Faizal, Nur Fazlin Akmal Muhammad
(2022)
Cytokines expression in primary and non-primary maternal cytomegalovirus (CMV) infection.
Masters thesis, Universiti Sains Malaysia.
Abstract
Cytomegalovirus (CMV) infection in pregnancy is the commonest cause of
congenital infection worldwide. Primary CMV infection in pregnancy carries a
higher risk of fetal transmission compared to non-primary infection. Primary
infection in the early trimester of pregnancy can cause serious complications such as
miscarriages and severe congenital malformations. CMV infection changes Th1 and
Th2 balance during pregnancy by altered cytokine (IL-8, IL-6) in placental cells.
Thus, this study aims to determine the cytokines expression in primary and nonprimary
maternal CMV infections and to compare the expression of cytokines in
both types of infection. This cross-sectional study was conducted at Microbiology
Laboratory, Hospital Universiti Sains Malaysia (HUSM) from June 2019 until July
2020. The result of this study showed that seventy-four pregnant women with
abnormal pregnancy outcomes with positive CMV IgG with or without IgM were
subjected to IgG avidity assay by electrochemiluminiscence immunoassay (ECLIA)
method to discriminate primary and non-primary CMV infection. Then, study also
showed sera of the patients in primary and non-primary CMV infection were
subjected to multiplex cytokine assay for cytokine analysis that involved seven
cytokines and two chemokines to determine their concentrations in both primary and
non-primary CMV infection. Cytokines and chemokines tested were IL-12, IL-2,
IFN- γ, TNF-α, IL-1β, IL-6, IL-10, IFN- γ, TNF-α, MCP-1 (CCL-2), and IFN- γ IP-
10 (CXCL-10). Concentrations of IL-1β, IL-6, and MCP-1 (CCL-2) were
significantly elevated in pregnant women with primary CMV infection. The intensity Cytomegalovirus (CMV) infection in pregnancy is the commonest cause of
congenital infection worldwide. Primary CMV infection in pregnancy carries a
higher risk of fetal transmission compared to non-primary infection. Primary
infection in the early trimester of pregnancy can cause serious complications such as
miscarriages and severe congenital malformations. CMV infection changes Th1 and
Th2 balance during pregnancy by altered cytokine (IL-8, IL-6) in placental cells.
Thus, this study aims to determine the cytokines expression in primary and nonprimary
maternal CMV infections and to compare the expression of cytokines in
both types of infection. This cross-sectional study was conducted at Microbiology
Laboratory, Hospital Universiti Sains Malaysia (HUSM) from June 2019 until July
2020. The result of this study showed that seventy-four pregnant women with
abnormal pregnancy outcomes with positive CMV IgG with or without IgM were
subjected to IgG avidity assay by electrochemiluminiscence immunoassay (ECLIA)
method to discriminate primary and non-primary CMV infection. Then, study also
showed sera of the patients in primary and non-primary CMV infection were
subjected to multiplex cytokine assay for cytokine analysis that involved seven
cytokines and two chemokines to determine their concentrations in both primary and
non-primary CMV infection. Cytokines and chemokines tested were IL-12, IL-2,
IFN- γ, TNF-α, IL-1β, IL-6, IL-10, IFN- γ, TNF-α, MCP-1 (CCL-2), and IFN- γ IP-
10 (CXCL-10). Concentrations of IL-1β, IL-6, and MCP-1 (CCL-2) were
significantly elevated in pregnant women with primary CMV infection. The intensity of IFN-γ, IL-12, and IL-2 was higher in primary CMV infection compared to nonprimary
CMV infection. The productions of pro-inflammatory cytokine together with
MCP-1 (CCL-2) in pregnant women with primary CMV infection were significant,
which showed the predominance of Th1 response. The low level of cytokines in nonprimary
CMV infection might be due to the latent state of CMV in a host. Thus, it
does not trigger the immune host cells' reactivation.
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