Interferons in pregnancy
Belokrinitskaya T.E., Frolova N.I., Vyzhlova E.N., Malinovskaya V.V.
The normal course and successful outcome of pregnancy are due to a carefully coordinated interaction between mother and fetus. Type I interferons refer to the key mediators of these interactions as they contribute to the uncomplicated course of gestation and protect the mother and fetus from various infections. According to the statistical data, the incidence of acute respiratory viral infections including influenza and COVID-19 in pregnant women exceeds more than twice the incidence of these diseases in non-pregnant women of the same age, while 33% of all hospitalizations of mothers are associated with acute respiratory viral infections.
The objective of the study is to analyze the sources of modern literature on the role of interferons in maternal antiviral immunity, in the prevention and treatment of acute respiratory viral infections, influenza and COVID-19.
The databases and services, namely PubMed, PubMed Central, Scopus, MEDLINE, ScienceDirect, Cochrane Library, eLibrary were searched for publications of the national and foreign scientists for the period from 2013 to December 2023.
The review presents the current information on the role of interferons in the gestational change of the maternal body, in providing the normal course of pregnancy and anti-infective protection of the mother and fetus. The paper also presents the results of evaluating the effectiveness and safety of the use of recombinant interferon alpha-2b drugs as a means of preventing and treating various acute respiratory infections including influenza and COVID-19 in pregnant women.
Conclusion: Due to the persistent epidemiological risk associated with the circulation of various respiratory viruses that cause the development of mixed infections, systematization of data on the role of interferons during gestation and fetal development, understanding the pathogenesis of respiratory viral diseases of the mother will help the doctors to choose the appropriate methods of prevention and therapy of acute respiratory viral infections in pregnant women.
Authors’ contributions: Belokrinitskaya T.E. – developing the concept and design of the study, writing the text; Belokrinitskaya T.E., Frolova N.I. – searching and processing literature sources; Belokrinitskaya T.E., Vyzhlova E.N., Malinovskaya V.V. – editing the article.
Conflicts of interest: Authors declare lack of the possible conflicts of interests.
Funding: The study was conducted without sponsorship.
For citation: Belokrinitskaya T.E., Frolova N.I., Vyzhlova E.N., Malinovskaya V.V. Interferons in pregnancy.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (2): 144-150 (in Russian)
https://dx.doi.org/10.18565/aig.2024.31
Keywords
References
- Белокриницкая Т.Е., Шаповалов К.Г. Грипп и беременность. М.: ГЭОТАР-Медиа; 2015. 144 c. [Belokrinitskaya T.E., Shapovalov K.G. Influenza and pregnancy. Moscow: GEOTAR-Media; 2015. 144 p. (in Russian)].
- Yockey L.J, Iwasaki A. Interferons and proinflammatory cytokines in pregnancy and fetal development. Immunity. 2018; 49(3): 397-412. https://dx.doi.org/10.1016/j.immuni.2018.07.017.
- Ding J., Maxwell A., Adzibolosu N., Hu A., You Y., Liao A., Mor G. Mechanisms of immune regulation by the placenta: Role of type I interferon and interferon-stimulated genes signaling during pregnancy. Immunol. Rev. 2022; 308(1): 9-24. https://dx.doi.org/10.1111/imr.13077.
- Yang X., Tian Y., Zheng L., Luu T., Kwak-Kim J. The update immune-regulatory role of pro- and anti-inflammatory cytokines in recurrent pregnancy losses. Int. J. Mol. Sci. 2022; 24(1): 132. https://dx.doi.org/10.3390/ijms24010132.
- Piccinni M.P., Raghupathy R., Saito S., Szekeres-Bartho J. Cytokines, hormones and cellular regulatory mechanisms favoring successful reproduction. Front. Immunol. 2021; 12: 717808. https://dx.doi.org/10.3389/fimmu.2021.717808.
- Casazza R.L., Lazear H.M., Miner J.J. Protective and pathogenic effects of interferon signaling during pregnancy. Viral Immunol. 2020; 33(1): 3-11. https://dx.doi.org/10.1089/vim.2019.0076.
- Bencze D., Fekete T., Pázmándi K. Correlation between type I interferon associated factors and COVID-19 severity. Int. J. Mol. Sci. 2022; 23(18): 10968. https://dx.doi.org/10.3390/ijms231810968.
- Белокриницкая Т.Е., Артымук Н.В., Филиппов О.С., Фролова Н.И. COVID-19 у беременных Сибири и Дальнего Востока: итоги 2 лет пандемии Акушерство и гинекология. 2022; 4: 47-54. [Belokrinitskaya T.E., Artymuk N.V., Filippov O.S., Frolova N.I. COVID-19 in pregnant women of Siberia and the Russian Far East: 2-year results of the pandemic. Obstetrics and Gynecology. 2022; (4): 47-54. (in Russian)]. https://dx.doi.org/10.18565/aig.2022.4.47-54.
