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Zhang Z, Liu H, Shi Y, Xu N, Wang Y, Li A, Song W. Increased circulating Th22 cells correlated with Th17 cells in patients with severe preeclampsia. Hypertens Pregnancy 2017; 36:100-107. [PMID: 27835036 DOI: 10.1080/10641955.2016.1239737] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 08/28/2016] [Accepted: 09/16/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVE We aimed to investigate Th22 cells and their association with Th17 and Treg cells in the etiology of severe preeclampsia (sPE). METHODS Thirty sPE patients and 30 healthy pregnant women were recruited in this study. The percentages of Th17, Th22, and regulatory T cells (Tregs) in the peripheral blood were measured by flow cytometry. ELISA was used to measure the plasma concentrations of interleukin (IL)-17, IL-22, and IL-10. RESULTS The percentages of Th17 and Th22 cells and the plasma concentrations of IL-17 and IL-22 were significantly increased in sPE patients along with a decreased percentage of Treg cells and a decreased plasma IL-10 concentration. There was a positive correlation between the levels of Th22 cells and Th17 cells in sPE patients. Moreover, a positive correlation was found between plasma IL-22 concentration and the percentage of Th22 cells in sPE patients. CONCLUSIONS Increased circulating Th22 cells, which were correlated with Th17 cells, were observed in patients with sPE. The immune imbalance between T helper (Th) cells may contribute to the pathogenesis of sPE.
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Affiliation(s)
- Zhan Zhang
- a Department of Clinical Laboratory , The Third Affiliated Hospital of Zhengzhou University , Zhengzhou , China
- b Shangqiu Medical College , Shangqiu , China
| | - Hui Liu
- a Department of Clinical Laboratory , The Third Affiliated Hospital of Zhengzhou University , Zhengzhou , China
| | - Ying Shi
- a Department of Clinical Laboratory , The Third Affiliated Hospital of Zhengzhou University , Zhengzhou , China
| | - Na Xu
- a Department of Clinical Laboratory , The Third Affiliated Hospital of Zhengzhou University , Zhengzhou , China
| | - Yuanyuan Wang
- c Department of Obstetrics and Gynecology , The Third Affiliated Hospital of Zhengzhou University , Zhengzhou , China
| | - Aiping Li
- a Department of Clinical Laboratory , The Third Affiliated Hospital of Zhengzhou University , Zhengzhou , China
| | - Wanyu Song
- c Department of Obstetrics and Gynecology , The Third Affiliated Hospital of Zhengzhou University , Zhengzhou , China
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The role of decidual NK cells in pregnancies with impaired vascular remodelling. J Reprod Immunol 2016; 119:81-84. [PMID: 27680579 DOI: 10.1016/j.jri.2016.09.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 09/08/2016] [Accepted: 09/16/2016] [Indexed: 12/22/2022]
Abstract
The pathologies of the dangerous pregnancy complications pre-eclampsia (PE) and fetal growth restriction (FGR) are established in the first trimester of human pregnancy yet we know little of how this happens. Finely tuned interactions between maternal and placental cells are essential for pregnancy to progress without complications; however, the precise nature of this cross-talk and how it can go wrong are crucial questions that remain to be answered. This review summarises recent studies examining the role played by natural killer cells in regulating normal placentation and remodelling. Their involvement when it is impaired in PE/FGR pregnancies will additionally be discussed.
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Hyde KJ, Schust DJ. Immunologic challenges of human reproduction: an evolving story. Fertil Steril 2016; 106:499-510. [PMID: 27477190 DOI: 10.1016/j.fertnstert.2016.07.1073] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/13/2016] [Accepted: 07/13/2016] [Indexed: 12/11/2022]
Abstract
Characterization of the implanting human fetus as an allograft prompted a field of research in reproductive immunology that continues to fascinate and perplex scientists. Paternal- or partner-derived alloantigens are present in the maternal host at multiple times during the reproductive process. They begin with exposure to semen, continue through implantation and placentation, and may persist for decades in the form of fetal microchimerism. Changes in maternal immune responses that allow allogenic fertilization and survival of semiallogenic concepti to delivery must be balanced with a continued need to respond appropriately to pathogenic invaders, commensals, cell or tissue damage, and any tendency toward malignant transformation. This complex and sophisticated balancing act is essential for survival of mother, fetus, and the species itself. We will discuss concepts of alloimmune recognition, tolerance, and ignorance as they pertain to mammalian reproduction with a focus on human reproduction, maternal immune modulation, and the very earliest events in the reproductive process, fertilization and implantation.
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Affiliation(s)
- Kassie J Hyde
- University of Missouri School of Medicine, Columbia, Missouri
| | - Danny J Schust
- Department of Obstetrics, Gynecology and Women's Health, University of Missouri School of Medicine, Columbia, Missouri.
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Tian M, Zhang Y, Liu Z, Sun G, Mor G, Liao A. The PD-1/PD-L1 inhibitory pathway is altered in pre-eclampsia and regulates T cell responses in pre-eclamptic rats. Sci Rep 2016; 6:27683. [PMID: 27277012 PMCID: PMC4899740 DOI: 10.1038/srep27683] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 05/24/2016] [Indexed: 12/20/2022] Open
Abstract
The programmed cell death-1(PD-1)/PD-ligand 1 (PD-L1) pathway is critical to immune homeostasis by promoting regulatory T (Treg) development and inhibiting effector T (such as Th17) cell responses. However, the association between the PD-1/PD-L1 pathway and the Treg/Th17 imbalance has not been fully investigated in pre-eclampsia (PE). In this study, we observed an inverse correlation between the percentages of Treg and Th17 cells, and the expression of PD-1 and PD-L1 on the two subsets also changed in PE compared with normal pregnancy. We further explored their relationship in vivo using the L-NG-Nitroarginine Methyl Ester (L-NAME) induced PE-like rat models, also characterized by Treg/Th17 imbalance. Administration of PD-L1-Fc protein provides a protective effects on the pre-eclamptic models, both to the mother and the fetuses, by reversing Treg/Th17 imbalance through inhibiting PI3K/AKT/m-TOR signaling and enhancing PTEN expression. In addition, we also observed a protective effect of PD-L1-Fc on the placenta by reversing placental damages. These results suggested that altered PD-1/PD-L1 pathway contributed to Treg/Th17 imbalance in PE. Treatment with PD-L1-Fc posed protective effects on pre-eclamptic models, indicating that the use of PD-L1-Fc might be a potential therapeutic target in PE treatment.
