[en] AIM: To understand the effects of delivery mode on the immune cells frequency and function in cord blood and placenta. METHODS: We evaluated immunological differences in cord blood and placental tissues for a case of twins one of which delivered vaginally while the other delivered by caesarian section (C-section). Cord blood mononuclear cells were isolated and placenta tissues were processed for cell isolation. Immune phenotyping was performed by flow cytometry methods following staining for T cells, natural killer (NK) cells, monocytes, neutrophils and CD71(+) erythroid cells in both cord blood and placenta tissues. In addition, fetal calprotectin of twins was measured 12 wk after birth. RESULTS: We found lower percentages of immune cells (e.g. T cells, monocytes and neutrophils) in the cord blood of C-section delivered compared to vaginally delivered newborn. In contrast, percentages of monocytes and neutrophils were > 2 folds higher in the placental tissues of C-section delivered newborn. More importantly, we observed lower percentages of CD71(+) erythroid cells in both cord blood and placental tissues of C-section delivered case. Lower CD71(+) erythroid cells were associated with a more pro-inflammatory milieu at the fetomaternal interface reflected by higher expression of inhibitory receptors on CD4(+) T cells, higher frequency of monocytes and neutrophils. Furthermore, type of delivery impacted the gene expression profile in CD71(+) erythroid cells. Finally, we found that C-section delivered child had > 20-fold higher FCP in his fecal sample at 12 wk of age. CONCLUSION: Mode of delivery impacted immune cells profile in cord blood/placenta. In particular frequency of immunosuppressive CD71(+) erythroid cells was reduced in C-section delivered newborn.
Disciplines :
Immunology & infectious disease
Author, co-author :
Dunsmore, Garett ; Université de Liège - ULiège > Département des sciences fonctionnelles (DSF) > Physiologie générale et des systèmes ; Department of Dentistry and Department of Medical Microbiology and Immunology, University of Alberta, Edmonton T6G2E1, Alberta, Canada.
Koleva, Petya; Department of Dentistry, University of Alberta, Edmonton T6G2E1 Alberta, Canada.
Sutton, Reed Taylor; Division of Gastroenterology, University of Alberta, Edmonton T6G2E1, Alberta, Canada.
Ambrosio, Lindsy; Division of Gastroenterology, University of Alberta, Edmonton T6G2E1, Alberta, Canada.
Huang, Vivian; Division of Gastroenterology, University of Alberta, Edmonton, T6G 2E1, Alberta, Canada and Division of Gastroenterology, University of Toronto, Mount Sinai Hospital, Sinai Health System, Toronto, M5G 1X5, Ontario, Canada.
Elahi, Shokrollah; Department of Dentistry and Department of Medical Microbiology and Immunology, University of Alberta, Edmonton T6G2E1, Alberta, Canada. elahi@ualberta.ca.
Language :
English
Title :
Mode of delivery by an ulcerative colitis mother in a case of twins: Immunological differences in cord blood and placenta.
Neu J, Rushing J. Cesarean versus vaginal delivery: longterm infant outcomes and the hygiene hypothesis. Clin Perinatol 2011; 38: 321331 [PMID: 21645799 DOI: 10.1016/j.clp.2011.03.008]
Patah LE, Malik AM. Models of childbirth care and cesarean rates in different countries. Rev Saude Publica 2011; 45: 185194 [PMID: 21181056]
Arabin B, Kyvernitakis I, Liao A, Zugaib M. Trends in cesarean delivery for twin births in the United States: 19952008. Obstet Gynecol 2012; 119: 657658; author reply 658659 [PMID: 22353970 DOI: 10.1097/AOG.0b013e318248be0b]
Lee HC, Gould JB, Boscardin WJ, ElSayed YY, Blumenfeld YJ. Trends in cesarean delivery for twin births in the United States: 19952008. Obstet Gynecol 2011; 118: 10951101 [PMID: 22015878 DOI: 10.1097/AOG.0b013e3182318651]
Palmer C, Bik EM, DiGiulio DB, Relman DA, Brown PO. Development of the human infant intestinal microbiota. PLoS Biol 2007; 5: e177 [PMID: 17594176 DOI: 10.1371/journal. pbio.0050177]
Dominguez-Bello MG, Costello EK, Contreras M, Magris M, Hidalgo G, Fierer N, Knight R. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proc Natl Acad Sci USA 2010; 107: 1197111975 [PMID: 20566857 DOI: 10.1073/pnas.1002601107]
Kelly D, King T, Aminov R. Importance of microbial colonization of the gut in early life to the development of immunity. Mutat Res 2007; 622: 5869 [PMID: 17612575 DOI: 10.1016/ j.mrfmmm.2007.03.011]
Guarner F, BourdetSicard R, Brandtzaeg P, Gill HS, McGuirk P, van Eden W, Versalovic J, Weinstock JV, Rook GA. Mechanisms of disease: the hygiene hypothesis revisited. Nat Clin Pract Gastroenterol Hepatol 2006; 3: 275284 [PMID: 16673007 DOI: 10.1038/ncpgasthep0471]
