Inflammation and Immune Reactions in the Fetus as a Response to COVID-19 in the Mother
<b>Background</b>: Contracting COVID-19 during pregnancy can harm both the mother and the unborn child. Pregnant women are highly likely to develop respiratory viral infection complications with critical conditions caused by physiological changes in the immune and cardiopulmonary systems...
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MDPI AG
2023-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/13/4256 |
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| author | Nilufar R. Gashimova Liudmila L. Pankratyeva Victoria O. Bitsadze Jamilya Kh. Khizroeva Maria V. Tretyakova Kristina N. Grigoreva Valentina I. Tsibizova Jean-Christophe Gris Natalia D. Degtyareva Fidan E. Yakubova Alexander D. Makatsariya |
| author_facet | Nilufar R. Gashimova Liudmila L. Pankratyeva Victoria O. Bitsadze Jamilya Kh. Khizroeva Maria V. Tretyakova Kristina N. Grigoreva Valentina I. Tsibizova Jean-Christophe Gris Natalia D. Degtyareva Fidan E. Yakubova Alexander D. Makatsariya |
| author_sort | Nilufar R. Gashimova |
| collection | DOAJ |
| description | <b>Background</b>: Contracting COVID-19 during pregnancy can harm both the mother and the unborn child. Pregnant women are highly likely to develop respiratory viral infection complications with critical conditions caused by physiological changes in the immune and cardiopulmonary systems. Asymptomatic COVID-19 in pregnant women may be accompanied by fetal inflammatory response syndrome, which has adverse consequences for the newborn’s life and health. <b>Purpose</b>: To conduct an inflammatory response assessment of the fetus due to the effects of COVID-19 on the mother during pregnancy by determining pro-inflammatory cytokines, cell markers, T regulatory cells, T cell response, evaluation of cardiac function, and thymus size. <b>Materials and methods</b>: A prospective study included pregnant women (<i>n</i> = 92). The main group consisted of 62 pregnant women with COVID-19 infection: subgroup 1—SARS-CoV-2 PCR-positive pregnant women 4–6 weeks before delivery (<i>n</i> = 30); subgroup 2—SARS-CoV-2 PCR-positive earlier during pregnancy (<i>n</i> = 32). The control group consisted of 30 healthy pregnant women. In all pregnant women, the levels of circulating cytokines and chemokines (IL-1α, IL-6, IL-8, IL-10, GM-CSF, TNF-α, IFN-γ, MIP-1β, and CXCL-10) were determined in the peripheral blood and after delivery in the umbilical cord blood, and an analysis was performed of the cell markers on dendritic cells, quantitative and functional characteristics of T regulatory cells, and specific T cell responses. The levels of thyroxine and thyroid-stimulating hormone were determined in the newborns of the studied groups, and ultrasound examinations of the thymus and echocardiography of the heart were also performed. <b>Results</b>: The cord blood dendritic cells of newborns born to mothers who suffered from COVID-19 4–6 weeks before delivery (subgroup 1) showed a significant increase in CD80 and CD86 expression compared to the control group (<i>p</i> = 0.023). In the umbilical cord blood samples of children whose mothers tested positive for COVID-19 4–6 weeks before delivery (subgroup 1), the CD4+CCR7+ T cells increased with a concomitant decrease in the proportion of naive CD4+ T cells compared with the control group (<i>p</i> = 0.016). Significantly higher levels of pro-inflammatory cytokines and chemokines were detected in the newborns of subgroup 1 compared to the control group. In the newborns of subgroup 1, the functional activity of T regulatory cells was suppressed, compared with the newborns of the control group (<i>p</i> < 0.001). In all pregnant women with a severe coronavirus infection, a weak T cell response was detected in them as well as in their newborns. In newborns whose mothers suffered a coronavirus infection, a decrease in thymus size, transient hypothyroxinemia, and changes in functional parameters according to echocardiography were revealed compared with the newborns of the control group. <b>Conclusions</b>: Fetal inflammatory response syndrome can occur in infants whose mothers suffered from a COVID-19 infection during pregnancy and is characterized by the activation of the fetal immune system and increased production of pro-inflammatory cytokines. The disease severity in a pregnant woman does not correlate with SIRS severity in the neonatal period. It can vary from minimal laboratory parameter changes to the development of complications in the organs and systems of the fetus and newborn. |
| first_indexed | 2024-03-11T01:36:57Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T01:36:57Z |
| publishDate | 2023-06-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-436028ec0e184fa7a5402a3e99623aad2023-11-18T16:51:20ZengMDPI AGJournal of Clinical Medicine2077-03832023-06-011213425610.3390/jcm12134256Inflammation and Immune Reactions in the Fetus as a Response to COVID-19 in the MotherNilufar R. Gashimova0Liudmila L. Pankratyeva1Victoria O. Bitsadze2Jamilya Kh. Khizroeva3Maria V. Tretyakova4Kristina N. Grigoreva5Valentina I. Tsibizova6Jean-Christophe Gris7Natalia D. Degtyareva8Fidan E. Yakubova9Alexander D. Makatsariya10Sechenov University, 2 bldg. 4, Bolshaya Pirogovskaya Str., 119991 Moscow, RussiaDmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, 1 Samory Mashela Street, 117997 Moscow, RussiaSechenov University, 2 bldg. 4, Bolshaya Pirogovskaya Str., 119991 Moscow, RussiaSechenov University, 2 bldg. 4, Bolshaya Pirogovskaya