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Affiliation(s)
- Mei Tian
- Family Planning Research Institute, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
| | - Yonghong Zhang
- Family Planning Research Institute, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
| | - Zhaozhao Liu
- Family Planning Research Institute, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
| | - Guoqiang Sun
- Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Hubei province, Wuhan, P.R. China
| | - Gil Mor
- Department of Obstetrics, Gynecology &Reproductive Sciences, Division of Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Aihua Liao
- Family Planning Research Institute, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P.R. China
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55
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Functional Genetic Variants of FOXP3 and Risk of Multiple Sclerosis. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016. [DOI: 10.5812/ircmj.34597] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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56
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LaMarca B, Cornelius DC, Harmon AC, Amaral LM, Cunningham MW, Faulkner JL, Wallace K. Identifying immune mechanisms mediating the hypertension during preeclampsia. Am J Physiol Regul Integr Comp Physiol 2016; 311:R1-9. [PMID: 27097659 DOI: 10.1152/ajpregu.00052.2016] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 04/18/2016] [Indexed: 12/13/2022]
Abstract
Preeclampsia (PE) is a pregnancy-associated disorder that affects 5-8% of pregnancies and is a major cause of maternal, fetal, and neonatal morbidity and mortality. Hallmark characteristics of PE are new onset hypertension after 20 wk gestation with or without proteinuria, chronic immune activation, fetal growth restriction, and maternal endothelial dysfunction. However, the pathophysiological mechanisms that lead to the development of PE are poorly understood. Recent data from studies of both clinical and animal models demonstrate an imbalance in the subpopulations of CD4+ T cells and a role for these cells as mediators of inflammation and hypertension during pregnancy. Specifically, it has been proposed that the imbalance between two CD4+ T cell subtypes, regulatory T cells (Tregs) and T-helper 17 cells (Th17s), is involved in the pathophysiology of PE. Studies from our laboratory highlighting how this imbalance contributes to vasoactive factors, endothelial dysfunction, and hypertension during pregnancy will be discussed in this review. Therefore, the purpose of this review is to highlight hypertensive mechanisms stimulated by inflammatory factors in response to placental ischemia, thereby elucidating a role.
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Affiliation(s)
- Babbette LaMarca
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi; and Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Denise C Cornelius
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi; and
| | - Ashlyn C Harmon
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi; and
| | - Lorena M Amaral
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi; and
| | - Mark W Cunningham
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi; and
| | - Jessica L Faulkner
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi; and
| | - Kedra Wallace
- Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi
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57
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Nakabayashi Y, Nakashima A, Yoshino O, Shima T, Shiozaki A, Adachi T, Nakabayashi M, Okai T, Kushima M, Saito S. Impairment of the accumulation of decidual T cells, NK cells, and monocytes, and the poor vascular remodeling of spiral arteries, were observed in oocyte donation cases, regardless of the presence or absence of preeclampsia. J Reprod Immunol 2016; 114:65-74. [DOI: 10.1016/j.jri.2015.07.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 07/24/2015] [Indexed: 01/13/2023]
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58
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LaMarca B, Amaral LM, Harmon AC, Cornelius DC, Faulkner JL, Cunningham MW. Placental Ischemia and Resultant Phenotype in Animal Models of Preeclampsia. Curr Hypertens Rep 2016; 18:38. [PMID: 27076345 PMCID: PMC5127437 DOI: 10.1007/s11906-016-0633-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Preeclampsia is new onset (or worsening of preexisting) hypertension that occurs during pregnancy. It is accompanied by chronic inflammation, intrauterine growth restriction, elevated anti-angiogenic factors, and can occur with or without proteinuria. Although the exact etiology is unknown, it is thought that preeclampsia begins early in gestation with reduced uterine spiral artery remodeling leading to decreased vasculogenesis of the placenta as the pregnancy progresses. Soluble factors, stimulated by the ischemic placenta, shower the maternal vascular endothelium and are thought to cause endothelial dysfunction and to contribute to the development of hypertension during pregnancy. Due to the difficulty in studying such soluble factors in pregnant women, various animal models have been designed. Studies from these models have contributed to a better understanding of how factors released in response to placental ischemia may lead to increased blood pressure and reduced fetal weight during pregnancy. This review will highlight various animal models and the major findings indicating the importance of placental ischemia to lead to the pathophysiology observed in preeclamptic patients.