Mueller NT, Bakacs E, Combellick J, Grigoryan Z, DominguezBello MG. The infant microbiome development: mom matters. Trends Mol Med 2015; 21: 109117 [PMID: 25578246 DOI: 10.1016/j.molmed.2014.12.002]
Pistiner M, Gold DR, Abdulkerim H, Hoffman E, Celedón JC. Birth by cesarean section, allergic rhinitis, and allergic sensitization among children with a parental history of atopy. J Allergy Clin Immunol 2008; 122: 274279 [PMID: 18571710 DOI: 10.1016/ j.jaci.2008.05.007]
Sevelsted A, Stokholm J, Bønnelykke K, Bisgaard H. Cesarean section and chronic immune disorders. Pediatrics 2015; 135: e92e98 [PMID: 25452656 DOI: 10.1542/peds.20140596]
Brodin P, Jojic V, Gao T, Bhattacharya S, Angel CJ, Furman D, ShenOrr S, Dekker CL, Swan GE, Butte AJ, Maecker HT, Davis MM. Variation in the human immune system is largely driven by non-heritable influences. Cell 2015; 160: 3747 [PMID: 25594173 DOI: 10.1016/j.cell.2014.12.020]
Delyea C, Bozorgmehr N, Koleva P, Dunsmore G, Shahbaz S, Huang V, Elahi S. CD71+ Erythroid Suppressor Cells Promote Fetomaternal Tolerance through Arginase2 and PDL1. J Immunol 2018; 200: 40444058 [PMID: 29735482 DOI: 10.4049/ jimmunol.1800113]
Elahi S, Ertelt JM, Kinder JM, Jiang TT, Zhang X, Xin L, Chaturvedi V, Strong BS, Qualls JE, Steinbrecher KA, Kalfa TA, Shaaban AF, Way SS. Immunosuppressive CD71+ erythroid cells compromise neonatal host defence against infection. Nature 2013; 504: 158162 [PMID: 24196717 DOI: 10.1038/nature12675]
Gomez-Lopez N, Romero R, Xu Y, Miller D, Unkel R, C MacKenzie T, Frascoli M, Hassan SS. Umbilical cord CD71+ erythroid cells are reduced in neonates born to women in spontaneous preterm labor. Am J Reprod Immunol 2016; 76: 280284 [PMID: 27625200 DOI: 10.1111/aji.12556]
Dunsmore G, Bozorgmehr N, Delyea C, Koleva P, Namdar A, Elahi S. Erythroid Suppressor Cells Compromise Neonatal Immune Response against Bordetella pertussis. J Immunol 2017; 199: 20812095 [PMID: 28779022 DOI: 10.4049/jimmunol.1700742]
Elahi S. New insight into an old concept: role of immature erythroid cells in immune pathogenesis of neonatal infection. Front Immunol 2014; 5: 376 [PMID: 25161654 DOI: 10.3389/fimmu.2014.00376]
Bogner G, Wallner V, Fazelnia C, Strobl M, Volgger B, Fischer T, Jacobs VR. Delivery of the second twin: influence of presentation on neonatal outcome, a case controlled study. BMC Pregnancy Childbirth 2018; 18: 176 [PMID: 29776396 DOI: 10.1186/ s1288401818150]
Nikischin W, Peter M, Oldigs HD. The influence of mode of delivery on hematologic values in the umbilical vein. Gynecol Obstet Invest 1997; 43: 104107 [PMID: 9067716 DOI: 10.1159/000291831]
Schlinzig T, Johansson S, Stephansson O, Hammarström L, Zetterström RH, von Döbeln U, Cnattingius S, Norman M. Surge of immune cell formation at birth differs by mode of delivery and infant characteristicsA populationbased cohort study. PLoS One 2017; 12: e0184748 [PMID: 28910364 DOI: 10.1371/journal. pone.0184748]
Okoye I, Namdar A, Xu L, Crux N, Elahi S. Atorvastatin downregulates coinhibitory receptor expression by targeting Rasactivated mTOR signalling. Oncotarget 2017; 8: 9821598232 [PMID: 29228684 DOI: 10.18632/oncotarget.21003]
Okoye IS, Houghton M, Tyrrell L, Barakat K, Elahi S. Coinhibitory Receptor Expression and Immune Checkpoint Blockade: Maintaining a Balance in CD8+ T Cell Responses to Chronic Viral Infections and Cancer. Front Immunol 2017; 8: 1215 [PMID: 29033936 DOI: 10.3389/fimmu.2017.01215]
Cho CE, Norman M. Cesarean section and development of the immune system in the offspring. Am J Obstet Gynecol 2013; 208: 249254 [PMID: 22939691 DOI: 10.1016/j.ajog.2012.08.009]
Thilaganathan B, MeherHomji N, Nicolaides KH. Labor: an immunologically beneficial process for the neonate. Am J Obstet Gynecol 1994; 171: 12711272 [PMID: 7977532]
Grönlund MM, Nuutila J, Pelto L, Lilius EM, Isolauri E, Salminen S, Kero P, Lehtonen OP. Mode of delivery directs the phagocyte functions of infants for the first 6 months of life. Clin Exp Immunol 1999; 116: 521526 [PMID: 10361245]
Savino F, Castagno E, Calabrese R, Viola S, Oggero R, Miniero R. High faecal calprotectin levels in healthy, exclusively breastfed infants. Neonatology 2010; 97: 299304 [PMID: 19887860 DOI: 10.1159/000255161]
Cohan J, Finlayson E. Delivery Mode in Pregnant Patients with IBD: Uncertainty Remains. Inflamm Bowel Dis 2017; 23: 727 [PMID: 28426454 DOI: 10.1097/MIB.0000000000001111]