Evaluating TRAIL and IP-10 alterations in vaccinated pregnant women after COVID-19 diagnosis and their correlation with neutralizing antibodies

Front Immunol. 2024 Sep 3:15:1415561. doi: 10.3389/fimmu.2024.1415561. eCollection 2024.

Abstract

Background: This study evaluates tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) and interferon-γ-induced protein-10 (IP-10) in pregnant women with COVID-19 and their newborns, exploring the effects of antiviral treatments and vaccine-induced neutralizing antibody (Nab) inhibition on these key viral infection biomarkers.

Methods: We studied 61 pregnant women with past COVID-19 and either three (n=56) or four (n=5) doses of vaccination, and 46 without COVID-19 but vaccinated. We analyzed them and their newborns' blood for TRAIL, IP-10, and Nab levels using enzyme-linked immunosorbent assays (ELISA), correlating these with other clinical factors.

Results: Our study found lower TRAIL but higher IP-10 levels in maternal blood than neonatal cord blood, irrespective of past COVID-19 diagnosis. Cases diagnosed with COVID-19 < 4 weeks previously had higher maternal blood TRAIL levels (16.49 vs. 40.81 pg/mL, p=0.0064) and IP-10 (154.68 vs. 225.81 pg/mL, p=0.0170) than those never diagnosed. Antiviral medication lowered TRAIL and IP-10 in maternal blood without affecting Nab inhibition (TRAIL: 19.24 vs. 54.53 pg/mL, p=0.028; IP-10: 158.36 vs. 255.47 pg/mL, p=0.0089). TRAIL and IP-10 levels were similar with three or four vaccine doses, but four doses increased Nab inhibition (p=0.0363). Previously COVID-19 exposed pregnant women had higher Nab inhibition (p < 0.0001). No obvious correlation was found among TRAIL, IP-10, and Nab inhibition level.

Conclusions: Our study suggests that lower maternal TRAIL and higher IP-10 levels compared to neonatal cord blood coupled with a rise in both markers following COVID-19 diagnosis that could be reduced by antivirals indicates a correlation to infection severity. Higher vaccine doses enhance Nab inhibition, irrespective of antiviral medication use and independent of TRAIL or IP-10 levels, highlighting the significance and safety of adequate vaccination and antiviral use post-diagnosis in pregnant women.

Keywords: COVID-19 vaccine; IP-10; Nab; TNF-related apoptosis-inducing ligand; TRAIL; interferon gamma-induced protein 10; neutralizing antibody.

MeSH terms

  • Adult
  • Antibodies, Neutralizing* / blood
  • Antibodies, Neutralizing* / immunology
  • Antibodies, Viral / blood
  • Antibodies, Viral / immunology
  • Biomarkers / blood
  • COVID-19 Vaccines / administration & dosage
  • COVID-19 Vaccines / immunology
  • COVID-19* / immunology
  • COVID-19* / prevention & control
  • Chemokine CXCL10* / blood
  • Female
  • Fetal Blood / immunology
  • Humans
  • Infant, Newborn
  • Pregnancy
  • Pregnancy Complications, Infectious* / blood
  • Pregnancy Complications, Infectious* / diagnosis
  • Pregnancy Complications, Infectious* / immunology
  • SARS-CoV-2* / immunology
  • TNF-Related Apoptosis-Inducing Ligand* / blood
  • Vaccination

Substances

  • Chemokine CXCL10
  • Antibodies, Neutralizing
  • TNF-Related Apoptosis-Inducing Ligand
  • CXCL10 protein, human
  • COVID-19 Vaccines
  • Antibodies, Viral
  • TNFSF10 protein, human
  • Biomarkers

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This research was funded by Taiwan’s Chang Gung Medical Foundation (grant number CRRPG2L0011, CMRPG2L0261, and CMRPVVM0121) for manuscript drafting and statistics analysis, Taiwan’s National Science and Technology Council (grant number 112-2622-E-007-028) for laboratory study, and Taiwan’s Kaohsiung Medical University Hospital (grant number KMUH111-1M33 and KMUH112-2M32) for recruitment of participants and samples.