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Deficit of IgG2 in HIV-positive pregnant women is responsible of inadequate IgG2 levels in their HIV-uninfected children in Malawi

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Abstract

Background

Transplacental passage of IgGs is impaired in HIV + pregnant women, possibly determining an inadequate immunological protection in their children. We aimed to determine the impact of maternal immunological IgG profile and immunoactivation status on the efficiency of transplacental passage of IgG subclasses in HIV + mothers.

Methods

16 mother/infants pairs were studied in Malawi. Mothers received antiretroviral therapy (ART) from the third trimester of pregnancy. Determinations of pre-ART levels of maternal sCD14, of IgG subclasses in mothers at delivery and in their 1-month-old infants, were performed using commercial ELISA kits.

Results

At delivery, after a median of 10 weeks of ART, 12/16 mothers were hypergammaglobulinemic, with IgG levels (20.5 mg/ml, 95% CI:18.8–26.8) directly correlated to the plasmatic levels of sCD14 (r = 0.640, p = 0.014). IgG1 levels (17.9 mg/ml) accounted for 82% of IgG, IgG3 and IgG4 levels were in the normal range. A profound deficit of IgG2 was observed both in mothers (0.60 mg/ml) and in infants (0.14 mg/ml). Placental transfer ratio (range 0.16–0.42) did not show a selective impairment between the different IgG subclasses. The transplacental passage of all IgG subclasses was decreased in the presence of maternal IgG over 16 mg/ml (significantly for IgG1, p = 0.031) and of high levels of sCD14 (p = 0.063).

Conclusions

Transplacental passage was reduced for all IgG subclasses and inversely correlated to high levels of maternal IgGs and to the degree of immunoactivation. The profound depression of IgG2 in mothers suggests that IgG2 neonatal levels mostly reflect the maternal deficit rather than a selective impairment of IgG2 transfer.

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Acknowledgements

We thank Alessandra Mattei for providing secretarial help, Marco Mirra, Massimiliano Di Gregorio, Stefano Lucattini and Luca Fucili for IT support and Ferdinando Costa and Patrizia Cocco, for technical support. We are grateful to Giuseppe Lucania for the technical support with BN ProSpec® System Analyzer, and to all the mothers and their neonates who participated in our study.

Funding

This work was supported by a grant from the Ministry of Health, Rome, Italy (grant no. 3C04/1) and by Esther-Italy, Ministry of Health (grant no. 9M34).

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Authors and Affiliations

  1. National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy

    Silvia Baroncelli, Clementina Maria Galluzzo, Mauro Andreotti, Roberta Amici & Marina Giuliano

  2. Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1 00133, Rome, Italy

    Giuseppe Liotta, Sandro Mancinelli, Leonardo Palombi & Francesca Lucaroni

  3. DREAM Program, Community of S. Egidio, P.O. Box 30355, Blantyre, Malawi

    Robert Mphwere & Enok Bokola

  4. Department of Human Sciences, LUMSA University, Via Traspontina 21, 00193, Rome, Italy

    Maria Cristina Marazzi

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  1. Silvia Baroncelli
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  2. Clementina Maria Galluzzo
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Correspondence to Silvia Baroncelli.

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The study received ethics approval by the National Health Research Committee of Malawi (approval number #486).

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Baroncelli, S., Galluzzo, C.M., Liotta, G. et al. Deficit of IgG2 in HIV-positive pregnant women is responsible of inadequate IgG2 levels in their HIV-uninfected children in Malawi. Med Microbiol Immunol 207, 175–182 (2018). https://doi.org/10.1007/s00430-018-0537-2

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