Departamento de Medicina Genómica, Hospital General de México "Dr. Eduardo Liceaga", Ciudad de México, México.
Servicio de Complicaciones de la Segunda Mitad del Embarazo, UMAE Hospital de Gineco-Obstetricia No. 4 "Dr. Luis Castelazo Ayala". Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, México.
PLoS One. 2022 Jul 28;17(7):e0264566. doi: 10.1371/journal.pone.0264566. eCollection 2022.
Current medical guidelines consider pregnant women with COVID-19 to be a high-risk group. Since physiological gestation downregulates the immunological response to maintain "maternal-fetal tolerance", SARS-CoV-2 infection may constitute a potentially threatening condition to both the mother and the fetus. To establish the immune profile in pregnant COVID-19+ patients, a cross-sectional study was conducted. Pregnant women with COVID-19 (P-COVID-19+; n = 15) were analyzed and compared with nonpregnant women with COVID-19 (NP-COVID-19+; n = 15) or those with physiological pregnancy (P-COVID-19-; n = 13). Serological cytokine and chemokine concentrations, leucocyte immunophenotypes, and mononuclear leucocyte responses to polyclonal stimuli were analyzed in all groups. Higher concentrations of serological TNF-α, IL-6, MIP1b and IL-4 were observed within the P-COVID-19+ group, while cytokines and chemokines secreted by peripheral leucocytes in response to LPS, IL-6 or PMA-ionomicin were similar among the groups. Immunophenotype analysis showed a lower percentage of HLA-DR+ monocytes in P-COVID-19+ than in P-COVID-19- and a higher percentage of CD39+ monocytes in P-COVID-19+ than in NP-COVID-19+. After whole blood polyclonal stimulation, similar percentages of T cells and TNF+ monocytes between groups were observed. Our results suggest that P-COVID-19+ elicits a strong inflammatory response similar to NP-COVID19+ but also displays an anti-inflammatory response that controls the ATP/adenosine balance and prevents hyperinflammatory damage in COVID-19.
目前的医学指南认为 COVID-19 孕妇属于高危人群。由于生理妊娠下调免疫反应以维持“母婴耐受”，因此 SARS-CoV-2 感染可能对母亲和胎儿构成潜在威胁。为了确定 COVID-19 孕妇的免疫谱，进行了一项横断面研究。分析了 COVID-19 孕妇（P-COVID-19+；n=15），并与 COVID-19 非孕妇（NP-COVID-19+；n=15）或生理妊娠孕妇（P-COVID-19-；n=13）进行比较。分析了所有组的血清细胞因子和趋化因子浓度、白细胞免疫表型以及多克隆刺激下单核细胞的反应。P-COVID-19+组中观察到更高的血清 TNF-α、IL-6、MIP1b 和 IL-4 浓度，而外周白细胞对 LPS、IL-6 或 PMA-离子霉素的反应中细胞因子和趋化因子的分泌在各组之间相似。免疫表型分析显示 P-COVID-19+中 HLA-DR+单核细胞的比例低于 P-COVID-19-，而 P-COVID-19+中 CD39+单核细胞的比例高于 NP-COVID-19+。在全血多克隆刺激后，各组之间 T 细胞和 TNF+单核细胞的百分比相似。我们的研究结果表明，P-COVID-19+引发的强烈炎症反应与 NP-COVID19+相似，但也显示出抗炎反应，可控制 ATP/腺苷平衡并防止 COVID-19 中的过度炎症损伤。
