What is it about?

The first pandemic of the 21st century occurred in 2009 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 mortality. During the H1N1pdm09 pandemic, few studies assessed the immune status of infected pregnant women. This paper evaluates 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). We found that pro-inflammatory (TNF-a, IL-1b, 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.

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Why is it important?

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 during pregnancy.

Perspectives

Our results provide evidence for a differential inflammatory response against H1N1 infection, which could explain clinical course differs from those of other influenza-like diseases in pregnancy. The CD69 overexpression in T and B lymphocytes and/or levels of serum cytokines might be used like biomarkers in the screening of H1N1 infection during pregnancy. The medical experience suggests that early attention with antiviral therapy is related with a better outcome. Efficiently run H1N1 influenza control programmes based on directly observed treatment with oseltamivir, and screning strategy are essential for preventing the antiviral resistant strains.

Dr Gabriel Arteaga-Troncoso
National Institute of Perinatology

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This page is a summary of: Pregnant Women Infected with Pandemic H1N1pdm2009 Influenza Virus Displayed Overproduction of Peripheral Blood CD69+ Lymphocytes and Increased Levels of Serum Cytokines, PLoS ONE, September 2014, PLOS,
DOI: 10.1371/journal.pone.0107900.
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