A role for interferons in the maternal recognition of pregnancy

Antiviral and antiretroviral use in pregnancy

The history of antiviral and antiretroviral therapy is recent compared with many other medical therapies, including traditional antibiotics in pregnancy. There are few long-term data on which to base decisions of management in pregnancy. Accessing up-to-date information is critical to optimizing the safety of care for mothers and their infants. Exposure to medications in pregnancy can be toxic to a fetus in a gestational age-dependent manner. Determination of safe medications for pregnancy must take into consideration the need for certain medications and the possibility of inadvertent exposure in early pregnancy because of unplanned pregnancies. This article reviews the most commonly used antiviral and antiretroviral agents and places emphasis on the issues regarding use in pregnancy.

Functional characteristics of human trophoblast interferons

Human trophoblast populations from first-and third-trimester placentas produce interferons (IFNs) in the presence of growth factors (CSF and PDGF) or when infected with virus. The highly invasive extravillous trophoblast population produced a higher level of IFNs (three- to eightfold, P < 0.05) than the noninvasive villous trophoblast population when stimulated with growth factors and/or virus. The level of IFN produced was dependent on the type of trophoblast population, the type of inducer and the stage of differentiation of the trophoblasts. Tandem immunoaffinity chromatography of the virus-induced trophoblast IFNs resulted in the isolation of trophoblast IFN-alpha and -beta types. The purified trophoblast IFNs have antiviral, antiproliferative and immunoregulatory properties. Furthermore, the trophoblast IFNs inhibited the expression of proto-oncogenes such as EGF-R, c-erbB2 and c-fms reported to be involved in normal trophoblast growth and differentiation. These data suggest essential roles of interferons in normal human development during pregnancy.

Modulation of interferon secretion by concanavalin A and interleukin-2 in first trimester placental explants in vitro

The human placenta has been demonstrated to be a site of interferon (IFN) production. We report here that early human placental explants in vitro release both type I (IFN-alpha and -beta) and type II (IFN-gamma) immunoreactive IFN. The mitogen concanavalin A (Con A) stimulated immunoreactive (ir-) IFN-gamma secretion in both a dose- and time-dependent manner, but had no significant effect on either ir-IFN-alpha or -beta release. The enhancement of ir-IFN-gamma secretion by Con A, at 2-20 micrograms/ml, was significant at 1 h and persisted until 24 h, but was not significant at 48 h. A high dose of recombinant human interleukin-2 (IL-2) stimulates the release of all three types of ir-IFNs, suggesting that interaction of IL-2 with its receptor might be one cause of the constitutive production of placental IFNs. The patterns of response to Con A and IL-2 were different from those of lymphocytes, providing indirect evidence suggesting that the source of these IFNs might not be lymphocytic. Taken together, these results indicate that first trimester human placental explants in vitro produce both type I and type II IFNs, the major IFN produced depending on the inducer. IL-2 may be one of the physiological inducers of placental IFNs.

Differential interferon production in human first and third trimester trophoblast cultures stimulated with viruses

Stimulation of human placental first and third trimester trophoblast and syncytiotrophoblast cultures with viruses [Newcastle Disease Virus (NDV) and Sendai virus] led to a high interferon (IFN) production. The magnitude of the production was dependent on the gestational age of the trophoblast, type of inducer and the stage of differentiation of the trophoblast. The data obtained indicated that the first trimester trophoblast cultures produced five to sixfold more IFN than the third trimester trophoblast on per cell basis whereas syncytiotrophoblast at term produced twice as much IFN than the mononuclear term trophoblast when stimulated with the viruses. NDV and Sendai virus produced different levels and composition of IFN-alpha and -beta in both first and third trimester trophoblast and syncytiotrophoblast cultures. Purification of the virus-induced trophoblast interferons (tro-IFNs) by tandem high-performance affinity chromatography resulted in specific activities between 0.7 and 2.7 x 10(8) IU/mg of protein when assayed on human amniotic WISH cells. The tro-IFN-alpha protected both human and bovine MDBK cells from virus infection whereas the tro-IFN-beta protected only the human cell lines tested. The possible roles of the tro-IFNs are discussed in light of the observed differences in trophoblast IFN response.

Immunohistochemical localization of interferons in human placental tissues in normal, ectopic, and molar pregnancy

Interferon (IFN)alpha, beta, and gamma have been localized in normal and pathological human pregnancy using both polyclonal and monoclonal antibodies in immunohistochemical techniques. IFN alpha was localized to fetal chorionic villous syncytiotrophoblast throughout normal pregnancy, as well as to extravillous trophoblast in the placental bed and chorion lave. Maternal decidual leukocytes, as well as fetal Hofbauer cells in the villous mesenchyme, also contained IFN alpha, IFN gamma was detected in villous syncytiotrophoblast, while anti-IFN beta showed only patchy weak reactivity with syncytiotrophoblast. Reaction patterns on ectopic pregnancy tissues were similar to those in early intrauterine pregnancy. In molar pregnancy, reactivity for IFN alpha, beta, and gamma was observed in syncytiotrophoblast. Along with their potential anti-viral effects, placental interferons could play a role in local immunomodulation or in regulation of embryonic cell proliferation and differentiation.