- Vanders R.L., Gibson P.G., Murphy V.E., Wark P.A. Plasmacytoid dendritic cells and CD8 T cells from pregnant women show altered phenotype and function following H1N1/09 infection. J. Infect. Dis. 2013; 208(7): 1062-70. https://dx.doi.org/10.1093/infdis/jit296.
- Potter J.A., Tong M., Aldo P., Kwon J.Y., Pitruzzello M., Mor G. et al. Viral infection dampens human fetal membrane type I interferon responses triggered by bacterial LPS. J. Reprod. Immunol. 2020; 140: 103126. https://dx.doi.org/10.1016/j.jri.2020.103126.
- Schneider W.M., Chevillotte M.D., Rice C.M. Interferon-stimulated genes: a complex web of host defenses. Ann. Rev. Immunol. 2014; 32: 513-45. https://dx.doi.org/10.1146/annurev-immunol-032713-120231.
- Mertowska P., Smolak K., Mertowski S., Grywalska E. Immunomodulatory role of interferons in viral and bacterial infections. Int. J. Mol. Sci. 2023; 24(12):10115. https://dx.doi.org/10.3390/ijms241210115.
- Ершов Ф.И., Наровлянский А.Н. Теоретические и прикладные аспекты системы интерферонов: к 60-летию открытия интерферонов. Вопросы вирусологии. 2018; 63(1): 10-8. [Ershov F.I., Narovlyansky A.N. Theoretical and applied aspects of the interferon system: to the 60th anniversary of the discovery of interferons. Problems of Virology. 2018; 63(1): 10-8. (in Russian)]. https://dx.doi.org/10.18821/0507-4088-2018-63-1-10-18.
- Косенкова Т.В., Зазерская И.Е., Кликунова К.А. Лечение урогенитальных инфекций у беременных женщин и внутриутробного инфицирования у новорожденных детей препаратами рекомбинантного интерферона альфа-2b: результаты мета-анализа. Вопросы гинекологии, акушерства и перинатологии. 2020; 19(4): 110-36. [Kosenkova T.V., Zazerskaya I.E., Klikunova K.A. Treatment of genitourinary infections in pregnant women and intrauterine infections in newborns using recombinant interferon alpha-2b: results of the meta-analysis. Gynecology, Obstetrics and Perinatology. 2020; 19(4): 110-36. (in Russian)]. https://dx.doi.org/10.20953/1726-1678-2020-4-110-136.
- Малиновская В.В., Баранов И.И., Выжлова Е.Н., Шувалов А.Н. Лечение острых респираторных инфекций у беременных. Акушерство и гинекология: новости, мнения, обучение. 2019; 7(4): 72-8. [Malinovskaya V.V., Baranov I.I., Vy'zhlova E.N., Shuvalov A.N. Treatment of acute respiratory infections in pregnant women. Obstetrics and Gynecology: News, Opinions, Training. 2019; 7(4): 72-8. (in Russian)]. https://dx.doi.org/10.24411/2303-9698-2019-14006.
- Байбарина Е.Н., Филиппов О.С., Гусева Е.В., Белокриницкая Т.Е., Шаповалов К.Г., Белокриницкая Т.Е., Шаповалов К.Г., Шифман Е.М., Куликов А.В., Хаитов Р.М., Лусс М.П., Сухих Г.Т., Адамян Л.В., Пырегов А.В., Малеев В.В. Грипп и вызванная им пневмония у беременных: этиотропная и респираторная терапия, акушерская тактика, профилактика. Информационно-методическое письмо Министерства здравоохранения Российской Федерации. Медицинский алфавит. 2017; 1(5): 53-8. [Baibarina E.N., Filippov O.S., Guseva E.V., Belokrinitskaya T.E., Shapovalov K.G., Shifman E.M. et al. Influenza and pneumonia caused by it in pregnant women: etiotropic and respiratory therapy, obstetric tactics, prevention. Information and methodological letter from the Ministry of Health of the Russian Federation. Medical Alphabet. 2017; 1(5): 53-8. (in Russian)]. https://www.elibrary.ru/download/elibrary_29426453_49859444.pdf
- Колобухина Л.В., Щелканов М.Ю., Бурцева Е.И., Альховский С.В., Прилипов А.Г., Кружкова И.С. и др. Клинико-эпидемиологическая характеристика гриппа А (H1N1) pdm09 в эпидсезоне 2012-2013 гг. в г. Москве. Вопросы вирусологии. 2013; 1: 90-101. [Kolobukhina L.V., Shchelkanov M.Yu., Burtseva E.I., Lakhovsky S.V., Prilipov F.G., Kruzhkova I.S. et al. Clinicoepidemiological characteristics of influenza А (H1N1) PDM09 during 2012-2013 epidemiological season in Moscow. Problems of Virology. 2013; (1): 90-101. (in Russian)].
