The increase of CD40 suggests an increase in immune activation, which is a consistent finding in studies investigating the effects of CMV infection on endothelial cells.41 These findings generate further questions about immune cell and trophoblast interactions during CMV infection, such as whether their interaction is overall helpful towards the protection of the fetus from the virus, or detrimental due to the associated inflammation the interaction may induce. Here, CD40 is linked to cytomegalovirus infection.