Role of hormones in the pregnancy and sex‐specific outcomes to infections with respiratory viruses

Pregnant women infected with pathogenic respiratory viruses, such as influenza A viruses (IAV) and coronaviruses, are at higher risk for mortality, hospitalization, preterm birth, and stillbirth. Several factors are likely to contribute to the susceptibility of pregnant individuals to severe lung di...

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Bibliographic Details
Published in:Immunological reviews 2022-07, Vol.308 (1), p.123-148
Main Authors: Cervantes, Orlando, Cruz Talavera, Irene, Every, Emma, Coler, Brahm, Li, Miranda, Li, Amanda, Li, Hanning, Adams Waldorf, Kristina
Format: Article
Language:English
Subjects:
Adaptive control
Chorionic gonadotropin
Coronavirus Infections
Coronaviruses
COVID‐19
Effector cells
estrogen
Estrogens
Female
Fetuses
Gonadotropins
Hormones
Humans
Immune system
Infant, Newborn
Infections
influenza
Influenza A
Influenza A virus
Lung
Lung diseases
Male
Pituitary (anterior)
pneumonia
Pregnancy
Premature Birth
Progesterone
Prolactin
Public health
Relaxin
Respiration
Sex
virus
Viruses
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Summary:Pregnant women infected with pathogenic respiratory viruses, such as influenza A viruses (IAV) and coronaviruses, are at higher risk for mortality, hospitalization, preterm birth, and stillbirth. Several factors are likely to contribute to the susceptibility of pregnant individuals to severe lung disease including changes in pulmonary physiology, immune defenses, and effector functions of some immune cells. Pregnancy is also a physiologic state characterized by higher levels of multiple hormones that may impact the effector functions of immune cells, such as progesterone, estrogen, human chorionic gonadotropin, prolactin, and relaxin. Each of these hormones acts to support a tolerogenic immune state of pregnancy, which helps prevent fetal rejection, but may also contribute to an impaired antiviral response. In this review, we address the unique role of adaptive and innate immune cells in the control of pathogenic respiratory viruses and how pregnancy and specific hormones can impact their effector actions. We highlight viruses with sex‐specific differences in infection outcomes and why pregnancy hormones may contribute to fetal protection but aid the virus at the expense of the mother's health.
ISSN:0105-2896
1600-065X
DOI:10.1111/imr.13078