J Infect Dis. 2021 Dec 20:jiab614. doi: 10.1093/infdis/jiab614. Online ahead of print.
ABSTRACT
BACKGROUND: Pregnancy is a risk factor for progression from latent tuberculosis infection (LTBI) to symptomatic tuberculosis (TB). However, how pregnancy influences T cell responses to M. tuberculosis (Mtb) is unknown.
METHODS: We measured Mtb-specific cytokines, T-cell memory markers, and overall CD4+ and CD8+ T-cell activation by flow cytometry from 49 women (18 with and 31 without HIV) who became pregnant while enrolled in a randomized controlled trial of pre-exposure prophylaxis for HIV prevention. We analyzed these data using COMPASS, an established statistical method for evaluating overall antigen-specific T cell responses.
RESULTS: Pregnant women with latent TB infection demonstrated significantly diminished Mtb-specific CD4+ cytokine responses in the third trimester (COMPASS score (PFS) 0.07) compared before (PFS 0.15), during (PFS 0.13 and 0.16), and after pregnancy (PFS 0.14; p = 0.0084, Kruskal-Wallis test). Paradoxically, Mtb-specific CD8+ cytokines and nonspecifically activated T-cells increased during late pregnancy. Nonspecific T-cell activation, a validated biomarker for progression from LTBI to TB disease, was increased in LTBI+ women postpartum, compared with LTBI- women.
CONCLUSIONS: Pregnancy-related functional T-cell changes were most pronounced during late pregnancy. Mtb-specific T-cell changes during pregnancy and postpartum, increases in immune activation may contribute to increased risk for TB progression in the postpartum period.
PMID:34929030 | DOI:10.1093/infdis/jiab614