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Affiliation(s)
- Babbette LaMarca
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS, 39216, USA.
| | - Lorena M Amaral
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS, 39216, USA
| | - Ashlyn C Harmon
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS, 39216, USA
| | - Denise C Cornelius
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS, 39216, USA
| | - Jessica L Faulkner
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS, 39216, USA
| | - Mark W Cunningham
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS, 39216, USA
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59
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Harmon AC, Cornelius DC, Amaral LM, Faulkner JL, Cunningham MW, Wallace K, LaMarca B. The role of inflammation in the pathology of preeclampsia. Clin Sci (Lond) 2016; 130:409-19. [PMID: 26846579 PMCID: PMC5484393 DOI: 10.1042/cs20150702] [Citation(s) in RCA: 336] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Preeclampsia (PE) affects 5-7% of all pregnancies in the United States and is the leading cause of maternal and prenatal morbidity. PE is associated with hypertension after week 20 of gestation, decreased renal function and small-for-gestational-age babies. Women with PE exhibit chronic inflammation and production of autoantibodies. It is hypothesized that during PE, placental ischaemia occurs as a result of shallow trophoblast invasion which is associated with an immune imbalance where pro-inflammatory CD4(+) T-cells are increased and T regulatory cells (Tregs) are decreased. This imbalance leads to chronic inflammation characterized by oxidative stress, pro-inflammatory cytokines and autoantibodies. Studies conducted in our laboratory have demonstrated the importance of this immune imbalance in causing hypertension in response to placental ischaemia in pregnant rats. These studies confirm that increased CD4(+) T-cells and decreased Tregs during pregnancy leads to elevated inflammatory cytokines, endothelin (ET-1), reactive oxygen species (ROS) and agonistic autoantibodies to the angiotensin II (Ang II), type 1 receptor (AT1-AA). All of these factors taken together play an important role in increasing the blood pressure during pregnancy. Specifically, this review focuses on the decrease in Tregs, and their associated regulatory cytokine interleukin (IL)-10, which is seen in response to placental ischaemia during pregnancy. This study will also examine the effect of regulatory immune cell repopulation on the pathophysiology of PE. These studies show that restoring the balance of the immune system through increasing Tregs, either by adoptive transfer or by infusing IL-10, reduces the blood pressure and pathophysiology associated with placental ischaemia in pregnant rats.
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Affiliation(s)
- Ashlyn C Harmon
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A
| | - Denise C Cornelius
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A
| | - Lorena M Amaral
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A
| | - Jessica L Faulkner
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A
| | - Mark W Cunningham
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A
| | - Kedra Wallace
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A
| | - Babbette LaMarca
- Departments of Pharmacology, Physiology, & Ob/Gyn, Center for Excellence in Cardiovascular and Renal Research, University of Mississippi Medical Center, Jackson, MS 39216, U.S.A.
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60
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van Egmond A, van der Keur C, Swings GMJS, Scherjon SA, Claas FHJ. The possible role of virus-specific CD8(+) memory T cells in decidual tissue. J Reprod Immunol 2015; 113:1-8. [PMID: 26496155 DOI: 10.1016/j.jri.2015.09.073] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 08/20/2015] [Accepted: 09/29/2015] [Indexed: 11/18/2022]
Abstract
The most abundant lymphocyte present in decidual tissue is the CD8(+) T cell. It has been shown that most decidual CD8(+) T cells have an effector-memory phenotype, but expressed reduced levels of perforin and granzyme B compared with the peripheral CD8(+) effector-memory T cells. The specificity of these CD8(+) memory T cells has yet to be determined. One hypothesis is that the decidual memory T cells are virus-specific T cells that should protect the fetus against incoming pathogens. As virus-specific CD8(+) memory T cells can cross-react with human leukocyte alloantigens, an alternative, but not mutually exclusive, hypothesis is that these CD8(+) T cells are fetus-specific. Using virus-specific tetramers, we found increased percentages of virus-specific CD8(+) T cells in decidual tissue compared with peripheral blood after uncomplicated pregnancy. So far, no evidence has been obtained for a cross-reactive response of these virus-specific T cells to fetal human leukocyte antigens. These results suggest that the virus-specific memory T cells accumulate in the placenta to protect the fetus from a harmful infection.
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Affiliation(s)
- A van Egmond
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, The Netherlands; Department of Obstetrics, Leiden University Medical Center, The Netherlands.
| | - C van der Keur
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, The Netherlands
| | - G M J S Swings
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, The Netherlands
| | - S A Scherjon
- Department of Obstetrics and Gynaecology, University Medical Center Groningen, The Netherlands
| | - F H J Claas
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, The Netherlands
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61
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Boij R, Mjösberg J, Svensson-Arvelund J, Hjorth M, Berg G, Matthiesen L, Jenmalm MC, Ernerudh J. Regulatory T-cell Subpopulations in Severe or Early-onset Preeclampsia. Am J Reprod Immunol 2015; 74:368-78. [DOI: 10.1111/aji.12410] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 05/26/2015] [Indexed: 01/10/2023] Open
Affiliation(s)
- Roland Boij
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
- Department of Obstetrics and Gynecology; County Hospital Ryhov; Jönköping Sweden
| | - Jenny Mjösberg
- Center for Infectious Medicine; Department of Medicine Huddinge; Karolinska Institutet; Stockholm Sweden
| | | | - Maria Hjorth
- Department of Clinical Immunology and Transfusion Medicine; Linköping University; Linköping Sweden
| | - Göran Berg
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| | - Leif Matthiesen
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
- Department of Obstetrics and Gynecology; Helsingborg Hospital; Helsingborg Sweden
| | - Maria C. Jenmalm
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| | - Jan Ernerudh
- Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
- Department of Clinical Immunology and Transfusion Medicine; Linköping University; Linköping Sweden
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62
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Nancy P, Erlebacher A. T cell behavior at the maternal-fetal interface. THE INTERNATIONAL JOURNAL OF DEVELOPMENTAL BIOLOGY 2015; 58:189-98. [PMID: 25023685 DOI: 10.1387/ijdb.140054ae] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Understanding the function of T cells at the maternal-fetal interface remains one of the most difficult problems in reproductive immunology. A great deal of work over the last two decades has led to the view that the T cells that populate the decidua have important roles in both normal and pathological pregnancies, but the exact nature of these roles has remained unclear. Indeed, the old assumption that decidual T cells are uniformly threatening to fetal survival because the placenta is fundamentally an 'allograft' has given way to the idea that different T cell subsets contribute in different ways to pregnancy success or failure. Accordingly, some T cells are thought to protect the placenta from immune rejection and facilitate embryo implantation, while others are thought to contribute to pregnancy pathologies such as preeclampsia and spontaneous abortion. Here, we review the current state of information on the behavior of decidual T cells with a focus on both mouse and human studies, and with an emphasis on the many unresolved areas within this overall emerging framework.
