Mechanisms of infection and fetal adverse effects of Zika virus, Ebola virus, Herpes Simplex virus and Human Papillomavirus infection during pregnancy

Abstract

Background. During pregnancy, the immune response of the placenta to viruses and other pathogens plays an important role in determining the vulnerability of a pregnant woman to various infectious diseases such as Zika, Ebola, herpes simplex, and human papilloma. At the maternal-fetal interface, trophoblastic cells, decidual cells, interferons, proteins, and pro-inflammatory molecules serve to minimize and mitigate the spread of viruses between the mother and the developing fetus through a complex system of antiviral immune signaling that involves cellular and molecular responses of maternal-fetal origin. Therefore, the main objective of the present review is to synthesize current information on the effects and mechanisms of action of viral infections during pregnancy. Method. A PubMed, Scopus, Web of Science literature search was performing. We reviewed the experimental studies of in vivo, in vitro and clinical models of viral infections, their adverse effects during pregnancy and the main current treatments published from 2001 to 2020, where each article synthesizes the information on the pregnancy, as well as the cellular mechanisms involved in the mitigation and infection of the different viruses included in this review. Results. A total of 30 articles were included, of which 8 were in vitro studies, 5 in vivo and 7 clinical; the remaining studies corresponded to bibliographic reviews. In general, viral infections during pregnancy were shown to have negative effects on the cardiovascular and central nervous system, in addition to causing premature labor and fetal death in most cases. Inflammatory responses, decidual cells, human antimicrobial cells, intrinsic regulators, proteins, and pro-inflammatory molecules help mitigate the fetal effects of viral infection, as well as secure and protect pregnancy. Conclusion. The placenta and its adjoining decidual cells, as well as the immune system and the gestational stage where the infection occurs, represent important immune components in maternal cellular responses to viral infections, which in turn promote the fetal immune response. However, more studies are still needed to elucidate and clarify the molecular mechanisms involved in viral infection in order to take future actions associated with treatment and prevention during future infections and pandemics.