Leukocyte counts and lymphocyte subsets in relation to pregnancy and HIV infection in Malawian women

Mandala, Wilson L.; Gondwe, Esther N.; Molyneux, Malcolm E.; MacLennan, Jenny; MacLennan, Calman A.

doi:10.1111/aji.12678

Cited by 11 publications

(8 citation statements)

References 25 publications

(22 reference statements)

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“…In agreement with others, a significant reduction in the numbers of CD4+ and CD8+ T cells was observed, in day‐14 pregnant animals compared with nonpregnant animals, showing that pregnancy itself leads to an alteration of the immune status namely in the number of T cells . As previously reported, T gondii infection induced increased CD4+ and CD8+ T‐cell numbers in the spleens of mice at day 7 post‐infection, and this was not affected by pregnancy .…”

Section: Discussionsupporting

confidence: 92%

Toxoplasma gondii infection reduces serum progesterone levels and adverse effects at the maternal‐foetal interface

Brito

Silva

Castro

et al. 2019

Parasite Immunology

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Aims Pregnant BALB/c mice infected with a Toxoplasma gondii type II strain were used to determine how pregnancy interferes with the development of maternal immunity to T gondii and how infection disrupts pregnancy and foetal development. Methods Maternal and foetal parasite loads were assessed by amplification of T gondii SAG1 using qPCR. Adverse effects of infection were evaluated on foetal‐placental development by quantification of implantation units undergoing resorption and by histopathological analyses. Serum progesterone levels were quantified by immunoassay. The effect of T gondii infection on maternal immunity was determined by assessing the cellular composition of spleens by flow cytometry. Results Infected pregnant mice exhibited clinical signs of infection, inflammation and necrosis at the maternal‐foetal interface and decreased serum progesterone levels. In infected mice, there was a clear effect of pregnancy and infection on macrophage cell numbers. However, no differences in the parasite load were detected between non‐pregnant and pregnant mice. Conclusions Maternal T gondii infection induced adverse effects at the maternal‐foetal interface. Alterations were found in immune spleen cells, dependent on the day of pregnancy, relative to nonpregnant animals. The results obtained suggest a pregnancy‐dependent mechanism during T gondii infection able to interfere with macrophage numbers.

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Section: Discussionsupporting

confidence: 92%

Toxoplasma gondii infection reduces serum progesterone levels and adverse effects at the maternal‐foetal interface

Brito

Silva

Castro

et al. 2019

Parasite Immunology

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“…This partly agrees with the increased WBC and neutrophil count, and reduced lymphocyte and unchanging monocyte counts observed by Mandala et al though the nonpregnant group in their study were newly diagnosed and 35% were 60+ years of age(43).…”

supporting

confidence: 92%

Pregnancy Gestation Impacts on HIV-1-Specific Granzyme B Response and Central Memory CD4 T Cells

et al. 2020

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Pregnancy induces alterations in peripheral T-cell populations with both changes in subset frequencies and anti-viral responses found to alter with gestation. In HIV-1 positive women anti-HIV-1 responses are associated with transmission risk, however detailed investigation into both HIV-1-specific memory responses associated with HIV-1 control and T-cell subset changes during pregnancy have not been undertaken. In this study we aimed to define pregnancy and gestation related changes to HIV-1-specific responses and T-cell phenotype in ART treated HIV-1 positive pregnant women. Eleven non-pregnant and 24 pregnant HIV-1 positive women were recruited, peripheral blood samples taken, fresh cells isolated, and compared using ELISpot assays and flow cytometry analysis. Clinical data were collected as part of standard care, and non-parametric statistics used. Alterations in induced IFNγ, IL-2, IL-10, and granzyme B secretion by peripheral blood mononuclear cells in response to HIV-1 Gag and Nef peptide pools and changes in T-cell subsets between pregnant and non-pregnant women were assessed, with data correlated with participant clinical parameters and longitudinal analysis performed. Cross-sectional comparison identified decreased IL-10 Nef response in HIV-1 positive pregnant women compared to non-pregnant, while correlations exhibited reversed Gag and Nef cytokine and protease response associations between groups. Longitudinal analysis of pregnant participants demonstrated transient increases in Gag granzyme B response and in the central memory CD4 T-cell subset frequency during their second trimester, with a decrease in CD4 effector memory T cells from their second to third trimester. Gag and Nef HIV-1-specific responses diverge with pregnancy time-point, coinciding with relevant T-cell phenotype, and gestation associated immunological adaptations. Decreased IL-10 Nef and both increased granzyme B Gag response and central memory CD4 T cells implies that amplified antigen production is occurring, which suggests a period of compromised HIV-1 control in pregnancy.

