PREGNANT WOMEN INFECTED WITH PANDEMIC INFLUENZA A(H1N1)pdm09 VIRUS SHOWED DIFFERENTIAL IMMUNE RESPONSE CORRELATED WITH DISEASE SEVERITY

PERIOLO NATALIA,; AVARO MARTIN; CZECH ANDREA; RUSSO MARA; BENEDETTI ESTEFANIA; PONTORIERO ANDREA; CAMPOS ANA; LILIANA MARTINEZ PERALTA; BAUMEISTER, ELSA

JOURNAL OF CLINICAL VIROLOGY : THE OFFICIAL PUBLICATION OF THE PAN AMERICAN SOCIETY FOR CLINICAL VIROLOGY.

ELSEVIER SCIENCE BV

Año: 2015 vol. 64 p. 52 - 58

1386-6532

Background During pregnancy, immunological and hormonal alterations place women at increased risk for influenza-related severe illnesses including hospitalization and death. Although A(H1N1) pdm09 infection resulted in increased disease severity in pregnant women, the precise mechanisms responsible for this risk have yet to be established. Objectives The present study was aimed to investigate the role of host chemokines and cytokine profiles in A(H1N1) pdm09 infection regarding disease severity in pregnant women. Study design This retrospective survey examined 41 pregnant women with confirmed A(H1N1) pdm09 infection. Of them, 12 died (D), 29 survived (S), and 17 remained uninfected and served as controls (C). Antiviral response was evaluated for IFN beta expression and gene expression profiles of cytokines (TNF alpha, IL-6, IL-12, TGF-beta) and chemokines (IL-8, RANTES, MCP-1, IP-10), and the viral Matrix (M1) gene was quantified and normalized using the housekeeping gene product beta-actin mRNA. Results Higher IL-8 and TNF-alpha mRNA expression were found in D and S compared with C, while IL-6 showed higher expression in D. Interestingly, these results were associated with a decrease in the anti-inflammatory response of TGF-beta mRNA and IFN-beta. These alterations would lead to an imbalance in the immune response of those patients. ConclusionsPregnancy-related reductions in IFN-beta and TGF-beta expression levels and elevated levels of pro-inflammatory cytokines could explain the increased severity of infection and death of pregnant women. These findings may help improve the understanding of the high susceptibility and disease severity to influenza virus infection during pregnancy.