Pregnant Women Infected with Pandemic H1N1pdm2009 Influenza Virus Displayed Overproduction of Peripheral Blood CD69+ Lymphocytes and Increased Levels of Serum Cytokines

Abstract

The first pandemic of the 21st century occurred in 2009 and was caused by the H1N1pdm influenza A virus. Severe cases of H1N1pdm infection in adults are characterized by sustained immune activation, whereas pregnant women are prone to more severe forms of influenza, with increased morbi-mortality. During the H1N1pdm09 pandemic, few studies assessed the immune status of infected pregnant women. The objective of this study was to evaluate the behavior of several immune markers in 13 H1N1pdm2009 virus-infected pregnant (PH1N1) women, in comparison to pregnant women with an influenza-like illness (ILI), healthy pregnant women (HP) and healthy non-pregnant women (HW). The blood leukocyte phenotypes and the serological cytokine and chemokine concentrations of the blood leukocytes, as measured by flow cytometry, showed that the CD69+ cell counts in the T and B-lymphocytes were significantly higher in the PH1N1 group. We found that pro-inflammatory (TNF-α, IL-1β, IL-6) and anti-inflammatory (IL-10) cytokines and some chemokines (CXCL8, CXCL10), which are typically at lower levels during pregnancy, were substantially increased in the women in the ILI group. Our findings suggest that CD69 overexpression in blood lymphocytes and elevated levels of serum cytokines might be potential markers for the discrimination of H1N1 disease from other influenza-like illnesses in pregnant women.

Interleukin-10 and soluble tumor necrosis factor receptor II are potential biomarkers of Plasmodium falciparum infections in pregnant women: a case-control study from Nanoro, Burkina Faso

“…It was already shown that pregnant women with influenza also present with increased concentrations of IL-10. In contrast, IL-10 levels were within normal range in women infected with the parasitic disease filariasis [ 38 , 39 ]. For sTNF-RII, that has mainly an anti-inflammatory effect by preventing circulating TNF-α from activating its cell bound receptors [ 40 ], there is a lack of available data on its dynamics in pregnant women with other infectious diseases.…”

DAMPs and influenza virus infection in ageing

“…In the recent swine flu pandemic H1N1/H3N2 outbreak in 2009, pregnant women were infected with pulmonary complications (Neuzil et al, 1998;Murata et al, 2007), and elderly people with medical problems were shown to be more prone to more severe forms of influenza infection (Cerbulo-Vazquez et al, 2014) and influenza infection even triggered stroke in some patients (Toschke et al, 2009). This leads to striking statistics where elderly make up 30-fold more high-risk of influenza related hospitalization and deaths than healthy individuals (Glezen et al, 1987;Izurieta et al, 2000;Hak et al, 2004;Rothberg et al, 2008;Jain et al, 2009), and the majority of deaths associated with influenza infections occur in ageing people over 65 years old (Viboud et al, 2004;Lemaitre et al, 2009;Lee et al, 2012).…”

Differential Immune Profiles in Two Pandemic Influenza A(H1N1)pdm09 Virus Waves at Pandemic Epicenter

“…In addition to soluble mediators, surface cellular markers such as CD69 (an early lymphocyte activation marker), lung homing related CD62L, Triggering Receptor Expressed on Myeloid cells (TREM)-1 and HLA-DR have been useful for inflammation analysis in influenza infections (22) , inflammatory systemic syndrome (23) and hypersensitivity states (24) .…”