Mode of delivery by an ulcerative colitis mother in a case of twins: Immunological differences in cord blood and placenta

AIM: To understand the effects of delivery mode on the immune cells frequency and function in cord blood and placenta. METHODS: We evaluated immunological differences in cord blood and placental tissues for a case of twins one of which delivered vaginally while the other delivered by caesarian section (C-section). Cord blood mononuclear cells were isolated and placenta tissues were processed for cell isolation. Immune phenotyping was performed by flow cytometry methods following staining for T cells, natural killer (NK) cells, monocytes, neutrophils and CD71(+) erythroid cells in both cord blood and placenta tissues. In addition, fetal calprotectin of twins was measured 12 wk after birth. RESULTS: We found lower percentages of immune cells (e.g. T cells, monocytes and neutrophils) in the cord blood of C-section delivered compared to vaginally delivered newborn. In contrast, percentages of monocytes and neutrophils were > 2 folds higher in the placental tissues of C-section delivered newborn. More importantly, we observed lower percentages of CD71(+) erythroid cells in both cord blood and placental tissues of C-section delivered case. Lower CD71(+) erythroid cells were associated with a more pro-inflammatory milieu at the fetomaternal interface reflected by higher expression of inhibitory receptors on CD4(+) T cells, higher frequency of monocytes and neutrophils. Furthermore, type of delivery impacted the gene expression profile in CD71(+) erythroid cells. Finally, we found that C-section delivered child had > 20-fold higher FCP in his fecal sample at 12 wk of age. CONCLUSION: Mode of delivery impacted immune cells profile in cord blood/placenta. In particular frequency of immunosuppressive CD71(+) erythroid cells was reduced in C-section delivered newborn.