Mode of delivery by an ulcerative colitis mother in a case of twins: Immunological differences in cord blood and placenta

Abstract

AIMTo understand the effects of delivery mode on the immune cells frequency and function in cord blood and placenta.METHODSWe evaluated immunological differences in cord blood and placental tissues for a case of twins one of which delivered vaginally while the other delivered by caesarian section (C-section). Cord blood mononuclear cells were isolated and placenta tissues were processed for cell isolation. Immune phenotyping was performed by flow cytometry methods following staining for T cells, natural killer (NK) cells, monocytes, neutrophils and CD71+ erythroid cells in both cord blood and placenta tissues. In addition, fetal calprotectin of twins was measured 12 wk after birth.RESULTSWe found lower percentages of immune cells (e.g. T cells, monocytes and neutrophils) in the cord blood of C-section delivered compared to vaginally delivered newborn. In contrast, percentages of monocytes and neutrophils were > 2 folds higher in the placental tissues of C-section delivered newborn. More importantly, we observed lower percentages of CD71+ erythroid cells in both cord blood and placental tissues of C-section delivered case. Lower CD71+ erythroid cells were associated with a more pro-inflammatory milieu at the fetomaternal interface reflected by higher expression of inhibitory receptors on CD4+ T cells, higher frequency of monocytes and neutrophils. Furthermore, type of delivery impacted the gene expression profile in CD71+ erythroid cells. Finally, we found that C-section delivered child had > 20-fold higher FCP in his fecal sample at 12 wk of age.CONCLUSIONMode of delivery impacted immune cells profile in cord blood/placenta. In particular frequency of immunosuppressive CD71+ erythroid cells was reduced in C-section delivered newborn.

Erythroid precursors and progenitors suppress adaptive immunity and get invaded by SARS-CoV-2

“…Given the high surface expression of ACE2 and TMPRSS2 on placental CECs and their permissibility to ARS-CoV-2 infection, raises the possibility of vertical viral transmission seems possible. Also, CECs become abundant in the peripheral blood of pregnant women at the later stage of pregnancy 33,34,40 , which in part may support the reported viremia and placental transmission of SARS-CoV-2 60 . This was challenged due to negligible co-expression of ACE2 and TMPRSS2 by placental cell types 61 .…”

“…6E and 6F). To examine the infectivity of CEC's obtained from a SARS-CoV2 naïve source we infected CECs isolated from human placenta with SARS-CoV2, because placenta is physiologically enriched with CECs 33,34,40,41 possessing ACE2 and TMPRSS2 (Fig. 3D, Fig.…”

Erythroid precursors and progenitors suppress adaptive immunity and get invaded by SARS-CoV-2

“…We found that the amount of viral RNA in CECs and produced by CECs was similar to monocytes ( Figures 6 E and 6F). To examine the infectivity of CECs obtained from a SARS-CoV2-naive source we infected CECs isolated from human placenta with SARS-CoV2, because placenta is physiologically enriched with CECs ( Delyea et al., 2018 ; Dunsmore et al., 2018a , 2018b ; Gomez-Lopez et al., 2016 ), possessing ACE2 and TMPRSS2 ( Figures 3 D and 5 G). Similar to CECs from COVID-19 patients, placental CD45 + CECs had substantial surface expression of ACE2 ( Figures S6 A and S6B) and TMPRSS2 ( Figure S6 C).…”

Immunological consequences of extramedullary erythropoiesis: immunoregulatory functions of CD71+ erythroid cells

“…Interestingly, not only was the frequency of CEC observed in the cord blood and placenta of a twin delivered by Cesarean section lower than that of the vaginally delivered twin, but the CEC of the two twins also had a different gene profile. 27 It can, therefore, be speculated that lower levels of CEC in IBD patients may result in intestinal dysbiosis and poor pregnancy outcomes. 28,29 In support of this hypothesis, lower CEC frequency was associated with preterm deliveries and emergency Cesarean sections.…”