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Open AccessReview

A Message from the Human Placenta: Structural and Immunomodulatory Defense against SARS-CoV-2

Division of Obstetrics and Prenatal Medicine, Department of Gynecology and Obstetrics, University Hospital Frankfurt, J. W. Goethe-University, Theodor-Stern-Kai 7, D-60590 Frankfurt, Germany
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Cells 2020, 9(8), 1777; https://doi.org/10.3390/cells9081777
Received: 3 July 2020 / Revised: 20 July 2020 / Accepted: 24 July 2020 / Published: 25 July 2020
The outbreak of the coronavirus disease 2019 (COVID-19) pandemic has caused a global public health crisis. Viral infections may predispose pregnant women to a higher rate of pregnancy complications, including preterm births, miscarriage and stillbirth. Despite reports of neonatal COVID-19, definitive proof of vertical transmission is still lacking. In this review, we summarize studies regarding the potential evidence for transplacental transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), characterize the expression of its receptors and proteases, describe the placental pathology and analyze virus-host interactions at the maternal-fetal interface. We focus on the syncytium, the barrier between mother and fetus, and describe in detail its physical and structural defense against viral infections. We further discuss the potential molecular mechanisms, whereby the placenta serves as a defense front against pathogens by regulating the interferon type III signaling, microRNA-triggered autophagy and the nuclear factor-κB pathway. Based on these data, we conclude that vertical transmission may occur but rare, ascribed to the potent physical barrier, the fine-regulated placental immune defense and modulation strategies. Particularly, immunomodulatory mechanisms employed by the placenta may mitigate violent immune response, maybe soften cytokine storm tightly associated with severely ill COVID-19 patients, possibly minimizing cell and tissue damages, and potentially reducing SARS-CoV-2 transmission. View Full-Text
Keywords: SARS-CoV-2; COVID-19; placenta; vertical transmission; immune defense; miRNA; interferon type III; NF-κB pathway SARS-CoV-2; COVID-19; placenta; vertical transmission; immune defense; miRNA; interferon type III; NF-κB pathway
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MDPI and ACS Style

Kreis, N.-N.; Ritter, A.; Louwen, F.; Yuan, J. A Message from the Human Placenta: Structural and Immunomodulatory Defense against SARS-CoV-2. Cells 2020, 9, 1777. https://doi.org/10.3390/cells9081777

AMA Style

Kreis N-N, Ritter A, Louwen F, Yuan J. A Message from the Human Placenta: Structural and Immunomodulatory Defense against SARS-CoV-2. Cells. 2020; 9(8):1777. https://doi.org/10.3390/cells9081777

Chicago/Turabian Style

Kreis, Nina-Naomi; Ritter, Andreas; Louwen, Frank; Yuan, Juping. 2020. "A Message from the Human Placenta: Structural and Immunomodulatory Defense against SARS-CoV-2" Cells 9, no. 8: 1777. https://doi.org/10.3390/cells9081777

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