Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Immunology and Allergy, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Curr Med Chem. 2024;31(26):4199-4212. doi: 10.2174/0929867330666230619114508.
As a physiological condition, pregnancy may cause temporary alterations in the hematological, cardiopulmonary, and immune responses, affecting the maternal susceptibility to viral infections. Pregnant women are vulnerable to infection with the influenza A virus, hepatitis E virus, MERS CoV, and SARS CoV. The agent of Coronavirus disease (COVID-19) is the SARS coronavirus (SARS CoV-2), which affects the cells upon binding to the angiotensin-converting enzyme-2 (ACE2). However, ACE2 expression is elevated in the placental tissue. However, surprisingly, COVID-19 infection in pregnant women tends to have a lower severity and mortality. Therefore, it is interesting to find the immunological mechanisms related to the severity of COVID-19 in pregnancy. Regulatory T cells (Tregs) are a subset of CD4+T cells that may play a central role in maintaining maternal tolerance by regulating immune responses. Pregnancy-induced Tregs are developed to control immune responses against paternal antigens expressed by the semi-allograft fetus. The role of uncontrolled immune responses in COVID-19 pathogenesis has already been identified. This review provides insight into whether pregnancy- induced regulatory T-cell functions could influence the severity of COVID-19 infection during pregnancy.
妊娠是一种生理状态，可能导致血液学、心肺和免疫反应的暂时改变，影响母体对病毒感染的易感性。孕妇易感染甲型流感病毒、戊型肝炎病毒、中东呼吸综合征冠状病毒和严重急性呼吸综合征冠状病毒。冠状病毒病（COVID-19）的病原体是严重急性呼吸综合征冠状病毒（SARS-CoV-2），它通过与血管紧张素转换酶-2（ACE2）结合来影响细胞。然而，胎盘组织中 ACE2 的表达增加。然而，令人惊讶的是，孕妇 COVID-19 感染的严重程度和死亡率往往较低。因此，寻找与妊娠 COVID-19 严重程度相关的免疫学机制很有趣。调节性 T 细胞（Tregs）是 CD4+T 细胞的一个亚群，通过调节免疫反应，可能在维持母体耐受方面发挥核心作用。妊娠诱导的 Tregs 是为了控制针对半同种异体胎儿表达的父系抗原的免疫反应而发展起来的。不受控制的免疫反应在 COVID-19 发病机制中的作用已经得到确定。本综述探讨了妊娠诱导的调节性 T 细胞功能是否会影响妊娠期间 COVID-19 感染的严重程度。
