In Utero Exposure to Histological Chorioamnionitis Primes the Exometabolomic Profiles of Preterm CD4+ T Lymphocytes [CLINICAL AND HUMAN IMMUNOLOGY]

Histological chorioamnionitis (HCA) is an intrauterine inflammatory condition that increases the risk for preterm birth, death, and disability because of persistent systemic and localized inflammation. The immunological mechanisms sustaining this response in the preterm newborn remain unclear. We sought to determine the consequences of HCA exposure on the fetal CD4⁺ T lymphocyte exometabolome. We cultured naive CD4⁺ T lymphocytes from HCA-positive and -negative preterm infants matched for gestational age, sex, race, prenatal steroid exposure, and delivery mode. We collected conditioned media samples before and after a 6-h in vitro activation of naive CD4⁺ T lymphocytes with soluble staphylococcal enterotoxin B and anti-CD28. We analyzed samples by ultraperformance liquid chromatography ion mobility–mass spectrometry. We determined the impact of HCA on the CD4⁺ T lymphocyte exometabolome and identified potential biomarker metabolites by multivariate statistical analyses. We discovered that: 1) CD4⁺ T lymphocytes exposed to HCA exhibit divergent exometabolomic profiles in both naive and activated states; 2) ~30% of detected metabolites differentially expressed in response to activation were unique to HCA-positive CD4⁺ T lymphocytes; 3) metabolic pathways associated with glutathione detoxification and tryptophan degradation were altered in HCA-positive CD4⁺ T lymphocytes; and 4) flow cytometry and cytokine analyses suggested a bias toward a T_H1-biased immune response in HCA-positive samples. HCA exposure primes the neonatal adaptive immune processes by inducing changes to the exometabolomic profile of fetal CD4⁺ T lymphocytes. These exometabolomic changes may link HCA exposure to T_H1 polarization of the neonatal adaptive immune response.

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