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de Alwis, N.

Publications and source records attributed to de Alwis, N..

3 recordsLinked to original sources

High-dimensional multiomics reveals perturbations to IL-6/IL-6R axis and RUNX3 in CD4+ T cells during third trimester pregnancy

ObjectivesCD4+ T cells play key roles in regulating immune responses during pregnancy, therefore we aimed to understand the CD4+ T cell surface proteome and transcriptome during pregnancy. MethodsCD4+ T cells were analysed in blood and decidua from term-pregnancies (>37 weeks), and non-pregnant blood. >350 surface proteins were screened via flow cytometry, and transcriptomes were analysed using single-cell RNA sequencing with >130 CITE-seq barcoded antibodies. ResultsSurface protein screening identified changes to ILT4/CD85d, CD9, IFN-{gamma} receptor {beta}-chain, CX3CR1 and CCR5 in the pregnant blood and decidual CD4+ T cells. CX3CR1 and CCR5 had the highest expression on the effector-memory T cell (TEM) subset in the blood, with expression consistent across subsets in decidua. CD126/IL-6R was lower in pregnant blood and decidual CD4+ T cells, while scRNAseq identified enrichment in the IL-6R signalling pathway in naive CD4+ T cells in pregnant blood. Both sIL-6R and IL-6 concentrations were increased in plasma during pregnancy, suggesting perturbations to the IL-6/IL-6R signalling axis. Meanwhile, decidual CD4+ T cells had increased expression of transcription factor RUNX3 in the CD69+ tissue-resident-like subset. ConclusionsOur findings demonstrate altered molecular expression in CD4+ T cells during pregnancy. This provides important mechanistic insight of their adaptation and regulation during placental development, which may drive placental dysfunction or pregnancy complications including preeclampsia, fetal growth restriction and stillbirth. These new data may inform future studies that focus on determining the significance of differentially- expressed immune features in pregnancy to identify potential targets for immune modulation to treat pregnancy complications and infections.

immunology↗

First-trimester exposure to anti-cytomegalovirus medications: a study of the effects of valaciclovir, letermovir and maribavir on early placental development

Congenital cytomegalovirus (CMV) infection is the leading preventable cause of childhood disability, including sensorineural hearing loss and cerebral palsy in high-income countries. Early maternal treatment with valaciclovir has been shown to reduce fetal infection. However, newer, more potent anti-CMV medications such as letermovir and maribavir are not routinely used in pregnancy due to limited safety data. This study aimed to assess the effect of aciclovir (the active metabolite of valaciclovir), letermovir, and maribavir on cell viability, functionality, and key cell signalling pathways in first-trimester human placental tissue. First-trimester placental tissue was obtained from individuals undergoing surgical abortion for psychosocial indications at 9-13 weeks of gestation. The effect of anti-CMV medications on primary cytotrophoblast cell survival was measured using a standard cell viability assay. The effects of anti-CMV medication exposure on Wnt and epithelial-to-mesenchymal transition (EMT) signalling pathways were evaluated in placental explant cultures. Their impact on cellular proliferation and migration was assessed using placental outgrowth cultures. Exposure to physiological or supraphysiological levels of aciclovir, letermovir, or maribavir for 48 hours did not significantly alter cytotrophoblast cell viability compared to vehicle-treated controls. Aciclovir did not significantly impact Wnt and EMT signalling gene expression in first-trimester placental explants; however, letermovir and maribavir induced significant gene dysregulation. None of the three anti-CMV medications altered first-trimester trophoblast proliferation or migration. These results provide reassuring data supporting the safety of maternal valaciclovir therapy in the first trimester. They may also inform the selection of newer anti-CMV medications for future clinical trials for use in pregnancy.

developmental biology↗

Amniotic fluid extracellular vesicle properties evolve with gestational age and reflect fetal development

Amniotic fluid (AF) is a valuable source of extracellular vesicles (EVs) derived from the fetoplacental unit. Preclinical and clinical studies have highlighted promising applications of AF-EVs and their role in cellular communication, yet our understanding of AF-EV physiology is limited. This study aimed to examine the physiological importance of AF-EVs in fetal development from the second trimester to term gestation. We obtained AF samples from routine second-trimester amniocentesis and prelabour Caesarean section at term. We isolated EVs using a combination of differential centrifugation, filtration, and ultracentrifugation and characterised them using nanoparticle tracking analysis, cryoelectron microscopy, and Western blotting. The differential EV proteome was analysed using label-free proteomics. We assessed the second trimester and term AF-EV properties through an enrichment analysis. The EV size and protein enrichment difference revealed a gestational-age-dependent variation in the predominant EV subtype. Second-trimester-derived EVs were enriched in ectosomes, while term EVs contained a significant proportion of exosomes. We identified several morphologies of AF-EVs, including unilamellar, multilamellar, multicompartmental and granular-centred EVs, across gestations. Proteomics analysis of AF-EVs identified 4137 proteins with high confidence, of which 1099 exhibited significant differential expression between the two groups. Second-trimester-enriched AF-EV proteins represented molecule assembly processes, metabolism and organogenesis. At term, AF-EV proteins corresponded to impending newborn functions such as immunity and digestion. In conclusion, we provide compelling evidence that EV biogenesis and secretion in the fetoplacental unit undergo significant alterations across gestation, revealing a complex and dynamic physiology and intercellular communication that adapts to the needs of the developing fetus. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=126 SRC="FIGDIR/small/649052v1_ufig1.gif" ALT="Figure 1"> View larger version (65K): org.highwire.dtl.DTLVardef@3358c4org.highwire.dtl.DTLVardef@108ec96org.highwire.dtl.DTLVardef@e49b91org.highwire.dtl.DTLVardef@a1888b_HPS_FORMAT_FIGEXP M_FIG O_FLOATNOGraphical abstractC_FLOATNO This figure summarises the studys main findings, including the shift in the predominant EV subtype, the different organs and biofluids represented by the enriched proteins at each gestation, and the main biological pathways. C_FIG

developmental biology↗