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Nagdas SK, Wallace S, Eaford D, Baker R, Carr K, Raychoudhuri SS. Fibrinogen-related protein, FGL2, of hamster cauda epididymal fluid: Purification, kinetic analysis of its prothrombinase activity, and its role in segregation of nonviable spermatozoa. Mol Reprod Dev 2020; 87:1206-1218. [PMID: 33216420 DOI: 10.1002/mrd.23438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/30/2020] [Accepted: 11/02/2020] [Indexed: 11/11/2022]
Abstract
Although the epididymal environment promotes the maturation and survival of spermatozoa, not all spermatozoa remain viable during passage through the epididymis. Does the epididymis has a protective mechanism(s) to segregate the viable sperm from defective spermatozoa? Previously, we identified 260/280 kDa oligomers (termed eFGL-Epididymal Fibrinogen-Like oligomer) are composed of two disulfide-linked subunits: a 64 kDa polypeptide identified as fibrinogen-like protein-2 (FGL2) and a 33 kDa polypeptide identified as fibrinogen-like protein-1 (FGL1). Our morphological studies demonstrated that the eFGL, secreted from the principal cells of the cauda epididymis, is polymerized into a death cocoon-like complex (DCF), masking defective luminal spermatozoa but, not the viable sperm population. In the present study, we purified FGL2 from hamster cauda epididymal fluid toward homogeneity and its prothrombinase catalytic activity was examined. Time-course conversion studies revealed that all prothrombin was converted to thrombin by purified hamster FGL2. Our biochemical studies demonstrate that FGL2 is a lipid-activated serine protease and functions as a lectin by binding specific carbohydrate residues. Co-immunoprecipitation analysis demonstrated that FGL2 of cauda epididymal fluid is ubiquitinated but not the FGL1. We propose that FGL2/FGL1 oligomers represent a novel and unique mechanism to shield the viable sperm population from degenerating spermatozoa contained within the tubule lumen.
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Affiliation(s)
- Subir K Nagdas
- Department of Chemistry, Physics & Materials Science, Fayetteville State University, Fayetteville, North Carolina, USA
| | - Shamar Wallace
- Department of Chemistry, Physics & Materials Science, Fayetteville State University, Fayetteville, North Carolina, USA
| | - Don Eaford
- Department of Chemistry, Physics & Materials Science, Fayetteville State University, Fayetteville, North Carolina, USA
| | - Rashad Baker
- Department of Chemistry, Physics & Materials Science, Fayetteville State University, Fayetteville, North Carolina, USA
| | - Ky'ara Carr
- Department of Chemistry, Physics & Materials Science, Fayetteville State University, Fayetteville, North Carolina, USA
| | - Samir S Raychoudhuri
- Department of Biology, Chemistry and Environmental Health Science, Benedict College, Columbia, South Carolina, USA
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Wang LQ, Yu XW, Zhang YA, Chu J, Zhou XL, Zhang HM, Cao GF, Teng L. Decreased expression of CD200 and CD200R1 by human decidual tissues in spontaneous early abortion. J Matern Fetal Neonatal Med 2019; 33:3399-3408. [PMID: 30897989 DOI: 10.1080/14767058.2019.1572741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: To examine the cellular distribution and the expression of CD200 and its receptor 1 (CD200R1) in human deciduas in first-trimester pregnant women with spontaneous early abortion (SEA) and normal pregnancy, and to explore their role in the etiology of SEA.Subjects and methods: Thirty-five women at 6-10-week gestation with SA and 30 women of similar gestational age with a healthy pregnancy were recruited. Expression of CD200 and CD200R1 in the deciduas was determined using immunohistochemistry, confocal laser scanning microscope, Western blot, and real-time PCR (RT-PCR).Results: The decidual stromal cells, glandular epithelial cells, and vessel endothelial cells during the first trimester of pregnancy express both CD200 and CD200R1 proteins. During this period, the expression of CD200 in glandular epithelial cells and vessel endothelial cells is significantly higher in normal pregnancy than that in women with SEA (0.3079 ± 0.0674 versus 0.2735 ± 0.0515; 0.4077 ± 0.1366 versus 0.3249 ± 0.0993); the expression of CD200R1 in stromal cells, decidual stromal cells, glandular epithelial cells is significantly higher during normal pregnancy than SEA (0.2574 ± 0.0588 versus 0.2292 ± 0.0415; 0.3617 ± 0.1046 versus 0.2804 ± 0.0640). Western blot analysis showed an approximately 44% decrease in CD200R1expression in decidua in the SEA versus the controls. Finally, in decidua, the expression of both CD200 protein and CD200R1 transcript are significantly higher in healthy first-trimester pregnancy than in SEA (CD200: 2.2089 ± 1.2754 versus 0.7241 ± 0.2143; CD200R1: 15.7843 ± 10.7085 versus 7.3381 ± 5.8529).Conclusions: Women with SEA have a lower level of CD200 and CD200R1 expression in deciduas compared with normal pregnant women suggesting that under physiological conditions, CD200 and CD200R1 expression by deciduas is important to prevent fetal loss ensure a successful pregnancy.
