Nuffield Department of Women's & Reproductive Health, University of Oxford, The Women's Centre, John Radcliffe Hospital, Oxford, OX3 9DU, UK.
South African Medical Research Council Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
Sci Rep. 2020 Aug 6;10(1):13265. doi: 10.1038/s41598-020-69966-0.
Preterm birth is the leading cause of neonatal and child mortality worldwide. Globally, 1.4 million pregnant women are estimated to be living with HIV/AIDS, the majority of whom live in sub-Saharan Africa. Maternal HIV infection and antiretroviral treatment (ART) have been associated with increased rates of preterm birth, but the underlying mechanisms remain unknown. Acute HIV infection is associated with a rapid depletion of all three subsets of innate lymphoid cells (ILCs), ILC1s, ILC2s and ILC3s, which is not reversed by ART. ILCs have been found at the maternal-fetal interface and we therefore investigated the potential association between maternal HIV infection, peripheral ILC frequencies and preterm birth. In our study of pregnant South African women with accurately dated pregnancies, we show that maternal HIV infection is associated with reduced levels of all three ILC subsets. Preterm birth was also associated with lower levels of all three ILC subsets in early pregnancy. ILC frequencies were lowest in HIV positive women who experienced preterm birth. Moreover, ILC levels were reduced in pregnancies resulting in spontaneous onset of preterm labour and in extreme preterm birth (< 28 weeks gestation). Our findings suggest that reduced ILC frequencies may be a link between maternal HIV infection and preterm birth. In addition, ILC frequencies in early pregnancy may serve as predictive biomarkers for women who are at risk of delivering preterm.
早产是全球新生儿和儿童死亡的主要原因。全球估计有 140 万孕妇感染艾滋病毒/艾滋病，其中大多数生活在撒哈拉以南非洲。母体艾滋病毒感染和抗逆转录病毒治疗（ART）与早产率升高有关，但潜在机制尚不清楚。急性艾滋病毒感染与所有三种先天淋巴细胞细胞亚群（ILC），即 ILC1、ILC2 和 ILC3 的迅速耗竭有关，而这一过程不会被 ART 逆转。已经在母体-胎儿界面发现了 ILCs，因此我们研究了母体 HIV 感染、外周 ILC 频率与早产之间的潜在关联。在对怀孕南非妇女进行的精确日期妊娠研究中，我们发现母体 HIV 感染与所有三种 ILC 亚群的水平降低有关。早产也与妊娠早期所有三种 ILC 亚群的水平降低有关。在经历早产的 HIV 阳性妇女中，ILC 频率最低。此外，在自发性早产和极早产（<28 周妊娠）的孕妇中，ILC 水平降低。我们的研究结果表明，ILC 频率降低可能是母体 HIV 感染与早产之间的联系。此外，妊娠早期的 ILC 频率可能是处于早产风险的女性的预测生物标志物。
