Investigating the role of maternal-fetal crosstalk on neonatal immunity in COVID-19 infection or vaccination in pregnancy

NIH Pandemic-Era Grants

Pandemic Era Grants

2023

Document text

Principal Investigator: Stephanie Lina Gaw
Organization: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
Fiscal Year: 2023
Award: $683,909
Funding agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development

ABSTRACT
Passive transfer of immunoglobulins (IgG) against SARS-CoV-2 occurs from the mother to fetus by
transplacental transfer and may protect the neonate against infection or cause disease. Recent studies have
shown maternal SARS-CoV-2 infection leads to the dysregulation of infant immune responses in cord blood
including altered T cell related cytokines and perturbations of immune cell subsets. It has not been yet shown if
this immune priming is SARS-CoV-2 antigen-specific or if it is secondary to non-specific maternal or placental
inflammation. Additionally, recent evidence has shown waning immunity after vaccination and further work is
needed to understand protective immunogenic responses to SARS-CoV-2 epitopes to optimize future
vaccination strategies in pregnancy, to benefit both mother and infant. We hypothesize that maternal SARS-
CoV-2 infection actively primes fetal immune responses in utero through 1) the transfer of immune complexes
with immunostimulatory activity, and 2) the passive transfer of both protective and autoreactive antibodies to the
fetus. Further, we hypothesize that differential placental tissue responses correlate with differences in maternal-
fetal crosstalk. In this application, we leverage valuable samples from two prospective cohorts of COVID-19
infection and vaccination in pregnancy to address the following specific aims: 1) Investigate the fetal T cell
immunostimulatory potential of SARS-CoV-2 Ags transferred to the fetus in immune complexes through a novel
mass spectrometry-based approach; 2) Map the antibody repertoire profiles of Abs generated after SARS-CoV-
2 infection vs vaccination to determine the breadth of maternal-fetal transfer of protective vs autoreactive immune
responses using PhIP-Seq technology; and 3) Identify differential transcriptomic and proteomic responses to
SARS-CoV-2 infection at the maternal-fetal interface that mediate differences in immune complex transfer
through the application of laser microdissection on patient biopsies. These results have immediate relevance to
understanding novel mechanisms of maternal-fetal immune crosstalk after viral infection. Our data will aid
vaccination strategies to protect both the mother and baby against COVID-19 and may significantly advance in
our understanding of maternal-fetal immune interplay in perinatal infections.

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