Assessment of Alterations in Immune Function During Pregnancy and Post Parturition
Condition: Pregnancy Immune Function
Study type: Observational

Summary: 
      Traditionally, it has been suggested that pregnancy causes an immunosuppressive state that
      would facilitate fetal tolerance and result in an increased susceptibility to infection.
      Although the suppression has been characterized as a global T-cell defect, the observation
      that the increase in susceptibility is restricted only to specific intracellular bacteria and
      viruses is consistent with a down regulation of only certain components of the innate immune
      system. Progress in the treatment and management of infections during pregnancy will require
      further understanding of the changes to the immune system that occur during pregnancy. It is
      hypothesized that there is a fundamental down-regulation in the innate immune system that
      occurs during pregnancy and remains until delivery and that changes in serum cytokines
      influence na(SqrRoot) ve CD4 differentiation to different subpopulations. To that end, this
      study will evaluate blood samples drawn from pregnant women during early, mid, and late
      pregnancy and post-partum for changes in the innate immune system and compare them to those
      of healthy, non-pregnant women. Changes in the cytokine profile and in the lymphocyte and
      natural killer (NK) cell populations will be identified. A comparison of any observed changes
      will be made with those previously reported for in vitro and in vivo studies.
    

Detailed description: 
      Traditionally, it has been suggested that pregnancy causes an immunosuppressive state that
      would facilitate fetal tolerance and result in an increased susceptibility to infection.
      Although the suppression has been characterized as a global T-cell defect, the observation
      that the increase in susceptibility is restricted only to specific intracellular bacteria and
      viruses is consistent with a down regulation of only certain components of the innate immune
      system. Progress in the treatment and management of infections during pregnancy will require
      further understanding of the changes to the immune system that occur during pregnancy. It is
      hypothesized that there is a fundamental down-regulation in the innate immune system that
      occurs during pregnancy and remains until delivery and that changes in serum cytokines
      influence na(SqrRoot) ve CD4 differentiation to different subpopulations. To that end, this
      study will evaluate blood samples drawn from pregnant women during early, mid, and late
      pregnancy and post-partum for changes in the innate immune system and compare them to data on
      a similar cohort of women of childbearing age from an existing database of healthy,
      non-pregnant women. Changes in the cytokine profile, gene expression by microarray, and in
      the lymphocyte and natural killer (NK) cell populations will be identified. We may perform
      neutrophil analysis. We will evaluate toll-like receptors functionality, and any changes in
      PBMC throughout pregnancy.

      We also plan to evaluate serum cytokine panels, PBMC by flow cytometry, and PBMC for
      microarray of gene expression, before and after administration of the influenza vaccine in up
      to 20 of the 40 pregnant subjects. Antibody levels will be measured as well.

      A comparison of any observed changes will be made with those previously reported for in vitro
      and in vivo studies.
    

Observational model: Case-Control
Time perspective: Prospective
Keywords: Gene Expression; IN VITRO; Immunosuppression; Infection; Neutrophils; Pregnancy; Immune Function