Phenotype of fetal monocytes and B lymphocytes during the third trimester of pregnancy

The neonate typically exhibits an immature immune response compared with the adult, yet the fetus is able to generate antigen-specific responses from around 20–22 weeks of gestation. Although antigen-presenting cells (APCs) must have attained the necessary level of maturity to support this, very little is known about the phenotype and function of these populations during human fetal development. Whole blood flow cytometry was, therefore, utilised to phenotype fetal/neonatal circulating monocytes and B cells throughout the third trimester of pregnancy. The percentage of B cells (CD19+) expressing MHC Class II was comparable to the adult at all gestations, whereas the percentage of MHC Class II-positive monocytes (CD14+) increased significantly over gestation (P=0.0008) but remained lower than the adult at term. In contrast, the percentage of CD40+ or CD86+ fetal/neonatal monocytes at all gestations was comparable to the adult, but there was a maturational increase in the percentage of CD40+ or CD86+ B cells (P=0.007) to adult levels by term. The expression of CD14 itself (mean fluorescence intensity, MFI) showed a trend to increase over gestation (P=0.062) and, although all CD14+ cells expressed other receptors associated with innate immune responses (CD11b and CD35), there was fluctuation in the intensity of expression over gestation. Functional immaturity of neonatal antigen-specific immune responses could be associated with reduced co-stimulation provided by both monocytes (via reduced MHC Class II) and B cells (via reduced CD40 and CD86); altered innate responsiveness of monocytes could also contribute.