In vivo immune signatures of healthy human pregnancy: Inherently inflammatory or anti-inflammatory?

PLoS One. 2017 Jun 21;12(6):e0177813. doi: 10.1371/journal.pone.0177813. eCollection 2017.

Abstract

Changes in maternal innate immunity during healthy human pregnancy are not well understood. Whether basal immune status in vivo is largely unaffected by pregnancy, is constitutively biased towards an inflammatory phenotype (transiently enhancing host defense) or exhibits anti-inflammatory bias (reducing potential responsiveness to the fetus) is unclear. Here, in a longitudinal study of healthy women who gave birth to healthy infants following uncomplicated pregnancies within the Canadian Healthy Infant Longitudinal Development (CHILD) cohort, we test the hypothesis that a progressively altered bias in resting innate immune status develops. Women were examined during pregnancy and again, one and/or three years postpartum. Most pro-inflammatory cytokine expression, including CCL2, CXCL10, IL-18 and TNFα, was reduced in vivo during pregnancy (20-57%, p<0.0001). Anti-inflammatory biomarkers (sTNF-RI, sTNF-RII, and IL-1Ra) were elevated by ~50-100% (p<0.0001). Systemic IL-10 levels were unaltered during vs. post-pregnancy. Kinetic studies demonstrate that while decreased pro-inflammatory biomarker expression (CCL2, CXCL10, IL-18, and TNFα) was constant, anti-inflammatory expression increased progressively with increasing gestational age (p<0.0001). We conclude that healthy resting maternal immune status is characterized by an increasingly pronounced bias towards a systemic anti-inflammatory innate phenotype during the last two trimesters of pregnancy. This is resolved by one year postpartum in the absence of repeat pregnancy. The findings provide enhanced understanding of immunological changes that occur in vivo during healthy human pregnancy.

MeSH terms

  • Adolescent
  • Adult
  • Anti-Inflammatory Agents / immunology*
  • Anti-Inflammatory Agents / metabolism
  • Biomarkers / metabolism*
  • Canada
  • Female
  • Gestational Age
  • Humans
  • Immunity, Innate / immunology*
  • Inflammation / immunology*
  • Inflammation / metabolism
  • Inflammation / pathology
  • Inflammation Mediators / immunology*
  • Inflammation Mediators / metabolism
  • Kinetics
  • Longitudinal Studies
  • Pregnancy
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Biomarkers
  • Inflammation Mediators

Grants and funding

The Canadian Institutes of Health Research (CIHR) and the Allergy, Genes and Environment (AllerGen) Network of Centres of Excellence provided core funding for the CHILD Study. Support for this work has also been provided by Canada Research Chairs, Children's Hospital Research Foundation of Manitoba. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.