Intrauterine activation of the fetal immune system in response to maternal COVID-19

Introduction. During pregnancy COVID-19 poses a serious threat to both maternal health and health of paired unborn child. Pregnant women have a high probability of complications due to respiratory viral infections followed by developing critical conditions caused by physiologically altered immune an...

Full description

Saved in:
Bibliographic Details
Main Authors: N. R. Gashimova, L. L. Pankratyeva, V. O. Bitsadze, J. Kh. Khizroeva, N. A. Makatsariya, M. V. Tretyakova, A. S. Shkoda, K. N. Grigoreva, V. I. Tsibizova, J.-C. Gris, F. E. Yakubova, D. V. Blinov, A. D. Makatsariya
Format: Article
Language:Russian
Published: IRBIS LLC 2023-05-01
Series:Акушерство, гинекология и репродукция
Subjects:
Online Access:https://www.gynecology.su/jour/article/view/1650
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849395181510459392
author N. R. Gashimova
L. L. Pankratyeva
V. O. Bitsadze
J. Kh. Khizroeva
N. A. Makatsariya
M. V. Tretyakova
A. S. Shkoda
K. N. Grigoreva
V. I. Tsibizova
J.-C. Gris
F. E. Yakubova
D. V. Blinov
A. D. Makatsariya
author_facet N. R. Gashimova
L. L. Pankratyeva
V. O. Bitsadze
J. Kh. Khizroeva
N. A. Makatsariya
M. V. Tretyakova
A. S. Shkoda
K. N. Grigoreva
V. I. Tsibizova
J.-C. Gris
F. E. Yakubova
D. V. Blinov
A. D. Makatsariya
author_sort N. R. Gashimova
collection DOAJ
description Introduction. During pregnancy COVID-19 poses a serious threat to both maternal health and health of paired unborn child. Pregnant women have a high probability of complications due to respiratory viral infections followed by developing critical conditions caused by physiologically altered immune and cardiopulmonary systems. However, asymptomatic COVID-19 in pregnant women may be accompanied by fetal inflammatory response syndrome (FIRS) that results in unfavorable sequelae for neonatal life and health.Aim: to assess a fetal inflammatory response resulting from maternal COVID-19 in pregnancy.Materials and Мethods. A prospective randomized comparative study involving 92 pregnant women was carried out. The main group included 62 pregnant COVID-19 convalescent women: subgroup 1 consisted of 30 pregnant women found to be positive for SARS-CoV-2 by using polymerase chain reaction (PCR) 4–6 weeks before delivery; subgroup 2 – 32 pregnant women with SARS-CoV-2 detected by PCR earlier during pregnancy. The control group enrolled 30 healthy pregnant women. The level of circulating cytokines – interleukins (IL) IL-1α, IL-6, IL-8, IL-10, granulocyte-macrophage colony-stimulating factor (GM-CSF), tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), macrophage inflammatory protein-1β (MIP-1β), C-X-C motif chemokine ligand 10 (CXCL-10) and cell markers (CD86, CD80, CD4, CD25, CD25, CCR7) were analyzed. In addition, all neonates underwent thymus gland ultrasound screening.Results. Cord blood dendritic cells from neonates born to mothers in subgroup 1 vs. control group showed a significantly upregulated expression of CD80 and CD86 (p = 0.023). Moreover, such cord blood samples in subgroup 1 were found to have increased percentage of CD4+, CCR7+ T cells paralleled with decreased proportion of naive CD4+ T cells as compared with control group (p = 0.016). It was found that count of maternal regulatory CD4+CD25+Foxp3+ T cells (Treg) did not differ significantly, whereas Treg cell functional activity in mothers with severe COVID-19 (subgroup 2) was significantly suppressed. Significantly higher level of neonatal proinflammatory cytokines and chemokines was detected in subgroup 1 vs. control group (p < 0.05). However, the cytokines level in maternal peripheral blood samples in main and control groups upon delivery was changed insignificantly. SARS-CoV-2-positive pregnant women showed a strong antigen-specific T cell response. A reduced thymus size was found in neonates born to paired COVID-19 mothers.Conclusion. Fetal inflammatory response syndrome occurs upon COVID-19, which is characterized by activated fetal immune system and increased production of pro-inflammatory cytokines. The disease severity in pregnant women has no correlation with FIRS intensity during neonatal period and can vary from minimally altered laboratory parameters to developing sequelae at organ and body system levels.
format Article
id doaj-art-c435c19f45fd4ecba9287ce13d24fca8
institution Kabale University
issn 2313-7347
2500-3194
language Russian
publishDate 2023-05-01
publisher IRBIS LLC
record_format Article
series Акушерство, гинекология и репродукция
spelling doaj-art-c435c19f45fd4ecba9287ce13d24fca82025-08-20T03:39:44ZrusIRBIS LLCАкушерство, гинекология и репродукция2313-73472500-31942023-05-0117218820110.17749/2313-7347/ob.gyn.rep.2023.404798Intrauterine activation of the fetal immune system in response to maternal COVID-19N. R. Gashimova0L. L. Pankratyeva1V. O. Bitsadze2J. Kh. Khizroeva3N. A. Makatsariya4M. V. Tretyakova5A. S. Shkoda6K. N. Grigoreva7V. I. Tsibizova8J.