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“…Some older papers suggest that there was no change overall in lymphocyte count during pregnancy (13,14). Results from more recent studies suggest that there is a decrease in lymphocyte count (15,16), with the biggest decrease occurring in the first and second trimesters (5). The bulk of available literature agrees with the findings of a reduction in overall lymphocyte count; however, a recent study in 2013 found a significant increase in the lymphocyte count of 200 pregnant women (17,18), further complicating the discussion.…”

Section: Discussionmentioning

confidence: 68%

Neutrophil/lymphocyte ratio and Lymphopenia as a severity marker rather than diagnostic marker of Covid-19 in pregnant population, A retrospective case series.

Elhossamy

Korrapati

Cole

et al. 2020

Preprint

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Objective: Recommending using lymphopenia and neutrophil/lymphocyte ratio(NLR) as a severity marker rather than diagnostic marker for pregnant patients with COVID-19. Design: retrospective study. Setting :Birmingham city hospital, Birmingham, United Kingdom maternity unit admissions to delivery suite between 10 March 2020 and 31 May 2020. Population: We reviewed all patients who tested positive for COVID-19 and were pregnant. Methods: We looked at the white blood cell counts of all the patients and their outcomes. We specifically looked at lymphocyte count as well as neutrophil count and calculated the neutrophil lymphocyte ratio(NLR) for every case in our series. Main Outcome Measures: Only 15.3% of pregnant patients who tested positive for COVID-19 had lymphopenia and raised NLR in contrast with up to 90% in non-pregnant population. Results: Our results indicate that out of 13 patients who tested positive, for COVID-19, only 2 915.3% had lymphopenia and raised NLR more than 8. Conclusions: There are very conflicting results for normal values of white blood cells and lymphocytes in pregnancy. In our study Lymphopenia and raised NLR do not seem to be common findings in confirmed pregnant cases of COVID-19 but can help determine morbidity as patients that had lymphopenia and raised NLR displayed severe symptoms, were more unwell and needed high dependency unit admission. Introduction: Coronaviruses can infect humans and animals. A novel Coronavirus was identified in 2019, causing pneumonia in patients within China initially then spread globally, resulting in an epidemic. The virus that causes COVID-19 has been named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). (1), (3) Full-genome analysis indicated that the coronavirus that causes COVID-19 is a beta coronavirus that resembles SARS Virus (severe acute respiratory syndrome virus). Similarly, the structure of the receptor-binding gene region is very similar to that of the SARS virus, and the virus has been shown to use the same receptor, the angiotensin-converting enzyme 2 (ACE2), for cell entry (2)

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Leukocyte counts and lymphocyte subsets in relation to pregnancy and HIV infection in Malawian women

Cited by 11 publications

References 25 publications

Toxoplasma gondii infection reduces serum progesterone levels and adverse effects at the maternal‐foetal interface

Toxoplasma gondii infection reduces serum progesterone levels and adverse effects at the maternal‐foetal interface

Pregnancy Gestation Impacts on HIV-1-Specific Granzyme B Response and Central Memory CD4 T Cells

Neutrophil/lymphocyte ratio and Lymphopenia as a severity marker rather than diagnostic marker of Covid-19 in pregnant population, A retrospective case series.

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