Publications
47 results found
Sooranna GR, Shah NM, Singh N, et al., 2019, The Immune Modulatory Effects of Both Progesterone and a Combination of Progesterone and Aminophylline on the Maternal Immune System., 66th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: SAGE PUBLICATIONS INC, Pages: 293A-293A, ISSN: 1933-7191
Briggs E, Greer O, Shah NM, et al., 2019, Hyponatraemia and pre-eclampsia, Publisher: WILEY, Pages: 41-41, ISSN: 1470-0328
Shah NM, Lai PF, Imami N, et al., 2019, Progesterone-Related Immune Modulation of Pregnancy and Labor., Frontiers in endocrinology, Vol: 10, ISSN: 1664-2392
Pregnancy involves a complex interplay between maternal neuroendocrine and immunological systems in order to establish and sustain a growing fetus. It is thought that the uterus at pregnancy transitions from quiescent to laboring state in response to interactions between maternal and fetal systems at least partly <i>via</i> altered neuroendocrine signaling. Progesterone (P4) is a vital hormone in maternal reproductive tissues and immune cells during pregnancy. As such, P4 is widely used in clinical interventions to improve the chance of embryo implantation, as well as reduce the risk of miscarriage and premature labor. Here we review research to date that focus on the pathways through which P4 mediates its actions on both the maternal reproductive and immune system. We will dissect the role of P4 as a modulator of inflammation, both systemic and intrinsic to the uterus, during human pregnancy and labor.
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Shah NM, Imami N, Johnson MR, 2018, Progesterone Modulation of Pregnancy-Related Immune Responses, FRONTIERS IN IMMUNOLOGY, Vol: 9, ISSN: 1664-3224
Progesterone (P4) is an important steroid hormone for the establishment and maintenance of pregnancy and its functional withdrawal in reproductive tissue is linked with the onset of parturition. However, the effects of P4 on adaptive immune responses are poorly understood. In this study, we took a novel approach by comparing the effects of P4 supplementation longitudinally, with treatment using a P4 antagonist mifepristone (RU486) in mid-trimester pregnancies. Thus, we were able to demonstrate the immune-modulatory functions of P4. We show that, in pregnancy, the immune system is increasingly activated (CD38, CCR6) with greater antigen-specific cytotoxic T cell responses (granzyme B). Simultaneously, pregnancy promotes a tolerant immune environment (IL-10 and regulatory-T cells) that gradually reverses prior to the onset of labor. P4 suppresses and RU486 enhances antigen-specific CD4 and CD8 T cell inflammatory cytokine (IFN-γ) and cytotoxic molecule release (granzyme B). P4 and RU486 effectively modulate immune cell-mediated interactions, by regulating differentiated memory T cell subset sensitivity to antigen stimulation. Our results indicate that P4 and RU486, as immune modulators, share a reciprocal relationship. These data unveil key contributions of P4 to the modulation of the maternal immune system and suggests targets for future modulation of maternal immune function during pregnancy.
Shah NM, Edey L, Sooranna G, et al., 2018, Labour is associated with a decline in Treg function and their modulation of TLR-Ligand induced immune responses, 65th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: Sage Publications Inc., Pages: 314A-314A, ISSN: 1071-5576
Shah NM, Sooranna G, Imami N, et al., 2018, Progesterone suppressed ex vivo pregnancy immune responses are reversed with the progesterone antagonist RU486, 65th Annual Scientific Meeting of the Society-for-Reproductive-Investigation (SRI), Publisher: Sage, Pages: 314A-314A, ISSN: 1933-7191
Shah NM, Herasimtschuk AA, Boasso A, et al., 2017, Changes in T Cell and Dendritic Cell Phenotype from Mid to Late Pregnancy Are Indicative of a Shift from Immune Tolerance to Immune Activation., Frontiers in Immunology, Vol: 8, ISSN: 1664-3224
During pregnancy, the mother allows the immunologically distinct fetoplacental unit to develop and grow. Opinions are divided as to whether this represents a state of fetal-specific tolerance or of a generalized suppression of the maternal immune system. We hypothesized that antigen-specific T cell responses are modulated by an inhibitory T cell phenotype and modified dendritic cell (DC) phenotype in a gestation-dependent manner. We analyzed changes in surface markers of peripheral blood T cells, ex vivo antigen-specific T cell responses, indoleamine 2,3-dioxygenase (IDO) activity (kynurenine/tryptophan ratio, KTR), plasma neopterin concentration, and the in vitro expression of progesterone-induced blocking factor (PIBF) in response to peripheral blood mononuclear cell culture with progesterone. We found that mid gestation is characterized by reduced antigen-specific T cell responses associated with (1) predominance of effector memory over other T cell subsets; (2) upregulation of inhibitory markers (programmed death ligand 1); (3) heightened response to progesterone (PIBF); and (4) reduced proportions of myeloid DC and concurrent IDO activity (KTR). Conversely, antigen-specific T cell responses normalized in late pregnancy and were associated with increased markers of T cell activation (CD38, neopterin). However, these changes occur with a simultaneous upregulation of immune suppressive mechanisms including apoptosis (CD95), coinhibition (TIM-3), and immune regulation (IL-10) through the course of pregnancy. Together, our data suggest that immune tolerance dominates in the second trimester and that it is gradually reversed in the third trimester in association with immune activation as the end of pregnancy approaches.