-C. Gris9F. E. Yakubova10D. V. Blinov11A. D. Makatsariya12Sechenov UniversityDmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Health Ministry of Russian Federation; Vorokhobov City Clinical Hospital No 67, Moscow Healthcare DepartmentSechenov UniversitySechenov UniversitySechenov UniversitySechenov UniversityVorokhobov City Clinical Hospital No 67, Moscow Healthcare DepartmentSechenov UniversityAlmazov National Medical Research Centre, Health Ministry of Russian FederationSechenov University; University of MontpellierSechenov UniversitySechenov University; Institute for Preventive and Social Medicine; Moscow Haass Medical – Social InstituteSechenov UniversityIntroduction. During pregnancy COVID-19 poses a serious threat to both maternal health and health of paired unborn child. Pregnant women have a high probability of complications due to respiratory viral infections followed by developing critical conditions caused by physiologically altered immune and cardiopulmonary systems. However, asymptomatic COVID-19 in pregnant women may be accompanied by fetal inflammatory response syndrome (FIRS) that results in unfavorable sequelae for neonatal life and health.Aim: to assess a fetal inflammatory response resulting from maternal COVID-19 in pregnancy.Materials and Мethods. A prospective randomized comparative study involving 92 pregnant women was carried out. The main group included 62 pregnant COVID-19 convalescent women: subgroup 1 consisted of 30 pregnant women found to be positive for SARS-CoV-2 by using polymerase chain reaction (PCR) 4–6 weeks before delivery; subgroup 2 – 32 pregnant women with SARS-CoV-2 detected by PCR earlier during pregnancy. The control group enrolled 30 healthy pregnant women. The level of circulating cytokines – interleukins (IL) IL-1α, IL-6, IL-8, IL-10, granulocyte-macrophage colony-stimulating factor (GM-CSF), tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), macrophage inflammatory protein-1β (MIP-1β), C-X-C motif chemokine ligand 10 (CXCL-10) and cell markers (CD86, CD80, CD4, CD25, CD25, CCR7) were analyzed. In addition, all neonates underwent thymus gland ultrasound screening.Results. Cord blood dendritic cells from neonates born to mothers in subgroup 1 vs. control group showed a significantly upregulated expression of CD80 and CD86 (p = 0.023). Moreover, such cord blood samples in subgroup 1 were found to have increased percentage of CD4+, CCR7+ T cells paralleled with decreased proportion of naive CD4+ T cells as compared with control group (p = 0.016). It was found that count of maternal regulatory CD4+CD25+Foxp3+ T cells (Treg) did not differ significantly, whereas Treg cell functional activity in mothers with severe COVID-19 (subgroup 2) was significantly suppressed. Significantly higher level of neonatal proinflammatory cytokines and chemokines was detected in subgroup 1 vs. control group (p < 0.05). However, the cytokines level in maternal peripheral blood samples in main and control groups upon delivery was changed insignificantly. SARS-CoV-2-positive pregnant women showed a strong antigen-specific T cell response. A reduced thymus size was found in neonates born to paired COVID-19 mothers.Conclusion. Fetal inflammatory response syndrome occurs upon COVID-19, which is characterized by activated fetal immune system and increased production of pro-inflammatory cytokines. The disease severity in pregnant women has no correlation with FIRS intensity during neonatal period and can vary from minimally altered laboratory parameters to developing sequelae at organ and body system levels.https://www.gynecology.su/jour/article/view/1650covid-19fetal inflammatory response syndromefirsregulatory t cellstregfetuspregnancycytokines
spellingShingle N. R. Gashimova
L. L. Pankratyeva
V. O. Bitsadze
J. Kh. Khizroeva
N. A. Makatsariya
M. V. Tretyakova
A. S. Shkoda
K. N. Grigoreva
V. I. Tsibizova
J.-C. Gris
F. E. Yakubova
D. V. Blinov
A. D. Makatsariya
Intrauterine activation of the fetal immune system in response to maternal COVID-19
Акушерство, гинекология и репродукция
covid-19
fetal inflammatory response syndrome
firs
regulatory t cells
treg
fetus
pregnancy
cytokines
title Intrauterine activation of the fetal immune system in response to maternal COVID-19
title_full Intrauterine activation of the fetal immune system in response to maternal COVID-19
title_fullStr Intrauterine activation of the fetal immune system in response to maternal COVID-19
title_full_unstemmed Intrauterine activation of the fetal immune system in response to maternal COVID-19
title_short Intrauterine activation of the fetal immune system in response to maternal COVID-19
title_sort intrauterine activation of the fetal immune system in response to maternal covid 19
topic covid-19
fetal inflammatory response syndrome
firs
regulatory t cells
treg
fetus
pregnancy
cytokines
url https://www.gynecology.su/jour/article/view/1650
work_keys_str_mv AT nrgashimova intrauterineactivationofthefetalimmunesysteminresponsetomaternalcovid19
AT llpankratyeva intrauterineactivationofthefetalimmunesysteminresponsetomaternalcovid19
AT vobitsadze intrauterineactivationofthefetalimmunesysteminresponsetomaternalcovid19
AT jkhkhizroeva intrauterineactivationofthefetalimmunesysteminresponsetomaternalcovid19
AT namakatsariya intrauterineactivationofthefetalimmunesysteminresponsetomaternalcovid19
AT mvtretyakova intrauterineactivationofthefetalimmunesysteminresponsetomaternalcovid19
AT asshkoda intrauterineactivationofthefetalimmunesysteminresponsetomaternalcovid19
AT kngrigoreva intrauterineactivationofthefetalimmunesysteminresponsetomaternalcovid19
AT vitsibizova intrauterineactivationofthefetalimmunesysteminresponsetomaternalcovid19
AT jcgris intrauterineactivationofthefetalimmunesysteminresponsetomaternalcovid19
AT feyakubova intrauterineactivationofthefetalimmunesysteminresponsetomaternalcovid19
AT dvblinov intrauterineactivationofthefetalimmunesysteminresponsetomaternalcovid19
AT admakatsariya intrauterineactivationofthefetalimmunesysteminresponsetomaternalcovid19