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Assessment of Alterations in Immune Function During Pregnancy and Post Parturition

Completed
Conditions
Pregnancy Immune Function
Registration Number
NCT01200979
Lead Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Brief 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.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
41
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Changes in Cytokine profiles during pregnancy1st, 2nd, and 3rd trimesters and postpartum and postpartum

Changes in Cytokine profiles during pregnancy compared to non-pregnant control samples

Functionality of Toll-like receptors and changes in gene expression1st, 2nd, and 3rd trimesters and postpartum and postpartum

Functionality of Toll-like receptors and changes in gene expression during pregnancy during pregnancy compared to non-pregnant control samples \[Time Frame: 1st, 2nd, and 3rd trimesters and postpartum\]

Changes in lymphocyte and NK cell populations during pregnancy compared to non-pregnant control samples.1st, 2nd, and 3rd trimesters and postpartum and postpartum

Changes in lymphocyte and NK cell populations during pregnancy compared to non- pregnant control samples. \[Time Frame: 1st, 2nd, and 3rd trimesters and postpartum and postpartum\]

Secondary Outcome Measures
NameTimeMethod
Changes in Cytokine profilesBefore and after the administration of the influenza vaccine in a subset of pregnant women

Changes in Cytokine profiles during pregnancy compared to non-pregnant control samples, in a subset of pregnant women \[Time Frame: Before and after the administration of the influenza vaccine in a subset of pregnant women\]

Changes in lymphocyte and INK cell populationsBefore and after the administration of the influenza vaccine in a subset of pregnant women

Changes in lymphocyte and INK cell populations during pregnancy compared to non-pregnant control samples, in a subset of pregnant women \[Time Frame: Before and after the administration of the influenza vaccine in a subset of pregnant women\]

Functionality of Toll-like receptors and changes in gene expressionBefore and after the administration of the influenza vaccine in a subset of pregnant women

Functionality of Toll-like receptors and changes in gene expression during pregnancy during pregnancy compared to non-pregnant control samples, in a subset of pregnant women \[Time Frame: Before and after the administration of the influenza vaccine in a subset of pregnant women\]

Trial Locations

Locations (1)

National Institutes of Health Clinical Center, 9000 Rockville Pike

🇺🇸

Bethesda, Maryland, United States

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