The role of the T-cell mediated immune response to Cytomegalovirus infection in intrauterine transmission

PLoS One. 2023 Feb 6;18(2):e0281341. doi: 10.1371/journal.pone.0281341. eCollection 2023.

Abstract

Introduction: Prognostic markers for fetal transmission of Cytomegalovirus (CMV) infection during pregnancy are poorly understood. Maternal CMV-specific T-cell responses may help prevent fetal transmission and thus, we set out to assess whether this may be the case in pregnant women who develop a primary CMV infection.

Methods: A multicenter prospective study was carried out at 8 hospitals in Spain, from January 2017 to April 2020. Blood samples were collected from pregnant women at the time the primary CMV infection was diagnosed to assess the T-cell response. Quantitative analysis of interferon producing specific CMV-CD8+/CD4+ cells was performed by intracellular cytokine flow cytometry.

Results: In this study, 135 pregnant women with a suspected CMV infection were evaluated, 60 of whom had a primary CMV infection and samples available. Of these, 24 mothers transmitted the infection to the fetus and 36 did not. No association was found between the presence of specific CD4 or CD8 responses against CMV at the time maternal infection was diagnosed and the risk of fetal transmission. There was no transmission among women with an undetectable CMV viral load in blood at diagnosis.

Conclusions: In this cohort of pregnant women with a primary CMV infection, no association was found between the presence of a CMV T-cell response at the time of maternal infection and the risk of intrauterine transmission. A detectable CMV viral load in the maternal blood at diagnosis of the primary maternal infection may represent a relevant biomarker associated with fetal transmission.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • CD8-Positive T-Lymphocytes
  • Cytomegalovirus
  • Cytomegalovirus Infections*
  • Female
  • Humans
  • Immunity
  • Infectious Disease Transmission, Vertical / prevention & control
  • Pregnancy
  • Pregnancy Complications, Infectious*
  • Prospective Studies

Grants and funding

Founders (Spanish Ministry of Science and Innovation Instituto de Salud Carlos III and the European Regional Development Fund) did not play any role in study design, data collection and analysis, decision to publish or preparation of the manuscript. No commercial company funded the study or played any role in in study design, data collection and analysis, decision to publish or preparation of the manuscript. Grants: 1. Grant PI 16/00807, to DBG, from Spanish Ministry of Science and Innovation Instituto de Salud Carlos III and co-funded by the European Regional Development Fund. 2. Grant 19/01333, to DBG, from Spanish Ministry of Science and Innovation Instituto de Salud Carlos III and co-funded by the European Regional Development Fund. 3. Grant INT20/00086 from Spanish Ministry of Science and Innovation Instituto de Salud Carlos III and co-funded by the European Regional Development Fund. 4. There is no additional external funding received for this study. 5. DBG received received fees from MSD as speaker in educational activities not related to the present study. 6. MSD is not a founder of the study. Sponsors websites: www.isciii.eshttps://ec.europa.eu/regional_policy/en/funding/erdf.