tetano
Editor, Senior Moderator
Am J Obstet Gynecol
. 2021 Mar 30;S0002-9378(21)00208-8.
doi: 10.1016/j.ajog.2021.03.028. Online ahead of print.
Pregnancy alters IL-1? expression and anti-viral antibody responses during SARS-CoV-2 infection
Morgan L Sherer[SUP] 1 [/SUP], Jun Lei[SUP] 2 [/SUP], Patrick Creisher[SUP] 1 [/SUP], Minyoung Jang[SUP] 2 [/SUP], Ramya Reddy[SUP] 2 [/SUP], Kristin Voegtline[SUP] 3 [/SUP], Sarah Olson[SUP] 4 [/SUP], Kirsten Littlefield[SUP] 1 [/SUP], Han-Sol Park[SUP] 1 [/SUP], Rebecca L Ursin[SUP] 5 [/SUP], Abhinaya Ganesan[SUP] 1 [/SUP], Theresa Boyer[SUP] 2 [/SUP], Nada Elsayed[SUP] 2 [/SUP], Diane M Brown[SUP] 6 [/SUP], Samantha N Walch[SUP] 6 [/SUP], Annukka A R Antar[SUP] 6 [/SUP], Yukari C Manabe[SUP] 6 [/SUP], Kimberly Jones-Beatty[SUP] 2 [/SUP], William Christopher Golden[SUP] 7 [/SUP], Andrew J Satin[SUP] 2 [/SUP], Jeanne S Sheffield[SUP] 2 [/SUP], Andrew Pekosz[SUP] 1 [/SUP], Sabra L Klein[SUP] 8 [/SUP], Irina Burd[SUP] 9 [/SUP]
Affiliations
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the disease-causing pathogen of the COVID-19 pandemic, has resulted in morbidity and mortality worldwide. Pregnant women are more susceptible to severe COVID-19 disease and are at higher risk for preterm birth compared to uninfected pregnant women. Despite this evidence, the immunological effects of SARS-CoV-2 infection during pregnancy remain understudied.
Objective: To assess the impact of SARS-CoV-2 infection during pregnancy on inflammatory and humoral responses in maternal and fetal samples and compare antibody responses to SARS-CoV-2 among pregnant and non-pregnant women.
Study design: Immune responses to SARS-CoV-2 were analyzed using samples from pregnant (n=33) and non-pregnant (n=17) women who had either tested positive (pregnant n=22; non-pregnant n=17) or negative for SARS-CoV-2 (pregnant n=11) at Johns Hopkins Hospital. We measured proinflammatory and placental cytokine mRNAs, neonatal Fc receptor (FcRn) expression, and tetanus antibody transfer in maternal and cord blood samples. Additionally, we evaluated anti-spike (S) IgG, anti-S-receptor binding domain (RBD) IgG, and neutralizing antibody (nAb) responses to SARS-CoV-2 in serum or plasma collected from non-pregnant women, pregnant women, and cord blood.
Results: SARS-COV-2 positive pregnant women expressed more IL1?, but not IL6, in blood samples collected within 14 days versus > 14 days after a confirmed SARS-CoV-2 test. Pregnant women with confirmed SARS-CoV-2 infection also had reduced anti-S-RBD IgG titers and were less likely to have detectable nAb as compared with non-pregnant women. Although SARS-CoV-2 infection did not disrupt FcRn expression in the placenta, maternal transfer of SARS-CoV-2 nAb was inhibited by infection during pregnancy.
Conclusions: SARS-CoV-2 infection during pregnancy was characterized by placental inflammation and reduced antiviral antibody responses, which may impact the efficacy of COVID-19 therapeutics in pregnancy. The long-term implications of placental inflammation for neonatal health also requires greater consideration.
Keywords: COVID-19; SARS-CoV-2; antibody; cytokine; maternal infection; pregnancy.
. 2021 Mar 30;S0002-9378(21)00208-8.
doi: 10.1016/j.ajog.2021.03.028. Online ahead of print.
Pregnancy alters IL-1? expression and anti-viral antibody responses during SARS-CoV-2 infection
Morgan L Sherer[SUP] 1 [/SUP], Jun Lei[SUP] 2 [/SUP], Patrick Creisher[SUP] 1 [/SUP], Minyoung Jang[SUP] 2 [/SUP], Ramya Reddy[SUP] 2 [/SUP], Kristin Voegtline[SUP] 3 [/SUP], Sarah Olson[SUP] 4 [/SUP], Kirsten Littlefield[SUP] 1 [/SUP], Han-Sol Park[SUP] 1 [/SUP], Rebecca L Ursin[SUP] 5 [/SUP], Abhinaya Ganesan[SUP] 1 [/SUP], Theresa Boyer[SUP] 2 [/SUP], Nada Elsayed[SUP] 2 [/SUP], Diane M Brown[SUP] 6 [/SUP], Samantha N Walch[SUP] 6 [/SUP], Annukka A R Antar[SUP] 6 [/SUP], Yukari C Manabe[SUP] 6 [/SUP], Kimberly Jones-Beatty[SUP] 2 [/SUP], William Christopher Golden[SUP] 7 [/SUP], Andrew J Satin[SUP] 2 [/SUP], Jeanne S Sheffield[SUP] 2 [/SUP], Andrew Pekosz[SUP] 1 [/SUP], Sabra L Klein[SUP] 8 [/SUP], Irina Burd[SUP] 9 [/SUP]
Affiliations
- PMID: 33798476
- DOI: 10.1016/j.ajog.2021.03.028
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the disease-causing pathogen of the COVID-19 pandemic, has resulted in morbidity and mortality worldwide. Pregnant women are more susceptible to severe COVID-19 disease and are at higher risk for preterm birth compared to uninfected pregnant women. Despite this evidence, the immunological effects of SARS-CoV-2 infection during pregnancy remain understudied.
Objective: To assess the impact of SARS-CoV-2 infection during pregnancy on inflammatory and humoral responses in maternal and fetal samples and compare antibody responses to SARS-CoV-2 among pregnant and non-pregnant women.
Study design: Immune responses to SARS-CoV-2 were analyzed using samples from pregnant (n=33) and non-pregnant (n=17) women who had either tested positive (pregnant n=22; non-pregnant n=17) or negative for SARS-CoV-2 (pregnant n=11) at Johns Hopkins Hospital. We measured proinflammatory and placental cytokine mRNAs, neonatal Fc receptor (FcRn) expression, and tetanus antibody transfer in maternal and cord blood samples. Additionally, we evaluated anti-spike (S) IgG, anti-S-receptor binding domain (RBD) IgG, and neutralizing antibody (nAb) responses to SARS-CoV-2 in serum or plasma collected from non-pregnant women, pregnant women, and cord blood.
Results: SARS-COV-2 positive pregnant women expressed more IL1?, but not IL6, in blood samples collected within 14 days versus > 14 days after a confirmed SARS-CoV-2 test. Pregnant women with confirmed SARS-CoV-2 infection also had reduced anti-S-RBD IgG titers and were less likely to have detectable nAb as compared with non-pregnant women. Although SARS-CoV-2 infection did not disrupt FcRn expression in the placenta, maternal transfer of SARS-CoV-2 nAb was inhibited by infection during pregnancy.
Conclusions: SARS-CoV-2 infection during pregnancy was characterized by placental inflammation and reduced antiviral antibody responses, which may impact the efficacy of COVID-19 therapeutics in pregnancy. The long-term implications of placental inflammation for neonatal health also requires greater consideration.
Keywords: COVID-19; SARS-CoV-2; antibody; cytokine; maternal infection; pregnancy.