Maternal-fetal immune responses in pregnant women infected with SARS-CoV-2

Garcia‐Flores, Valeria; Romero, Roberto; Xu, Yi; Theis, Kevin R.; Arenas‐Hernandez, Marcia; Miller, Derek; Peyvandipour, Azam; Bhatti, Gaurav; Galaz, José; Gershater, Meyer; Levenson, Dustyn; Pusod, Errile; Li, Tao; Kracht, David; Florova, Violetta; Leng, Yaozhu; Motomura, Kenichiro; Para, Robert; Faucett, Megan; Hsu, Chaur‐Dong; Zhang, Gary; Tarca, Adi L.; Piqué-Regi, Roger; Gomez‐Lopez, Nardhy

doi:10.1038/s41467-021-27745-z

Cited by 159 publications

(214 citation statements)

References 115 publications

(138 reference statements)

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“…Increased cord blood cytokine levels and altered cord blood immune cell profiles including increased proportion of natural killer cells, Vδ2+ γδ T cells, and regulatory T cells have been observed in maternal SARS-CoV-2 infection in the absence of fetal infection [85,86], pointing to the potential for MIA itself to generate a proinflammatory fetal response. Single-cell RNA sequencing of cord blood mononuclear cells demonstrates a significant impact of maternal SARS-CoV-2 on cord blood monocyte programs, with ISGs upregulated in CD14 + and CD16 + monocytes [87].…”

Section: Mia and Placental Immune Activation In Response To Sars-cov-...mentioning

confidence: 99%

COVID-19 in pregnancy: implications for fetal brain development

Shook

Sullivan

et al. 2022

Trends in Molecular Medicine

109

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The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy on the developing fetal brain is poorly understood. Other antenatal infections such as influenza have been associated with adverse neurodevelopmental outcomes in offspring. Although vertical transmission has been rarely observed in SARS-CoV-2 to date, given the potential for profound maternal immune activation, impact on the developing fetal brain is likely. Here we review evidence that SARS-CoV-2 and other viral infections during pregnancy can result in maternal, placental and fetal immune activation, and ultimately in offspring neurodevelopmental morbidity. Finally, we highlight the need for cellular models of fetal brain development to better understand potential short- and long-term impacts of maternal SARS-CoV-2 infection on the next generation.

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Section: Mia and Placental Immune Activation In Response To Sars-cov-...mentioning

confidence: 99%

COVID-19 in pregnancy: implications for fetal brain development

Shook

Sullivan

et al. 2022

Trends in Molecular Medicine

109

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“…Moreover, viral RNA and proteins were found in the syncytiotrophoblast, cytotrophoblasts, villous stroma, and possibly Hofbauer cells ( 84 ). SARS-CoV-2 functional modulation of macrophages localized on chorioamniotic membranes has also been reported, resulting in a mild inflammatory response systemically and at the maternal-fetal interface mediated by IL-8, IL-10, and IL-15 ( 92 ). Accordingly, histopathologic findings of abnormal maternal or fetal vascular perfusion were detected in 46% and 35% of analyzed placentas, respectively ( 86 – 91 ).…”

Section: Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-cov-2)...mentioning

confidence: 99%

Effects of Vertical Transmission of Respiratory Viruses to the Offspring

et al. 2022

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Overt and subclinical maternal infections in pregnancy can have multiple and significant pathological consequences for the developing fetus, leading to acute perinatal complications and/or chronic disease throughout postnatal life. In this context, the current concept of pregnancy as a state of systemic immunosuppression seems oversimplified and outdated. Undoubtedly, in pregnancy the maternal immune system undergoes complex changes to establish and maintain tolerance to the fetus while still protecting from pathogens. In addition to downregulated maternal immunity, hormonal changes, and mechanical adaptation (e.g., restricted lung expansion) make the pregnant woman more susceptible to respiratory pathogens, such as influenza virus, respiratory syncytial virus (RSV), and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Depending on the infectious agent and timing of the infection during gestation, fetal pathology can range from mild to severe, and even fatal. Influenza is associated with a higher risk of morbidity and mortality in pregnant women than in the general population, and, especially during the third trimester of pregnancy, mothers are at increased risk of hospitalization for acute cardiopulmonary illness, while their babies show higher risk of complications such as prematurity, respiratory and neurological illness, congenital anomalies, and admission to neonatal intensive care. RSV exposure in utero is associated with selective immune deficit, remodeling of cholinergic innervation in the developing respiratory tract, and abnormal airway smooth muscle contractility, which may predispose to postnatal airway inflammation and hyperreactivity, as well as development of chronic airway dysfunction in childhood. Although there is still limited evidence supporting the occurrence of vertical transmission of SARS-CoV-2, the high prevalence of prematurity among pregnant women infected by SARS-CoV-2 suggests this virus may alter immune responses at the maternal-fetal interface, affecting both the mother and her fetus. This review aims at summarizing the current evidence about the short- and long-term consequences of intrauterine exposure to influenza, RSV, and SARS-CoV-2 in terms of neonatal and pediatric outcomes.

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“…]. This is supported by the lack of IgM antibodies targeting SARS-CoV-2 in the cord plasma and SARS-CoV-2 RNA in the placenta of pregnant women with a recent or ongoing infection [ 116 , 117 ]. However, there are some reports of adverse foetal outcomes following maternal SARS-CoV-2 infection, including preterm birth and intrauterine growth retardation [ 114 , 118 ].…”

Section: Transgenerational Covid-19: Mia In the Context Of The Global...mentioning

confidence: 99%