627 - Evaluation of Cytokine Expression at the Maternal-Fetal Interface in Pregnancies with Opioid Use Disorder: Implications for In Utero inflammation

Publication Number: 4613.627

Rachel Pfau, Boston University School of Medicine, Boston, MA, United States; Elizabeth Taglauer, Boston University School of Medicine, Boston, MA, United States; Diya Pamidimukkla, Boston University School of Medicine, Boston, MA, United States; Elisha Wachman, Boston Medical Center, Newton, MA, United States

Background: Infant neurodevelopmental outcomes following opioid use disorder (OUD) in pregnancy have a complex pathogenesis and may involve inflammation. While the direct impact of opioids on the developing fetus is an ongoing area of analysis, evaluation of the impact of in-utero opioid exposure on the placenta is also an important area of investigation. Opioid exposure has been associated with increased immune activation/inflammation in other organs, however this phenomenon has been less-well characterized in immune-active areas of the maternal-fetal interface.

Objective: We hypothesize that OUD in pregnancy is associated with increased inflammatory signals in the placental bed, particularly the immune-rich area of the decidua that contains specialized maternal immune cells.

Design/Methods: In a pilot study, we isolated decidual tissues from a cohort of control (CTL) vs OUD pregnant patients (n=6 each) delivered at term. RNA was isolated from decidual tissues followed by qRT-PCR analysis of inflammatory cytokines interleukin (IL)-10, IL-6 and tumor necrosis factor (TNF)-alpha. Gestational age, birth weight and placental pathology was also evaluated for each group.

Results: When compared with control decidual tissues, we identified trends in increased expression of inflammatory cytokines in decidual tissues from OUD as compared with CTL pregnancies: IL-10 (1.29-fold increase, SEM: +/-0.23), IL-6 (1.27-fold increase, SEM +/-0.29), TNF-alpha (1.57-fold increase, SEM +/-0.27) (Fig.1). We also identified an increased percentage of placentas with evidence of tissue inflammation in OUD when compared with CTL tissues (50 vs 16%).

Conclusion(s): This pilot study suggests that there is increased evidence of pro-inflammatory cytokine expression and tissue inflammation at the maternal-fetal interface in pregnancies impacted by OUD. Ongoing studies with expanded cohorts will be informative to investigate important source of in-utero inflammation with in-utero opioid exposure.

Figure 1. Cytokine expression in Decidual Tissues from Control vs Opioid Use Disorder Affected Pregnancies
Quantitative reverse transcriptase-PCR (qRT-PCR) analysis of inflammatory cytokine expression in decidual tissues from either control or opioid use disorder (OUD) pregnancies (n=6 each).