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Virol J . Influenza a(H1N1) virus infection impairs syncytiotrophoblast functions by promoting ferroptosis through the TNF-α/ISG15/EGR1 axis

tetano

Editor, Senior Moderator
Virol J


. 2025 Nov 17;22(1):379.
doi: 10.1186/s12985-025-02995-1. Influenza a(H1N1) virus infection impairs syncytiotrophoblast functions by promoting ferroptosis through the TNF-α/ISG15/EGR1 axis

Yetian Zhao[SUP] 1 [/SUP], Yanwen Wang[SUP] 2 [/SUP], Kailun Huang[SUP] 2 [/SUP], Feifei Wang[SUP] 2 [/SUP], Yan Wang[SUP] 3 [/SUP]



Affiliations
Abstract

Influenza A virus (IAV) is linked to adverse pregnancy outcomes like spontaneous abortion, preterm birth, and neonatal death. Inhibition of trophoblast cell fusion by IAV infection is a key factor contributing to these adverse pregnancy outcomes. Cytokine TNF-α modulates fusion defects in human trophoblast cells. Ferroptosis, a new form of programmed cell death, involves iron-dependent lipid peroxide buildup. It's unclear if the adverse outcomes of IAV infection on pregnant women are related to trophoblast cell ferroptosis. This study made a syncytiotrophoblast (STB) cell model by treating BeWo cells with forskolin (FSK) in vitro. We investigated the impact of H1N1 virus infection on trophoblast cell syncytialization. We found TNF-α expression rose significantly in H1N1-infected fused trophoblast cells, causing ferroptosis and disrupting syncytialization. ISG15 was identified as a downstream gene of TNF-α, and its knockdown reversed the effects of TNF-α. ISG15 overexpression enhanced ferroptosis-related gene transcription via EGR1, further disrupting syncytialization. EGR1 was found to promote TNF-α transcription, thereby forming a TNF-α, ISG15, EGR1 positive feedback loop. In vivo TNF-α inhibition reduced ferroptosis markers and improved trophoblast cell fusion. This investigation demonstrated that H1N1 infection initiates ferroptosis and compromises trophoblast cell fusion through the TNF-α/ISG15/EGR1 pathway. These findings imply a potential therapeutic approach for pregnancy complicated by influenza A virus infection.

Keywords: EGR1; Ferroptosis; H1N1; ISG15; Syncytification; TNF-α.

 
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