Women living with HIV can give birth without passing the virus to their babies thanks to breakthrough therapies like antiretroviral therapy (A.R.T.). But many babies born to HIV-positive women experience negative outcomes, some of which are not discovered until a long time after a child is born.
In certain parts of the world, despite A.R.T. stopping the transmission of HIV from mother to child, multiple long-term immune and neurocognitive deficiencies can develop in children born to HIV-positive mothers.
Without an answer as to why this is happening, the pregnancy journey gets riddled with psychosocial effects, including complicated grief, depression and more.
Scientists continue to debate whether antiretroviral medication or HIV is responsible for these pregnancy outcomes, but thanks to the efforts of Dr. Ancuta and her Montreal research team, we may be much closer to the answer.
Dr. Petronela Ancuta, one of CANFAR’s Innovation Research Grant Recipients (Cycle 31) has started a pilot study taking a much closer look at long-lived cells in placenta to see what we can learn about how HIV affects pregnancy.
Our bodies include a unique sort of cell called a macrophage, which, depending on its type, can perform multiple roles. A macrophage that is present in the body can either be short-lived and help the body’s immediate immune system responses; or, if a macrophage exists in the body for a long time, it is considered long-lived and works as a housekeeper for immune functions. These long-lived macrophages are responsible for maintaining our bone and tissue structures, and without them, humans cannot give birth.
In an interview, Dr. Ancuta explains that by learning if and how HIV infects macrophages in the placenta, we can understand better what the consequences of the infection are. If we know these effects, then we can connect the changes seen in the placenta to the complications seen in a child born to a person living with HIV. By understanding how these changes work, we can then identify new strategies to limit adverse pregnancy outcomes.
“By understanding how viruses target such important cell types in the body, we can develop model systems that work to help us screen what kind of implications infection will have on the child,” says Dr. Ancuta.
To implement this research, Dr. Ancuta and her team (Co-investigators Dr. Isabelle Boucoiran – Ste Justine Hospital, Montréal; Dr. Cécilia Costiniuk – McGill University Health Center, Montréal; Mr. Ramon Edwin Caballero, PhD Student – McGill University, CHUM Research Centre; Mrs. Shari Margolese – Community Knowledge user) will be comparing the macrophages of women living with HIV against those who are not. Using advanced research techniques, like spectral flow cytometry, the team will sort long-lived and short-lived HIV-infected cells based on noticeable alterations. With these observations, they can learn more about the pathways the virus uses to alter macrophages and, with enough of this data, determine whether A.R.T. or HIV itself is behind the negative pregnancy outcomes that women living with HIV experience.
The potential for this research doesn’t stop there. What makes Dr. Ancuta and her team’s approach unique is that the macrophages in the placenta are already matured, so the models they build based off these matured cells can be applied to other kinds of macrophages that are often targeted by HIV. One of the main barriers in current research is accessing macrophages in a non-invasive way, because there are not many places in the body where long-lived cells and short-lived cells exist. Others include the heart, liver and brain, but those can’t be easily or non-invasively accessed. The placenta is one of the few places in the body that meets the necessary criteria and is one of the main reasons why Dr. Ancuta chose placental macrophages for her study.
Through this new and innovative approach, we have the potential to understand how viruses replicate in other important macrophages, including those in the heart, liver and brain. This means that through this research we can build models that can be applied to find treatments or cures for other HIV co-morbidities. As Dr. Ancuta expresses, “There is a lot of fundamental knowledge that has clinical applications, not only in the context of mother-to-child transmission. Therefore, fundamental research is a key step in biomedical research for the intelligent design of new therapeutic interventions.”
The work that Dr. Ancuta’s lab is investigating has potential to pave the way for innovations that can improve the experience of motherhood for women living with HIV. With the right support and the right researchers on the case, women living with HIV will be able to give birth to children unaffected by the virus or its treatments.
To learn more about CANFAR’s latest research, please click here.