Case study: May human norovirus infection be associated with premature delivery?

Jiaying Cao; Yuetong Li; Feiyang Xue; Ziyang Sheng; Libo Liu; Yingying Zhang; Lele Wang; Liang Zeng; Yanmin Jiang; Dongying Fan; Fang Li; Jing An

doi:10.1016/j.virs.2024.10.004

December 2024

. doi: 10.1016/j.virs.2024.10.004

Citation: Jiaying Cao, Yuetong Li, Feiyang Xue, Ziyang Sheng, Libo Liu, Yingying Zhang, Lele Wang, Liang Zeng, Yanmin Jiang, Dongying Fan, Fang Li, Jing An. Case study: May human norovirus infection be associated with premature delivery? .VIROLOGICA SINICA, 2024, 39(6) : 951-962. http://dx.doi.org/10.1016/j.virs.2024.10.004

病例研究:人诺如病毒感染是否与早产有关?

曹嘉莹 ^a,b ,
李玥彤 ^a ,
薛飞飏 ^a ,
盛子洋 ^a ,
刘利波 ^a ,
张莹莹 ^a,c ,
王乐乐 ^d ,
曾亮 ^e ,
蒋艳敏 ^c ,
范东瀛 ^a ,
李芳 ^d,, ,
安静 ^a,,

cstr: 32224.14.j.virs.2024.10.004

a. 首都医科大学基础医学院微生物教研室, 北京 100069;
b. 济南市第五人民医院检验科, 济南 250022;
c. 浙江大学医学院邵逸夫医院输血科, 杭州 310016;
d. 广州市妇女儿童医疗中心妇产科, 广州 510180;
e. 广州市妇女儿童医疗中心病理科, 广州 510180

通讯作者： 李芳, gz8hlf@126.com; 安静, anjing@ccmu.edu.cn
收稿日期： 2024-02-06
录用日期： 2024-10-18

摘要

人诺如病毒(HuNoV)是急性胃肠炎的重要病因。免疫缺陷患者慢性感染HuNoV的严重程度各不相同，这给公共卫生带来了额外的负担。然而，鲜有研究报道HuNoV感染对怀孕——这一特定的免疫紊乱状态期间的潜在影响。最近，广州市妇女儿童医疗中心收治了4例晚期妊娠期HuNoV感染的患者。我们在这些病例中观察到以胎膜早破为主的不良影响。在分娩时采集了其中两例患者的胎儿附属组织样本，以探讨潜在的发病机制。病理分析显示出胎盘血管灌注不良，但是胎盘绒毛血管未见减少。胎膜绒毛膜出现明显病理损伤，有Th-1免疫偏倚的倾向。值得注意的是，我们在胎膜的绒毛膜中观察到M2巨噬细胞的聚集，提示发生组织修复。转录组测序的结果显示，与正常孕妇相比，HuNoV感染患者胎盘组织内免疫通路变化微小，而胎膜中免疫相关基因的表达下调。综上所述，本研究为HuNoV与早产之间的关系提供了证据，这种相关性需要引起临床工作者的重视。
- 人诺如病毒
- , 不良妊娠结局
- , 早产
- , 胎膜早破
- , 病毒感染

Case study: May human norovirus infection be associated with premature delivery?

Jiaying Cao ^a,b ,
Yuetong Li ^a ,
Feiyang Xue ^a ,
Ziyang Sheng ^a ,
Libo Liu ^a ,
Yingying Zhang ^a,c ,
Lele Wang ^d ,
Liang Zeng ^e ,
Yanmin Jiang ^c ,
Dongying Fan ^a ,
Fang Li ^d,, ,
Jing An ^a,,

a. Department of Microbiology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China;
b. Department of Clinical Laboratory, The Fifth People's Hospital of Jinan, Jinan, 250022, China;
c. Department of Blood Transfusion, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China;
d. Department of Obstetrics & Gynaecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510180, China;
e. Department of Pathology, Guangzhou Women and Children Medical Center, Guangzhou Medical University, Guangzhou, 510180, China

Corresponding author: Fang Li, gz8hlf@126.com Jing An, anjing@ccmu.edu.cn
Received Date: 06 February 2024
Accepted Date: 18 October 2024

Abstract

Human norovirus (HuNoV) is the leading cause of acute gastroenteritis. The varying severity of chronic infection in patients with underlying immune deficiencies poses additional burdens on public health. However, the potential effects of HuNoV infection during pregnancy, a specific immune perturbed state, have been rarely reported. Recently, four cases of HuNoV-infected patients in the late stages of pregnancy were admitted to the Guangzhou Women and Children's Medical Center, and premature rupture of membranes as primary adverse outcome was observed in these cases. Samples of fetal accessory tissue were collected from two of these cases at delivery to explore the potential pathogenesis. Pathological analysis showed placental malperfusion in both maternal and fetal vascular, while a decrease in vessels was not observed in villi of placenta. There was obvious pathological change in the chorion of fetal membrane, accompanied by a tendency of Th-1 immune bias. Notably, aggregation of M2 macrophages was observed in the chorion of the fetal membrane, potentially recruited for tissue repair. Next-generation sequencing showed minimal changes in immune pathways within placenta tissue. A gene panel associated with immunosuppression was identified in the fetal membrane of HuNoV-infected women compared to those of normal parturient. Taken together, this study provides clues for the association between the HuNoV and premature delivery, which requires the attention of the clinicians.
- Human norovirus (HuNoV)
- , Adverse pregnancy outcome
- , Premature delivery
- , Premature rupture of membranes
- , Virus infection

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