Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu, Taiwan.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Front Immunol. 2024 Sep 3;15:1415561. doi: 10.3389/fimmu.2024.1415561. eCollection 2024.
This study evaluates tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) and interferon-γ-induced protein-10 (IP-10) in pregnant women with COVID-19 and their newborns, exploring the effects of antiviral treatments and vaccine-induced neutralizing antibody (Nab) inhibition on these key viral infection biomarkers.
We studied 61 pregnant women with past COVID-19 and either three (n=56) or four (n=5) doses of vaccination, and 46 without COVID-19 but vaccinated. We analyzed them and their newborns' blood for TRAIL, IP-10, and Nab levels using enzyme-linked immunosorbent assays (ELISA), correlating these with other clinical factors.
Our study found lower TRAIL but higher IP-10 levels in maternal blood than neonatal cord blood, irrespective of past COVID-19 diagnosis. Cases diagnosed with COVID-19 < 4 weeks previously had higher maternal blood TRAIL levels (16.49 vs. 40.81 pg/mL, p=0.0064) and IP-10 (154.68 vs. 225.81 pg/mL, p=0.0170) than those never diagnosed. Antiviral medication lowered TRAIL and IP-10 in maternal blood without affecting Nab inhibition (TRAIL: 19.24 vs. 54.53 pg/mL, p=0.028; IP-10: 158.36 vs. 255.47 pg/mL, p=0.0089). TRAIL and IP-10 levels were similar with three or four vaccine doses, but four doses increased Nab inhibition (p=0.0363). Previously COVID-19 exposed pregnant women had higher Nab inhibition (p < 0.0001). No obvious correlation was found among TRAIL, IP-10, and Nab inhibition level.
Our study suggests that lower maternal TRAIL and higher IP-10 levels compared to neonatal cord blood coupled with a rise in both markers following COVID-19 diagnosis that could be reduced by antivirals indicates a correlation to infection severity. Higher vaccine doses enhance Nab inhibition, irrespective of antiviral medication use and independent of TRAIL or IP-10 levels, highlighting the significance and safety of adequate vaccination and antiviral use post-diagnosis in pregnant women.
本研究评估了 COVID-19 孕妇及其新生儿的肿瘤坏死因子相关凋亡诱导配体（TRAIL）和干扰素-γ诱导蛋白-10（IP-10），探索了抗病毒治疗和疫苗诱导中和抗体（Nab）抑制对这些关键病毒感染生物标志物的影响。
我们研究了 61 名过去患有 COVID-19 的孕妇，其中 56 名接受了三剂、5 名接受了四剂疫苗接种，46 名未感染 COVID-19 但接种了疫苗。我们使用酶联免疫吸附测定（ELISA）分析了她们及其新生儿的血液中的 TRAIL、IP-10 和 Nab 水平，并将这些水平与其他临床因素相关联。
本研究发现，无论过去是否诊断出 COVID-19，母体血液中的 TRAIL 水平低于新生儿脐带血，但 IP-10 水平高于新生儿脐带血。最近在 <4 周前被诊断出 COVID-19 的病例中，母体血液中的 TRAIL 水平（16.49 与 40.81 pg/mL，p=0.0064）和 IP-10 水平（154.68 与 225.81 pg/mL，p=0.0170）均高于从未被诊断出的病例。抗病毒药物降低了母体血液中的 TRAIL 和 IP-10，但不影响 Nab 抑制（TRAIL：19.24 与 54.53 pg/mL，p=0.028；IP-10：158.36 与 255.47 pg/mL，p=0.0089）。三剂或四剂疫苗接种的 TRAIL 和 IP-10 水平相似，但四剂疫苗接种增加了 Nab 抑制（p=0.0363）。以前接触过 COVID-19 的孕妇的 Nab 抑制水平更高（p<0.0001）。TRAIL、IP-10 和 Nab 抑制水平之间未发现明显相关性。
本研究表明，与新生儿脐带血相比，母体血液中的 TRAIL 水平较低，IP-10 水平较高，并且 COVID-19 诊断后这两种标志物的水平均升高，这可能与感染严重程度有关。更高的疫苗剂量增强了 Nab 抑制，无论是否使用抗病毒药物，且与 TRAIL 或 IP-10 水平无关，这突出表明在孕妇中，充分接种疫苗和使用抗病毒药物在诊断后具有重要意义和安全性。