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Affiliation(s)
- Patrice Nancy
- Department of Pathology, NYU School of Medicine, New York, USA.
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63
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Lee SK, Kim CJ, Kim DJ, Kang JH. Immune cells in the female reproductive tract. Immune Netw 2015; 15:16-26. [PMID: 25713505 PMCID: PMC4338264 DOI: 10.4110/in.2015.15.1.16] [Citation(s) in RCA: 149] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 01/28/2015] [Accepted: 01/28/2015] [Indexed: 02/07/2023] Open
Abstract
The female reproductive tract has two main functions: protection against microbial challenge and maintenance of pregnancy to term. The upper reproductive tract comprises the fallopian tubes and the uterus, including the endocervix, and the lower tract consists of the ectocervix and the vagina. Immune cells residing in the reproductive tract play contradictory roles: they maintain immunity against vaginal pathogens in the lower tract and establish immune tolerance for sperm and an embryo/fetus in the upper tract. The immune system is significantly influenced by sex steroid hormones, although leukocytes in the reproductive tract lack receptors for estrogen and progesterone. The leukocytes in the reproductive tract are distributed in either an aggregated or a dispersed form in the epithelial layer, lamina propria, and stroma. Even though immune cells are differentially distributed in each organ of the reproductive tract, the predominant immune cells are T cells, macrophages/dendritic cells, natural killer (NK) cells, neutrophils, and mast cells. B cells are rare in the female reproductive tract. NK cells in the endometrium significantly expand in the late secretory phase and further increase their number during early pregnancy. It is evident that NK cells and regulatory T (Treg) cells are extremely important in decidual angiogenesis, trophoblast migration, and immune tolerance during pregnancy. Dysregulation of endometrial/decidual immune cells is strongly related to infertility, miscarriage, and other obstetric complications. Understanding the immune system of the female reproductive tract will significantly contribute to women's health and to success in pregnancy.
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Affiliation(s)
- Sung Ki Lee
- Department of Obstetrics and Gynecology, College of Medicine, Konyang University, Daejeon 302-718, Korea
| | - Chul Jung Kim
- Department of Obstetrics and Gynecology, College of Medicine, Konyang University, Daejeon 302-718, Korea
| | - Dong-Jae Kim
- Department of Obstetrics and Gynecology, College of Medicine, Konyang University, Daejeon 302-718, Korea
| | - Jee-Hyun Kang
- Department of Family Medicine, College of Medicine, Konyang University, Daejeon 302-718, Korea
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64
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Schumacher A, Zenclussen AC. The Paternal Contribution to Fetal Tolerance. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 868:211-25. [PMID: 26178852 DOI: 10.1007/978-3-319-18881-2_10] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Recognition of foreign paternal antigens expressed in the semi-allogeneic fetus by maternal immune cells is a requirement for successful pregnancy. However, despite intensive research activity during the last decades, the precise mechanisms contributing to the acceptance of the paternal alloantigens are still puzzling and pregnancy remains a fascinating phenomenon. Moreover, most studies focused on the maternal and fetal contribution to pregnancy success, and relatively little is known about the paternal involvement. In the current review, we address the contribution of paternal-derived factors to fetal-tolerance induction. First, we discuss data suggesting that in both humans and mice, the female body gets prepared for a pregnancy in every cycle, also in regard to male alloantigens delivered at coitus. Then, we provide an overview about factors present in seminal fluid and how these factors influence immune responses in the female reproductive tract. We further discuss ways of paternal alloantigen presentation and identify the immune modulatory properties of seminal fluid-derived factors with a special focus on Treg biology. Finally, we highlight the therapeutic potential of seminal fluid in different clinical applications.
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Affiliation(s)
- Anne Schumacher
- Department of Experimental Obstetrics and Gynecology, Medical Faculty, Otto-von-Guericke University, Gerhart-Hauptmann Straße 35, 39108, Magdeburg, Germany
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65
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Immunity at the Maternal–Fetal Interface. Mucosal Immunol 2015. [DOI: 10.1016/b978-0-12-415847-4.00114-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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66
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Ferreira LC, Gomes CEM, Araújo ACP, Bezerra PF, Duggal P, Jeronimo SMB. Association between ACVR2A and early-onset preeclampsia: replication study in a Northeastern Brazilian population. Placenta 2014; 36:186-90. [PMID: 25499008 DOI: 10.1016/j.placenta.2014.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 10/31/2014] [Accepted: 11/10/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Preeclampsia is a complex and heterogeneous disease with increased risk of maternal mortality, especially for earlier gestational onset. There is a great inconsistency regarding the genetics of preeclampsia across the literature. The gene Activin A receptor, type IIA (ACVR2A), was reported as associated to preeclampsia in Australian/New Zealand and Norwegian populations. The goal of this study was to validate this genetic association in a Brazilian population. METHODS We performed a case-control study using 693 controls and 613 cases (443 preeclampsia, 64 eclampsia and 106 HELLP syndrome), from a Northeastern Brazilian population. Five single nucleotide polymorphisms (SNPs) in ACVR2A were tested for association through multiple logistic regression models. RESULTS There was no statistical association with preeclampsia (per se), eclampsia or HELLP. However, by grouping preeclampsia in accordance to the gestational age at delivery, SNPs rs1424954 (OR = 1.86; 95% CI, 1.25-2.78; p = 0.002) and rs1014064 (OR = 1.77; 95% CI, 1.21-2.60; p = 0.004) were significantly associated with early onset preeclampsia (gestational age ≤ 34 weeks). The risk haplotype had a frequency of 0.468 in early preeclampsia compared to 0.316 in controls (p = 0.0008 and permuted p = 0.002). DISCUSSION Activin A receptors are important in decidualization, trophoblast invasion and placentation processes during pregnancy. The gene ACVR2A was associated with the more severe early onset preeclampsia. This finding supports the hypothesis of different pathogenic mechanisms contributing to the early- and late-onset preeclampsia.
