2 are intrinsic components of the intrauterine environment, though cellular elements such as polymorphonuclear cells, monocytes and macrophages are functionally immature . While these and many other endogenous factors provide a measure of security, fetal viability is also critically dependent on passive immunity sourced by the mother.
Even though transference of maternal-derived humoral immunity begins by the end of the first trimester, fetal immunoglobulin (Ig) levels are usually less than 10% of maternal concentrations early in the second trimester. As the pregnancy progresses, cross placental antibody transfer increases, reaching 50% of the maternal concentration by the middle of the third trimester; acquired passive immunity is greatest during the final four weeks of gestation. Interestingly, passive immunity at term pregnancy often exceeds maternal antibody levels by as much as 30%. And not surprising, the acquired humoral immune repertoire in the full term neonate mirrors that of the mother, further solidifying materno-fetal harmony. In essence, the amount and specificities of immunoglobulin transferred are dependent not only on maternal Ig concentrations and immunologic exposure, but also on duration of gestation and placental integrity. Ultimately, acquisition of passive immunity by the fetus is critical for extra-uterine adaptation and protection against infectious diseases during the first year after birth.
Even more intriguing are epidemiological and laboratory data linking behavioral abnormalities such as autism spectrum disorder (ASD) in children with in utero exposure to maternal antibodies and research in animal models provides some of the most tangible evidence supporting this belief. One study showed that offsprings of non-human primates (who were immunized with purified immunoglobulin from mothers of children with autism spectrum disorder) exhibited signs of neurodevelopmental dysfunction similar to human ASD. Another study in mice had similar results.
The impetus for undertaking this endeavor is to merge our increased, though by no means complete, understanding of neonatal disorders associated with maternal antibodies. While select portions of the published literature were used to support the accuracy of the textual content, unresolved issues provided the opportunity for reasoned author viewpoints. This opinionbased paper extends upon the former concept in a novel manner by examining a potential fetal abnormality borne, in utero, by exposure to trastuzumab, an engineered monoclonal antibody (mAb) that has significantly improved the prognosis in women with Human EGFR-Related 2-positive (HER2+) breast cancer. While the likelihood of fetal harm may be perceived as unlikely because the drug is not given to pregnant women during cancer therapy, the pathological effect could be significant if conception occurs relatively soon after treatment is completed. As such, the dynamics of maternal-fetal Ig transfer and developmental biology of the heart are reviewed. And to further enhance reader appreciation, a structural and clinical overview of trastuzumab is also included. Finally, an attempt is made to provide proof-of-principle insight into the potential pathogenicity of in utero transfer of this therapeutic mAb on the developing heart and humoral immune response.
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Journal of Molecular Oncology Research