Str., 119991 Moscow, RussiaSechenov University, 2 bldg. 4, Bolshaya Pirogovskaya Str., 119991 Moscow, RussiaSechenov University, 2 bldg. 4, Bolshaya Pirogovskaya Str., 119991 Moscow, RussiaFederal State Budgetary Institution “Almazov National Medical Research Centre”, Ministry of Health of the Russian Federation 2 Akkuratova Street, 197341 St. Petersburg, RussiaSechenov University, 2 bldg. 4, Bolshaya Pirogovskaya Str., 119991 Moscow, RussiaSechenov University, 2 bldg. 4, Bolshaya Pirogovskaya Str., 119991 Moscow, RussiaSechenov University, 2 bldg. 4, Bolshaya Pirogovskaya Str., 119991 Moscow, RussiaSechenov University, 2 bldg. 4, Bolshaya Pirogovskaya Str., 119991 Moscow, Russia<b>Background</b>: Contracting COVID-19 during pregnancy can harm both the mother and the unborn child. Pregnant women are highly likely to develop respiratory viral infection complications with critical conditions caused by physiological changes in the immune and cardiopulmonary systems. Asymptomatic COVID-19 in pregnant women may be accompanied by fetal inflammatory response syndrome, which has adverse consequences for the newborn’s life and health. <b>Purpose</b>: To conduct an inflammatory response assessment of the fetus due to the effects of COVID-19 on the mother during pregnancy by determining pro-inflammatory cytokines, cell markers, T regulatory cells, T cell response, evaluation of cardiac function, and thymus size. <b>Materials and methods</b>: A prospective study included pregnant women (<i>n</i> = 92). The main group consisted of 62 pregnant women with COVID-19 infection: subgroup 1—SARS-CoV-2 PCR-positive pregnant women 4–6 weeks before delivery (<i>n</i> = 30); subgroup 2—SARS-CoV-2 PCR-positive earlier during pregnancy (<i>n</i> = 32). The control group consisted of 30 healthy pregnant women. In all pregnant women, the levels of circulating cytokines and chemokines (IL-1α, IL-6, IL-8, IL-10, GM-CSF, TNF-α, IFN-γ, MIP-1β, and CXCL-10) were determined in the peripheral blood and after delivery in the umbilical cord blood, and an analysis was performed of the cell markers on dendritic cells, quantitative and functional characteristics of T regulatory cells, and specific T cell responses. The levels of thyroxine and thyroid-stimulating hormone were determined in the newborns of the studied groups, and ultrasound examinations of the thymus and echocardiography of the heart were also performed. <b>Results</b>: The cord blood dendritic cells of newborns born to mothers who suffered from COVID-19 4–6 weeks before delivery (subgroup 1) showed a significant increase in CD80 and CD86 expression compared to the control group (<i>p</i> = 0.023). In the umbilical cord blood samples of children whose mothers tested positive for COVID-19 4–6 weeks before delivery (subgroup 1), the CD4+CCR7+ T cells increased with a concomitant decrease in the proportion of naive CD4+ T cells compared with the control group (<i>p</i> = 0.016). Significantly higher levels of pro-inflammatory cytokines and chemokines were detected in the newborns of subgroup 1 compared to the control group. In the newborns of subgroup 1, the functional activity of T regulatory cells was suppressed, compared with the newborns of the control group (<i>p</i> < 0.001). In all pregnant women with a severe coronavirus infection, a weak T cell response was detected in them as well as in their newborns. In newborns whose mothers suffered a coronavirus infection, a decrease in thymus size, transient hypothyroxinemia, and changes in functional parameters according to echocardiography were revealed compared with the newborns of the control group. <b>Conclusions</b>: Fetal inflammatory response syndrome can occur in infants whose mothers suffered from a COVID-19 infection during pregnancy and is characterized by the activation of the fetal immune system and increased production of pro-inflammatory cytokines. The disease severity in a pregnant woman does not correlate with SIRS severity in the neonatal period. It can vary from minimal laboratory parameter changes to the development of complications in the organs and systems of the fetus and newborn.https://www.mdpi.com/2077-0383/12/13/4256COVID-19fetal inflammatory response syndromeTreg cellsfetuspregnancycytokines |
| spellingShingle | Nilufar R. Gashimova Liudmila L. Pankratyeva Victoria O. Bitsadze Jamilya Kh. Khizroeva Maria V. Tretyakova Kristina N. Grigoreva Valentina I. Tsibizova Jean-Christophe Gris Natalia D. Degtyareva Fidan E. Yakubova Alexander D. Makatsariya Inflammation and Immune Reactions in the Fetus as a Response to COVID-19 in the Mother Journal of Clinical Medicine COVID-19 fetal inflammatory response syndrome Treg cells fetus pregnancy cytokines |
| title | Inflammation and Immune Reactions in the Fetus as a Response to COVID-19 in the Mother |
| title_full | Inflammation and Immune Reactions in the Fetus as a Response to COVID-19 in the Mother |
| title_fullStr | Inflammation and Immune Reactions in the Fetus as a Response to COVID-19 in the Mother |
| title_full_unstemmed | Inflammation and Immune Reactions in the Fetus as a Response to COVID-19 in the Mother |
| title_short | Inflammation and Immune Reactions in the Fetus as a Response to COVID-19 in the Mother |
| title_sort | inflammation and immune reactions in the fetus as a response to covid 19 in the mother |
| topic | COVID-19 fetal inflammatory response syndrome Treg cells fetus pregnancy cytokines |
| url | https://www.mdpi.com/2077-0383/12/13/4256 |
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