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Affiliation(s)
- L C Ferreira
- Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, Brazil; Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Brazil
| | - C E M Gomes
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Brazil; Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - A C P Araújo
- Department of Obstetrics and Gynecology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - P F Bezerra
- Maternidade Escola Januário Cicco, Federal University of Rio Grande do Norte, Natal, Brazil
| | - P Duggal
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - S M B Jeronimo
- Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, Brazil; Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Brazil; Institute of Science and Technology of Tropical Diseases (INCT-DT), Brazil.
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67
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Kim YM, Chaemsaithong P, Romero R, Shaman M, Kim CJ, Kim JS, Qureshi F, Jacques SM, Ahmed AI, Chaiworapongsa T, Hassan SS, Yeo L, Korzeniewski SJ. The frequency of acute atherosis in normal pregnancy and preterm labor, preeclampsia, small-for-gestational age, fetal death and midtrimester spontaneous abortion. J Matern Fetal Neonatal Med 2014; 28:2001-9. [PMID: 25308204 DOI: 10.3109/14767058.2014.976198] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Acute atherosis is characterized by subendothelial lipid-filled foam cells, fibrinoid necrosis and perivascular lymphocytic infiltration. This lesion is generally confined to non-transformed spiral arteries and is frequently observed in patients with preeclampsia. However, the frequency of acute atherosis in the great obstetrical syndromes is unknown. The purpose of this study was to determine the frequency and topographic distribution of acute atherosis in placentas and placental bed biopsy samples obtained from women with normal pregnancy and those affected by the "great obstetrical syndromes". We also examined the relationship between acute atherosis and pregnancy outcome in patients with preeclampsia. MATERIAL AND METHODS A retrospective cohort study of pregnant women who delivered between July 1998 and July 2014 at Hutzel Women's Hospital/Detroit Medical Center was conducted to examine 16, 345 placentas. Patients were classified into the following groups: (1) uncomplicated pregnancy; (2) spontaneous preterm labor (sPTL) and preterm prelabor rupture of membranes (PPROM); (3) preeclampsia; (4) gestational hypertension; (5) small-for-gestational age (SGA); (6) chronic hypertension; (5) fetal death; (6) spontaneous abortion and (7) others. A subset of patients had placental bed biopsy. The incidence of acute atherosis was compared among the different groups. RESULTS (1) The prevalence of acute atherosis in uncomplicated pregnancies was 0.4% (29/6961) based upon examination of nearly 7000 placentas; (2) the frequency of acute atherosis was 10.2% (181/1779) in preeclampsia, 9% (26/292) in fetal death, 2.5% (3/120) in midtrimester spontaneous abortion, 1.7% (22/1,298) in SGA neonates and 1.2% (23/1,841) in sPTL and PPROM; (3) among patients with preeclampsia, those with acute atherosis than in those without the lesion had significantly more severe disease, earlier onset, and a greater frequency of SGA neonates (p < 0.05 all) and (4) the lesion was more frequently observed in the decidua (parietalis or basalis) than in the decidual segment of the spiral arteries in patients with placental bed biopsies. CONCLUSIONS Acute atherosis is rare in normal pregnancy, and occurs more frequently in patients with pregnancy complications, including preeclampsia, sPTL, preterm PROM, midtrimester spontaneous abortion, fetal death and SGA.
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Affiliation(s)
- Yeon Mee Kim
- a Department of Pathology , Haeundae Paik Hospital, Inje University College of Medicine , Busan , Korea
| | - Piya Chaemsaithong
- b Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH , Bethesda, MD and Detroit, MI , USA .,c Department of Obstetrics and Gynecology , Wayne State University , Detroit , MI , USA
| | - Roberto Romero
- b Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH , Bethesda, MD and Detroit, MI , USA .,d Department of Obstetrics and Gynecology , University of Michigan , Ann Arbor , MI , USA .,e Department of Epidemiology and Biostatistics , Michigan State University , East Lansing , MI , USA
| | - Majid Shaman
- b Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH , Bethesda, MD and Detroit, MI , USA .,c Department of Obstetrics and Gynecology , Wayne State University , Detroit , MI , USA
| | - Chong Jai Kim
- b Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH , Bethesda, MD and Detroit, MI , USA .,f Department of Pathology , University of Ulsan College of Medicine, Asan Medical Center , Seoul , Korea
| | - Jung-Sun Kim
- b Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH , Bethesda, MD and Detroit, MI , USA .,g Department of Pathology , Samsung Medical Center, University of Sungkyunkwan School of Medicine , Seoul , Korea
| | - Faisal Qureshi
- b Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH , Bethesda, MD and Detroit, MI , USA .,h Department of Pathology , Harper University Hospital , Detroit , MI , USA , and.,i Department of Pathology , Wayne State University , Detroit , MI , USA
| | - Suzanne M Jacques
- b Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH , Bethesda, MD and Detroit, MI , USA .,h Department of Pathology , Harper University Hospital , Detroit , MI , USA , and.,i Department of Pathology , Wayne State University , Detroit , MI , USA
| | - Ahmed I Ahmed
- b Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH , Bethesda, MD and Detroit, MI , USA .,c Department of Obstetrics and Gynecology , Wayne State University , Detroit , MI , USA
| | - Tinnakorn Chaiworapongsa
- b Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH , Bethesda, MD and Detroit, MI , USA .,c Department of Obstetrics and Gynecology , Wayne State University , Detroit , MI , USA
| | - Sonia S Hassan
- b Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH , Bethesda, MD and Detroit, MI , USA .,c Department of Obstetrics and Gynecology , Wayne State University , Detroit , MI , USA
| | - Lami Yeo
- b Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH , Bethesda, MD and Detroit, MI , USA .,c Department of Obstetrics and Gynecology , Wayne State University , Detroit , MI , USA
| | - Steven J Korzeniewski
- b Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH , Bethesda, MD and Detroit, MI , USA .,c Department of Obstetrics and Gynecology , Wayne State University , Detroit , MI , USA .,e Department of Epidemiology and Biostatistics , Michigan State University , East Lansing , MI , USA
