Histological Analysis of Term Placentas from Hyperimmune Globulin-Treated and Untreated Mothers with Primary Cytomegalovirus Infection.
Cytomegalovirus
/ immunology
Cytomegalovirus Infections
/ prevention & control
Female
Humans
Immunoglobulins, Intravenous
/ therapeutic use
Immunotherapy
Infectious Disease Transmission, Vertical
/ prevention & control
Placenta
/ pathology
Pregnancy
Pregnancy Complications, Infectious
/ virology
Viral Load
Immunohistochemistry
Infection
PCR
Placenta
Prenatal treatment
Journal
Fetal diagnosis and therapy
ISSN: 1421-9964
Titre abrégé: Fetal Diagn Ther
Pays: Switzerland
ID NLM: 9107463
Informations de publication
Date de publication:
2019
2019
Historique:
received:
04
12
2017
accepted:
29
01
2018
pubmed:
24
4
2018
medline:
12
9
2019
entrez:
24
4
2018
Statut:
ppublish
Résumé
The Congenital Human Cytomegalovirus Infection Prevention (CHIP) study, a randomized, blinded, placebo-controlled trial, demonstrated that the efficacy of hyperimmune globulin (HIG) was not different from that of placebo regarding transmission of cytomegalovirus (CMV) from mothers to newborns. Our aim was to analyze histologically HIG effects on placentas collected for the CHIP study. Virological and histological analyses were performed on 40 placentas from transmitter and nontransmitter HIG-treated and untreated mothers by assessing the number of CMV-positive cells, tissue viral load, tissue damage, and compensatory mechanisms. The HIG and placebo groups showed no significant differences in the number of CMV-positive cells (median number in 10 fields at 10 high-power fields: 2.5 vs. 2, p = 0.969) and viral load (median load: 5 copies/5 ng vs. 10.5 copies/5 ng, p = 0.874). Regarding histological examination, the scores of parameters related to tissue damage and hypoxic parenchymal compensation were higher in transmitters except for chorangiosis, with statistically significant differences observed for chronic villitis (p = 0.007), calcification (p = 0.011), and the total score of tissue damage (p < 0.001). The HIG and placebo groups showed no significant differences for all tissue damage and compensation parameters and overall scores. HIGs are not able to reduce placental viral load and histological damage, which was significantly associated only with infection.
Sections du résumé
BACKGROUND
BACKGROUND
The Congenital Human Cytomegalovirus Infection Prevention (CHIP) study, a randomized, blinded, placebo-controlled trial, demonstrated that the efficacy of hyperimmune globulin (HIG) was not different from that of placebo regarding transmission of cytomegalovirus (CMV) from mothers to newborns. Our aim was to analyze histologically HIG effects on placentas collected for the CHIP study.
MATERIALS AND METHODS
METHODS
Virological and histological analyses were performed on 40 placentas from transmitter and nontransmitter HIG-treated and untreated mothers by assessing the number of CMV-positive cells, tissue viral load, tissue damage, and compensatory mechanisms.
RESULTS
RESULTS
The HIG and placebo groups showed no significant differences in the number of CMV-positive cells (median number in 10 fields at 10 high-power fields: 2.5 vs. 2, p = 0.969) and viral load (median load: 5 copies/5 ng vs. 10.5 copies/5 ng, p = 0.874). Regarding histological examination, the scores of parameters related to tissue damage and hypoxic parenchymal compensation were higher in transmitters except for chorangiosis, with statistically significant differences observed for chronic villitis (p = 0.007), calcification (p = 0.011), and the total score of tissue damage (p < 0.001). The HIG and placebo groups showed no significant differences for all tissue damage and compensation parameters and overall scores.
DISCUSSION
CONCLUSIONS
HIGs are not able to reduce placental viral load and histological damage, which was significantly associated only with infection.
Identifiants
pubmed: 29684915
pii: 000487302
doi: 10.1159/000487302
doi:
Substances chimiques
Immunoglobulins, Intravenous
0
cytomegalovirus-specific hyperimmune globulin
129L90A25N
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
111-117Informations de copyright
© 2018 S. Karger AG, Basel.