Ampomah S, Brar R, Laverick B, et al., 2017, Diagnosing DVT/PE in the obstetric population. From audit to quality improvement, Publisher: WILEY, Pages: 93-93, ISSN: 1470-0328
Shah N, Imami N, Johnson MR, 2015, Changes in T Cell, Dendritic Cell and NK Cell Phenotype, and T Cell Function From Mid To Late Pregnancy Indicate a Shift From Immune Tolerance To Increased Immune Activation., REPRODUCTIVE SCIENCES, Vol: 22, Pages: 279A-279A, ISSN: 1933-7191
Shah N, Imami N, Johnson M, 2014, Antigenic Readiness, Enhanced Immune Response and Modified Tolerant Phenotypes Follows Flu Vaccination in Pregnancy, REPRODUCTIVE SCIENCES, Vol: 21, Pages: 411A-411A, ISSN: 1933-7191
Shah N, Westrop S, Low-Beer N, et al., 2013, Expanded CD56+subset in HIV-1-positive mothers on HAART is associated with premature delivery, HIV MEDICINE, Vol: 14, Pages: 32-32, ISSN: 1464-2662
Shah N, Westrop S, Low-Beer N, et al., 2013, Premature Delivery in HIV plus Mothers on HAART Is Associated with an Expanded Peripheral Blood CD56+Subset, 60th Annual Scientific Meeting of the Society-for-Gynecologic-Investigation (SGI), Publisher: SAGE PUBLICATIONS INC, Pages: 197A-197A, ISSN: 1933-7191
Shah N, Imami N, Johnson M, 2013, Pregnancy Is Associated with Greater PIBF Expression on Peripheral Blood CD8+T-Cells In-Vitro, 60th Annual Scientific Meeting of the Society-for-Gynecologic-Investigation (SGI), Publisher: SAGE PUBLICATIONS INC, Pages: 323A-323A, ISSN: 1933-7191
Shah N, Imami N, Johnson M, 2012, T-cell phenotypic profile in pregnancy: link between immune activation and exhaustion, BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 119, Pages: 62-62, ISSN: 1470-0328
Shah N, Agarwal N, Ratcliff S, et al., 2012, A comparative audit of total abdominal hysterectomy, subtotal hysterectomy, vaginal hysterectomy and laparoscopically assisted vaginal hysterectomy in a London District General Hospital, BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 119, Pages: 230-230, ISSN: 1470-0328
Shah N, Benlarech A, Imami N, et al., 2012, Phenotypic analysis of dendritic cell lineage and maturity, and T-Cell exhaustion indicate dampened immune activation in pregnancy, Joint International Congress of the American-Society-for-Reproductive-Immunology (ASRI) and the European-Society-for-Reproductive-Immunology (ESRI), Publisher: ELSEVIER IRELAND LTD, Pages: 50-50, ISSN: 0165-0378
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Sahoo S, Jose J, Shah N, et al., 2009, Recurrent cornual ectopic pregnancies, Gynecological Surgery, Vol: 6, ISSN: 1613-2076
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