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Schumacher A, Zenclussen AC. Regulatory T cells: regulators of life. Am J Reprod Immunol 2014; 72:158-70. [PMID: 24661545 DOI: 10.1111/aji.12238] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 02/25/2014] [Indexed: 12/31/2022] Open
Abstract
Pregnancy still represents one of the most fascinating paradoxical phenomena in science. Immediately after conception, the maternal immune system is challenged by the presence of foreign paternal antigens in the semen. This triggers mechanisms of recognition and tolerance that all together allow the embryo to implant and later the fetus to develop. Tolerance mechanisms to maintain pregnancy are of special interest as they defy the classical immunology rules. Several cell types, soluble factors, and immune regulatory molecules have been proposed to contribute to fetal tolerance. Within these, regulatory T cells (Treg) are one of the most studied immune cell populations lately. They are reportedly involved in fetal acceptance. Here, we summarize several aspects of Treg biology in normal and pathologic pregnancies focusing on Treg frequencies, subtypes, antigen specificity, and activity as well as on factors influencing Treg generation, recruitment, and function. This review also highlights the contribution of fetal Treg in tolerance induction and addresses the role of Treg in autoimmune diseases and infections during gestation. Finally, the potential of Treg as a predictive marker for the success of assisted reproductive techniques and for therapeutic interventions is discussed.
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Affiliation(s)
- Anne Schumacher
- Department of Experimental Obstetrics & Gynecology, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany
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69
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Sohlberg S, Wikström AK, Olovsson M, Lindgren P, Axelsson O, Mulic-Lutvica A, Weis J, Wikström J. In vivo ³¹P-MR spectroscopy in normal pregnancy, early and late preeclampsia: a study of placental metabolism. Placenta 2014; 35:318-23. [PMID: 24612844 DOI: 10.1016/j.placenta.2014.02.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 02/07/2014] [Accepted: 02/11/2014] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Preeclampsia affects about 3% of pregnancies and the placenta is believed to play a major role in its pathophysiology. Lately, the role of the placenta has been hypothesised to be more pronounced in preeclampsia of early (<34 weeks) rather than late (≥ 34 weeks) onset. (31)P Magnetic Resonance Spectroscopy (MRS) enables non-invasive, in vivo studies of placental metabolism. Our aim was to study placental energy and membrane metabolism in women with normal pregnancies and those with early and late onset preeclampsia. METHODS The study population included fourteen women with preeclampsia (five with early onset and nine with late onset preeclampsia) and sixteen women with normal pregnancy (seven with early and nine with late pregnancy). All women underwent a (31)P-MRS examination of the placenta. RESULTS The phosphodiester (PDE) spectral intensity fraction of the total (31)P signal and the phosphodiester/phosphomonoester (PDE/PME) spectral intensity ratio was higher in early onset preeclampsia than in early normal pregnancy (p = 0.03 and p = 0.02). In normal pregnancy the PDE spectral intensity fraction and the PDE/PME spectral intensity ratio increased with increasing gestational age (p = 0.006 and p = 0.001). DISCUSSION Since PDE and PME are related to cell membrane degradation and formation, respectively, our findings indicate increased cell degradation and maybe also decreased cell proliferation in early onset preeclampsia compared to early normal pregnancy, and with increasing gestational age in normal pregnancy. CONCLUSIONS Our findings could be explained by increased apoptosis due to ischaemia in early onset preeclampsia and also increased apoptosis with increasing gestational age in normal pregnancy.
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Affiliation(s)
- S Sohlberg
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | - A-K Wikström
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | - M Olovsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | - P Lindgren
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | - O Axelsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; The Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.
| | - A Mulic-Lutvica
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | - J Weis
- Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden.
| | - J Wikström
- Department of Radiology, Oncology and Radiation Science, Uppsala University, Uppsala, Sweden.
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70
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Robertson SA, Prins JR, Sharkey DJ, Moldenhauer LM. Seminal fluid and the generation of regulatory T cells for embryo implantation. Am J Reprod Immunol 2013; 69:315-30. [PMID: 23480148 DOI: 10.1111/aji.12107] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2012] [Accepted: 01/30/2013] [Indexed: 12/13/2022] Open
Abstract
T regulatory (Treg) cells are essential mediators of the maternal immune adaptation necessary for embryo implantation. In mice, insufficient Treg cell activity results in implantation failure, or constrains placental function and fetal growth. In women, Treg cell deficiency is linked with unexplained infertility, miscarriage, and pre-eclampsia. To devise strategies to improve Treg cell function, it is essential to define the origin of the Treg cells in gestational tissues, and the regulators that control their functional competence and recruitment. Male seminal fluid is a potent source of the Treg cell-inducing agents TGFβ and prostaglandin E, and coitus is one key factor involved in expanding the pool of inducible Treg cells that react with paternal alloantigens shared by conceptus tissues. In mice, coitus initiates a sequence of events whereby female dendritic cells cross-present seminal fluid antigens and activate T cells, which in turn circulate via the blood to be sequestered into the endometrium. Similar events may occur in the human genital tract, where seminal fluid induces immune cell changes that appear competent to prime Treg cells. Improved understanding of how seminal fluid influences Treg cells in women should ultimately assist in the development of new therapies for immune-mediated pathologies of pregnancy.
