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Abstract
The infection of pregnant animals and women by Coxiella burnetii, an intracellular bacterium, compromises both maternal health and foetal development. The placenta is targeted by C. burnetii, as demonstrated by bacteriological and histological evidence. It now appears that placental strains of C. burnetii are highly virulent compared to reference strains and that placental injury involves different types of placental cells. Trophoblasts, the major placental cells, are largely infected by C. burnetii and may represent a replicating niche for the bacteria. The placenta also contains numerous immune cells, including macrophages, dendritic cells, and mast cells. Placental macrophages are infected and activated by C. burnetii in an unusual way of M1 polarisation associated with bacterial elimination. Placental mast cells eliminate bacteria through a mechanism including the release of extracellular actin filaments and antimicrobial peptides. In contrast, C. burnetii impairs the maturation of decidual dendritic cells, favouring bacterial pathogenicity. Our aim is to review C. burnetii infections of human placentas, paying special attention to both the action and function of the different cell types, immune cells, and trophoblasts targeted by C. burnetii in relation to foetal injury.
Highlights
Coxiella burnetii is a Gram-negative bacterium that infects numerous animals, including mammals, birds, and arthropods [1]
C. burnetii infection in pregnant goats leads to abortions, and Q fever during pregnancy presents important risks for both the mother and the foetus [5]
Several C. burnetii strains isolated from animals or humans including patients with acute or persistent focalised Q fever have been used for research [25]
Summary
Coxiella burnetii is a Gram-negative bacterium that infects numerous animals, including mammals, birds, and arthropods [1]. The manifestations of acute Q fever are atypical pneumonia, hepatitis, or flu-like self-limiting disease In immunocompromised situations such as cancer or corticosteroid treatment, C. burnetii infection may become persistent and result in life-threatening endocarditis [5]. C. burnetii infection in pregnant goats leads to abortions, and Q fever during pregnancy presents important risks for both the mother and the foetus [5]. It has been shown that women who contract acute Q fever just before pregnancy do not present an increased risk of abortion or premature delivery. A seroprevalence of acute Q fever of 1.2% was found among women who experienced spontaneous abortion in the first semester of pregnancy in Denmark, with a significant proportion of asymptomatic patients [18]. The inhalation of contaminated aerosols during parturition or lactation may be another source of contamination [1,24]
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