Functional impairment of CMV‐reactive cellular immunity during pregnancy. Issue 2 (7th September 2016) - Reuschel, Edith
Abstract : Cytomegalovirus (CMV) is the most common congenital viral infection. Mother‐to‐child transmission can cause severe child disability. Intact CMV‐specific cell‐mediated immunity (CMI) was shown to prevent uncontrolled replication in healthy individuals. This study aimed to determine whether CMV‐specific CMI is impaired in pregnant women, thus potentially increasing the overall risk for active CMV replication and transmission. CMV‐specific CMI in peripheral blood of 60 pregnant women was determined using T‐Track® CMV for detection of IE‐1 and pp65‐reactive effector cells by IFN‐γ ELISpot, and compared to the CMV‐IgG and ‐IgM serostatus. CMV‐specific CMI was detected in 65% of CMV‐seropositive pregnant women. Five percent of CMV‐IgG seronegative women showed IE‐1‐ but not pp65‐reactive cells. The overall number of CMV‐reactive cells in pregnant women was significantly lower compared to a matched non‐pregnant control group ( P < 0.001). No significant difference in CMV‐specific CMI was detected in the course of the three trimesters of pregnancy of CMV‐IgG seropositive women. Postpartum (median days postnatal = 123), IE‐1‐ and pp65‐specific CMI remained significantly lower than in the non‐pregnant control group ( P < 0.001 and 0.0032, respectively). Functional analysis of CMV‐reactive immune cells using T‐Track® CMV therefore suggests a systemic down‐regulation of CMV‐specific CMI in pregnant women. Further studies are needed to investigate whether this may be indicative of a higher susceptibility to CMV reactivation or transmission. J. Med. Virol. 89:324–331, 2017 . © 2016 Wiley Periodicals, Inc.