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Affiliation(s)
- Sarah A Robertson
- Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, SA, Australia.
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71
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Kim Y, Kim JS, Lee K, Shim JY, Won HS, Lee P, Kim A, Kim C. Memb-roller: An effective way of making membrane rolls for pathological examination and studies of human placenta. Placenta 2013; 34:722-5. [DOI: 10.1016/j.placenta.2013.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 04/08/2013] [Accepted: 05/04/2013] [Indexed: 10/26/2022]
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Barakonyi A, Miko E, Szereday L, Polgar PD, Nemeth T, Szekeres-Bartho J, Engels GL. Cell Death Mechanisms and Potentially Cytotoxic Natural Immune Cells in Human Pregnancies Complicated by Preeclampsia. Reprod Sci 2013; 21:155-66. [DOI: 10.1177/1933719113497288] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Aliz Barakonyi
- Department of Medical Microbiology and Immunology, Clinical Centre, University of Pecs, Pecs, Hungary
- Janos Szentagothai Research Centre, Pecs, Hungary
| | - Eva Miko
- Department of Medical Microbiology and Immunology, Clinical Centre, University of Pecs, Pecs, Hungary
- Janos Szentagothai Research Centre, Pecs, Hungary
| | - Laszlo Szereday
- Department of Medical Microbiology and Immunology, Clinical Centre, University of Pecs, Pecs, Hungary
- Janos Szentagothai Research Centre, Pecs, Hungary
| | - Petra Dora Polgar
- Department of Medical Microbiology and Immunology, Clinical Centre, University of Pecs, Pecs, Hungary
| | - Timea Nemeth
- Department of Languages for Specific Purposes, Medical School, University of Pecs, Pecs, Hungary
| | - Julia Szekeres-Bartho
- Department of Medical Microbiology and Immunology, Clinical Centre, University of Pecs, Pecs, Hungary
- Janos Szentagothai Research Centre, Pecs, Hungary
| | - Geraldine Laura Engels
- Department of Medical Microbiology and Immunology, Clinical Centre, University of Pecs, Pecs, Hungary
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McDonald EA, Friedman JF, Sharma S, Acosta L, Pond-Tor S, Cheng L, White ES, Kurtis JD. Schistosoma japonicum soluble egg antigens attenuate invasion in a first trimester human placental trophoblast model. PLoS Negl Trop Dis 2013; 7:e2253. [PMID: 23755313 PMCID: PMC3675010 DOI: 10.1371/journal.pntd.0002253] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 04/25/2013] [Indexed: 11/19/2022] Open
Abstract
Background Schistosomiasis affects nearly 40 million women of reproductive age, and is known to elicit a pro-inflammatory signature in the placenta. We have previously shown that antigens from schistosome eggs can elicit pro-inflammatory cytokine production from trophoblast cells specifically; however, the influence of these antigens on other characteristics of trophoblast function, particularly as it pertains to placentation in early gestation, is unknown. We therefore sought to determine the impact of schistosome antigens on key characteristics of first trimester trophoblast cells, including migration and invasion. Methods First trimester HTR8/SVneo trophoblast cells were co-cultured with plasma from pregnant women with and without schistosomiasis or schistosome soluble egg antigens (SEA) and measured cytokine, cellular migration, and invasion responses. Results Exposure of HTR8 cells to SEA resulted in a pro-inflammatory, anti-invasive signature, characterized by increased pro-inflammatory cytokines (IL-6, IL-8, MCP-1) and TIMP-1. Additionally, these cells displayed 62% decreased migration and 2.7-fold decreased invasion in vitro after treatment with SEA. These results are supported by increased IL-6 and IL-8 in the culture media of HTR8 cells exposed to plasma from Schistosoma japonica infected pregnant women. Conclusions Soluble egg antigens found in circulation during schistosome infection increase pro-inflammatory cytokine production and inhibit the mobility and invasive characteristics of the first trimester HTR8/SVneo trophoblast cell line. This is the first study to assess the impact of schistosome soluble egg antigens on the behavior of an extravillous trophoblast model and suggests that schistosomiasis in the pre-pregnancy period may adversely impact placentation and the subsequent health of the mother and newborn. Approximately 40 million women of childbearing age suffer from schistosome infection globally at any given time. Multiple studies in rodent models, as well as a few reports in humans, suggest that schistosome infection results in poor pregnancy outcomes. We have previously shown that antigens released from schistosome eggs result in a pronounced pro-inflammatory response in syncytialized third trimester trophoblasts. Herein, we examine the effect of schistosome egg antigens on a first trimester trophoblast cell line, an accepted model for early placental development. Not only is the pro-inflammatory response recapitulated in this model system, but we also observed a decrease in migration and invasion of trophoblast cells after exposure to these antigens. Both migration and invasion are key aspects in early placental development, and inadequate invasion has been implicated in pregnancy-related diseases such as growth restriction and preeclampsia. This study is the first to examine the impact of schistosome antigens on early placental development, and may have implications for the subsequent health of both the pregnancy and the child.
