Benefits and Risks of IgG Transplacental Transfer

Ciobanu, Anca Marina; Dumitru, Andreea Elena; Gică, Nicolae; Botezatu, Radu; Peltecu, Gheorghe; Panaitescu, Anca Maria

doi:10.3390/diagnostics10080583

Cited by 54 publications

(39 citation statements)

References 140 publications

(158 reference statements)

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“…While previous reports in adults have noted sex differences in production of SARS-CoV-2-specific antibodies ( 26, 87 ), this is the first report of sex-biased maternal production and transplacental transfer of SARS-CoV-2-specific antibodies. We previously reported impaired placental transfer of maternal SARS-CoV-2-specific antibodies in the setting of maternal SARS-CoV-2 infection ( 46, 47 ), consistent with the reduced transplacental transfer of maternal antibodies in other maternal infections such as malaria and HIV ( 38, 88–91 ). While there are known sex differences in adult antibody production in response to SARS-CoV-2 infection ( 26, 80 ), little is known about sex differences in maternal titers or transplacental antibody transfer ( 92, 93 ), particularly in the setting of maternal SARS-CoV-2 infection.…”

Section: Discussionsupporting

confidence: 76%

Sexually dimorphic placental responses to maternal SARS-CoV-2 infection

Bordt

Shook

Atyeo

et al. 2021

Preprint

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There is a persistent male bias in the prevalence and severity of COVID-19 disease. Underlying mechanisms accounting for this sex difference remain incompletely understood. Interferon responses have been implicated as a modulator of disease in adults, and play a key role in the placental anti-viral response. Moreover, the interferon response has been shown to alter Fc-receptor expression, and therefore may impact placental antibody transfer. Here we examined the intersection of viral-induced placental interferon responses, maternal-fetal antibody transfer, and fetal sex. Placental interferon stimulated genes (ISGs), Fc-receptor expression, and SARS-CoV-2 antibody transfer were interrogated in 68 pregnancies. Sexually dimorphic placental expression of ISGs, interleukin-10, and Fc receptors was observed following maternal SARS-CoV-2 infection, with upregulation in males. Reduced maternal SARS-CoV-2-specific antibody titers and impaired placental antibody transfer were noted in pregnancies with a male fetus. These results demonstrate fetal sex-specific maternal and placental adaptive and innate immune responses to SARS-CoV-2.

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Section: Discussionsupporting

confidence: 76%

Sexually dimorphic placental responses to maternal SARS-CoV-2 infection

Bordt

Shook

Atyeo

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…It is both a strength and a limitation that our study necessarily examines transplacental antibody transfer in the setting of third trimester maternal infection with SARS-CoV-2, owing to the timing of the pandemic in Boston. The third trimester is typically regarded as the time when highest placental antibody transfer occurs, 57 , 58 , 59 with most of these data from vaccinatable pathogens. 60 , 61 , 62 , 63 While it is possible that antibody transfer may be lower in third trimester natural or native infection compared with second trimester infection, data are lacking in this regard.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Maternal and Neonatal SARS-CoV-2 Viral Load, Transplacental Antibody Transfer, and Placental Pathology in Pregnancies During the COVID-19 Pandemic

et al. 2020

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Key Points Question What key biological characteristics of maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and placental function and pathology have implications for vertical transmission and neonatal protection? Findings In this prospective cohort study including 127 pregnancies, there was no maternal viremia, placental infection, or vertical transmission of SARS-CoV-2. Compromised transplacental transfer of anti–SARS-CoV-2 antibodies with robust transfer of influenza-specific immunity and nonoverlapping placental expression of SARS-CoV-2 receptors angiotensin-converting enzyme 2 and transmembrane serine protease 2 were noted. Meaning These findings suggest that, although low rates of maternal viremia and patterns of placental SARS-CoV-2 receptor distribution may underlie the rarity of vertical transmission, reduced transplacental transfer of anti–SARS-CoV-2 antibodies may leave neonates at risk for infection.

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“…In most women who were treated during pregnancy, anti-CD20 mAbs were given early during the first trimester, suggesting that only limited amounts of the drugs passed through the placental barrier and fetal exposure was low. 29 So far, data on B-cell counts in the newborn, especially from mothers with MS or NMOSD, are based on single case reports. 30 In our study, B-cell counts were normal in the majority (73%) of the babies, of note also in 2 first trimester exposed babies.…”

Section: Discussionmentioning

confidence: 99%

Anti-CD20 therapies and pregnancy in neuroimmunologic disorders

Kümpfel

Thiel

Meinl

et al. 2021

Neurol Neuroimmunol Neuroinflamm

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ObjectiveTo report pregnancy outcomes and disease activity (DA) in women with MS, neuromyelitis optica spectrum disorders (NMOSDs), and other neuroimmunologic diseases (ONID) after treatment with rituximab (RTX)/ocrelizumab (OCR) 12 months before or during pregnancy.MethodsData were collected in the German MS and pregnancy registry and centers from the Neuromyelitis Optica Study Group. Sixty-eight known outcomes of 88 pregnancies from 81 women (64 MS, 10 NMOSD, and 7 ONID) were included and stratified in 3 exposure groups: >6M-group = RTX/OCR >6 but ≤12 months before the last menstrual period (LMP) (n = 8); <6M group = RTX/OCR <6 months before the LMP (n = 47); preg group = RTX/OCR after the LMP (n = 13).ResultsPregnancy outcomes were similar between groups, but significantly more preterm births (9.8% vs 45%) occurred after exposure during pregnancy. Overall, 2 major congenital abnormalities (3.3%), both in the preg group, were observed. Three women had severe infections during pregnancy. All women with MS (35) and 12/13 women with NMOSD, RTX/OCR exposure before the LMP and known pregnancy outcomes after gestational week 22 were relapse free during pregnancy. Five of 29 (17.2%) women with relapsing-remitting MS (RRMS) and 1 of 12 (8.3%) with NMOSD and at least 6 months postpartum follow-up experienced a relapse postpartum. Duration of RTX/OCR and early retreatment but not detection of B-cells were possible predictors for postpartum relapses in patients with RRMS/NMOSD.ConclusionsAlthough RTX/OCR might be an interesting option for women with RRMS/NMOSD who plan to become pregnant to control DA, more data on pregnancy outcomes and rare risks are needed.

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Benefits and Risks of IgG Transplacental Transfer

Cited by 54 publications

References 140 publications

Sexually dimorphic placental responses to maternal SARS-CoV-2 infection

Sexually dimorphic placental responses to maternal SARS-CoV-2 infection

Assessment of Maternal and Neonatal SARS-CoV-2 Viral Load, Transplacental Antibody Transfer, and Placental Pathology in Pregnancies During the COVID-19 Pandemic

Anti-CD20 therapies and pregnancy in neuroimmunologic disorders

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