- Мещерякова А.К., Костинов М.П., Магаршак О.О., Гусева Т.С., Паршина О.В. Влияние препарата рекомбинантного интерферона -2b в форме геля на течение острой респираторной инфекции и состояние мукозального иммунитета у беременных. Вестник оториноларингологии. 2014; 6: 50‑3. [Meshheryakova A.K., Kostinov M.P., Magarshak O.O., Guseva T.S., Parshina O.V. The effect of recombinant interferon -2b in gel form on the course of acute respiratory infection and the state of mucosal immunity in pregnant women. Bulletin of Otorhinolaryngology. 2014; (6): 50‑3. (in Russian)].
- Синчихин С.П., Степанян Л.В., Проскурина Е.В., Насри О., Синчихина Е.С. Профилактическая эффективность применения рекомбинантного интерферона альфа-2b у беременных в период их нахождение в семейном очаге новой коронавирусной инфекции. Гинекология. 2022; 24(2): 114-9. [Sinchikhin S.P., Stepanyan L.V., Proskurina E.V., Nasri O., Sinchikhina E.S. Prophylactic efficacy of recombinant interferon alfa-2b in pregnant women during their stay in the family focus of new coronavirus infection. Gynecology. 2022; 24(2): 114-9. (in Russian)]. https://dx.doi.org/10.26442/20795696.2022.2.201448.
- Yu N., Li W., Kang Q., Xiong Z., Wang S., Lin X. et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-center, descriptive study. Lancet Infect. Dis. 2020; 20(5): 559-64. https://dx.doi.org/10.1016/S1473-3099(20)30176-6.
- Zhao X., Jiang Y., Zhao Y., Xi H., Liu C., Qu F. et al. Analysis of the susceptibility to COVID-19 in pregnancy and recommendations on potential drug screening. Eur. J. Clin. Microbiol. Infect. Dis. 2020; 39(7): 1209-20. https://dx.doi.org/10.1007/s10096-020-03897-6.
- Favilli A., Mattei Gentili M., Raspa F., Giardina I., Parazzini F., Vitagliano A. et al. Effectiveness and safety of available treatments for COVID-19 during pregnancy: a critical review. J. Matern. Fetal Neonatal Med. 2022; 35(11): 2174-87. https://dx.doi.org/10.1080/14767058.2020.1774875.
- Кравченко Е.Н., Куклина Л.В., Овчинникова Е.М., Чебакова В.Ю., Выжлова Е.Н., Баранов И.И. COVID-19: исходы беременности и родов при использовании в лечении препаратов рекомбинантного интерферона α-2b. Вопросы гинекологии, акушерства и перинатологии. 2021; 20(5): 36-7. [Kravchenko E.N., Kuklina L.V., Ovchinnikova E.M., Chebakova V.Yu., Vyzhlova E.N., Baranov I.I. COVID-19: pregnancy and childbirth outcomes after treatment with recombinant interferon α-2b. Gynecology, Obstetrics and Perinatology. 2021; 20(5): 36-7. (in Russian)]. https://dx.doi.org/10.20953/1726-1678-2021-5-36-37.
- https://www.cdc.gov/respiratory-viruses/tools-resources/health-care-providers.html#prepare-for-virus-season
- https://www.who.int/news/item/05-05-2023-statement-on-the-fifteenth-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-coronavirus-disease-(covid-19)-pandemic
Received 09.02.2024
Accepted 15.02.2024
About the Authors
Tatiana E. Belokrinitskaya, Dr. Med. Sci., Professor, Head of the Obstetrics and Gynecology Department of the Pediatric Faculty and Faculty of Professional Retraining,Chita State Medical Academy, Ministry of Health of Russia, 672000, Russia, Chita, Gorky str., 39a +7(3022)32-30-58, tanbell24@mail.ru,
https://orcid.org/0000-0002-5447-4223
Nataly I. Frolova, Dr. Med. Sci., Associate Professor of the Department of Obstetrics and Gynecology of the Pediatric Faculty and Faculty of Professional Retraining,
Chita State Medical Academy, Ministry of Health of Russia, 672000, Russia, Chita, Gorky str., 39a, taasyaa@mail.ru, https://orcid.org/0000-0002-7433-6012
Evgeniya N. Vyzhlova, PhD (Bio), Researcher at the Laboratory of Ontogenesis and Correction of the Interferon System, Gamaleya National Research Center for Epidemiology and Microbiology, 123098, Russia, Moscow, Gamaleya str., 18, +7(499)193-30-60, evizhlova@yandex.ru, https://orcid.org/0000-0003-3054-8694
Valentina V. Malinovskaya, Dr. Bio. Sci., Professor, Chief Researcher at the Laboratory of Ontogenesis and Correction of the Interferon System, Gamaleya National Research Center for Epidemiology and Microbiology, 123098, Russia, Moscow, Gamaleya str., 18, +7(499)350-93-03, info@viferon.su, https://orcid.org/0000-0003-1856-8924
Corresponding author: Tatiana E. Belokrinitskaya, tanbell24@mail.ru