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Affiliation(s)
- Emily A. McDonald
- Center for International Health Research, Rhode Island Hospital, Brown University Medical School, Providence, Rhode Island, United States of America
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Brown University Medical School, Providence, Rhode Island, United States of America
- * E-mail:
| | - Jennifer F. Friedman
- Center for International Health Research, Rhode Island Hospital, Brown University Medical School, Providence, Rhode Island, United States of America
- Department of Pediatrics, Rhode Island Hospital, Brown University Medical School, Providence, Rhode Island, United States of America
| | - Surendra Sharma
- Department of Pediatrics, Women and Infants Hospital, Brown University Medical School, Providence, Rhode Island, United States of America
| | - Luz Acosta
- Center for International Health Research, Rhode Island Hospital, Brown University Medical School, Providence, Rhode Island, United States of America
- Department of Immunology, Research Institute of Tropical Medicine, Manila, The Philippines
| | - Sunthorn Pond-Tor
- Center for International Health Research, Rhode Island Hospital, Brown University Medical School, Providence, Rhode Island, United States of America
| | - Ling Cheng
- Center for International Health Research, Rhode Island Hospital, Brown University Medical School, Providence, Rhode Island, United States of America
| | - Eric S. White
- Department of Medicine, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Jonathan D. Kurtis
- Center for International Health Research, Rhode Island Hospital, Brown University Medical School, Providence, Rhode Island, United States of America
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Brown University Medical School, Providence, Rhode Island, United States of America
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Chen X, Gan T, Liao Z, Chen S, Xiao J. Foxp3 (-/ATT) polymorphism contributes to the susceptibility of preeclampsia. PLoS One 2013; 8:e59696. [PMID: 23560055 PMCID: PMC3613390 DOI: 10.1371/journal.pone.0059696] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 02/17/2013] [Indexed: 01/31/2023] Open
Abstract
Objective To evaluate the potential influence of Foxp3 polymorphism on preeclampsia (PE) susceptibility, we conducted a case-control study in Han Chinese women. Methods Foxp3 genotyping was determined by polymerase chain reaction with sequence-specific primers (PCR-SSP) in 156 PE patients and 252 age-frequency matched controls. Immunohistochemical staining was used to detect the expression of Foxp3 specific transcription factor in 30 PE and 30 normal pregnant women. Results The positive rate of Foxp3 expression in PE (26.67%) was significant difference from that in normal control (63.33%, P<0.05). The frequency of Foxp3-6054 TT genotype was significantly lower in PE patient than that in control. No significant difference was found in Foxp3-3279 genotypes between PE and control, as well as for the variant allele. The frequency of Foxp3-6054A/−3279C haplotype in PE was significantly higher than that in control (P<0.01), while the frequency of Foxp3 6054T/−3279C haplotype was significantly lower in PE patient than that in control (P<0.01). Conclusion Our findings suggest that the immune suppression function in PE patients is weakened, which may result in the occurrence of PE. Foxp3 polymorphism (rs5902434) may be a potential contributor for the development of PE in Han Chinese women.
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Affiliation(s)
- Ximing Chen
- Medical College of University of South, Guangzhou, China.
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Quinn KH, Parast MM. Decidual regulatory T cells in placental pathology and pregnancy complications. Am J Reprod Immunol 2013; 69:533-8. [PMID: 23384284 DOI: 10.1111/aji.12077] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 12/31/2012] [Indexed: 12/11/2022] Open
Abstract
Regulatory T cells (Tregs) have been identified as immunomodulatory cells, which induce tolerance. Evidence from numerous recent studies implicates these cells as critical for maternal tolerance to the fetal-derived placenta, proper functioning of which is required for normal gestation and growth and development of the fetus in utero. This review focuses on the recent studies of Tregs at the maternal-fetal interface in pregnancy complications, as well as their identification in specific inflammatory lesions in the placenta.
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Affiliation(s)
- Kristen H Quinn
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, USA
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Natural killer cells promote immune tolerance by regulating inflammatory TH17 cells at the human maternal-fetal interface. Proc Natl Acad Sci U S A 2012; 110:E231-40. [PMID: 23271808 DOI: 10.1073/pnas.1206322110] [Citation(s) in RCA: 214] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Natural killer (NK) cells accumulate at the maternal-fetal interface in large numbers, but their exact roles in successful pregnancy remain poorly defined. Here, we provide evidence that T(H)17 cells and local inflammation can occur at the maternal-fetal interface during natural allogenic pregnancies. We found that decidual NK cells promote immune tolerance and successful pregnancy by dampening inflammatory T(H)17 cells via IFN-γ secreted by the CD56(bright)CD27(+) NK subset. This NK-cell-mediated regulatory response is lost in patients who experience recurrent spontaneous abortions, which results in a prominent T(H)17 response and extensive local inflammation. This local inflammatory response further affects the regulatory function of NK cells, leading to the eventual loss of maternal-fetal tolerance. Thus, our data identify NK cells as key regulatory cells at the maternal-fetal interface by suppressing T(H)17-mediated local inflammation.
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Clark DA, Chaouat G. Regulatory T cells and reproduction: how do they do it? J Reprod Immunol 2012; 96:1-7. [PMID: 23021867 DOI: 10.1016/j.jri.2012.07.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 07/04/2012] [Accepted: 07/05/2012] [Indexed: 01/09/2023]
Abstract
Regulatory T cells (Treg cells) identified by expression of Foxp3 play an important role in successful implantation and gestation. Various mechanisms have been proposed to explain their actions, and the more credible and less credible are set out in this review. Induction of Treg cells is believed to occur in response to paternal antigens in seminal plasma at the time of mating, and these Treg cells home to the uterus prior to implantation. Tolerogenic dendritic cells are proposed to play an important role in the generation of Treg cells in the draining lymph nodes and in maintaining Treg activity in the uterus. Recent data indicate that abortion in the CBAxDBA/2 model may be prevented by seminal plasma antigens from DBA/2 and BALB/c males, but H-2(d) restriction suggests that presentation to Treg cells might occur via a novel mechanism. The relevance of findings in mice to human pregnancy problems is also discussed.
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Affiliation(s)
- David A Clark
- Departments of Medicine, Molecular Medicine and Pathology, Obstetrics and Gynecology, McMaster University, Health Sciences Centre Rm 3H1E, Hamilton, Ontario, Canada L8S 4K1.
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