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Affiliation(s)
- Li-Qin Wang
- Nursing Department and Shaanxi Key Laboratory of Ischemic Cardiovascular Disease, Xi'an Medical College, Xi'an, P. R. China
| | - Xue-Wen Yu
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, P. R. China
| | - Yong-Ai Zhang
- Nursing Department and Shaanxi Key Laboratory of Ischemic Cardiovascular Disease, Xi'an Medical College, Xi'an, P. R. China
| | - Jing Chu
- Nursing Department and Shaanxi Key Laboratory of Ischemic Cardiovascular Disease, Xi'an Medical College, Xi'an, P. R. China
| | - Xiao-Lan Zhou
- Nursing Department and Shaanxi Key Laboratory of Ischemic Cardiovascular Disease, Xi'an Medical College, Xi'an, P. R. China
| | - Hai-Miao Zhang
- Nursing Department and Shaanxi Key Laboratory of Ischemic Cardiovascular Disease, Xi'an Medical College, Xi'an, P. R. China
| | - Guo-Fen Cao
- Nursing Department and Shaanxi Key Laboratory of Ischemic Cardiovascular Disease, Xi'an Medical College, Xi'an, P. R. China
| | - Li Teng
- Nursing Department and Shaanxi Key Laboratory of Ischemic Cardiovascular Disease, Xi'an Medical College, Xi'an, P. R. China
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Vendelova E, Ashour D, Blank P, Erhard F, Saliba AE, Kalinke U, Lutz MB. Tolerogenic Transcriptional Signatures of Steady-State and Pathogen-Induced Dendritic Cells. Front Immunol 2018. [PMID: 29541071 PMCID: PMC5835767 DOI: 10.3389/fimmu.2018.00333] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Dendritic cells (DCs) are key directors of tolerogenic and immunogenic immune responses. During the steady state, DCs maintain T cell tolerance to self-antigens by multiple mechanisms including inducing anergy, deletion, and Treg activity. All of these mechanisms help to prevent autoimmune diseases or other hyperreactivities. Different DC subsets contribute to pathogen recognition by expression of different subsets of pattern recognition receptors, including Toll-like receptors or C-type lectins. In addition to the triggering of immune responses in infected hosts, most pathogens have evolved mechanisms for evasion of targeted responses. One such strategy is characterized by adopting the host’s T cell tolerance mechanisms. Understanding these tolerogenic mechanisms is of utmost importance for therapeutic approaches to treat immune pathologies, tumors and infections. Transcriptional profiling has developed into a potent tool for DC subset identification. Here, we review and compile pathogen-induced tolerogenic transcriptional signatures from mRNA profiling data of currently available bacterial- or helminth-induced transcriptional signatures. We compare them with signatures of tolerogenic steady-state DC subtypes to identify common and divergent strategies of pathogen induced immune evasion. Candidate molecules are discussed in detail. Our analysis provides further insights into tolerogenic DC signatures and their exploitation by different pathogens.
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Affiliation(s)
- Emilia Vendelova
- Institute for Virology and Immunobiology, University of Würzburg, Würzburg, Germany
| | - Diyaaeldin Ashour
- Institute for Virology and Immunobiology, University of Würzburg, Würzburg, Germany
| | - Patrick Blank
- Institute for Experimental Infection Research, TWINCORE, Centre for Experimental and Clinical Infection Research, a joint venture between the Helmholtz Centre for Infection Research and the Hannover Medical School, Hannover, Germany
| | - Florian Erhard
- Institute for Virology and Immunobiology, University of Würzburg, Würzburg, Germany
| | | | - Ulrich Kalinke
- Institute for Experimental Infection Research, TWINCORE, Centre for Experimental and Clinical Infection Research, a joint venture between the Helmholtz Centre for Infection Research and the Hannover Medical School, Hannover, Germany
| | - Manfred B Lutz
- Institute for Virology and Immunobiology, University of Würzburg, Würzburg, Germany
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Matteo M, Cicinelli E, Neri M, Carrubba R, Carpagnano FA, Romeo F, Scutiero G, Greco P, Garlanda C, Vendemiale G, Levi Setti PE, Serviddio G. Pro-inflammatory M1/Th1 type immune network and increased expression of TSG-6 in the eutopic endometrium from women with endometriosis. Eur J Obstet Gynecol Reprod Biol 2017; 218:99-105. [PMID: 28963923 DOI: 10.1016/j.ejogrb.2017.08.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 08/01/2017] [Accepted: 08/09/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The study aimed to explore the type 1 and type 2 cytokines expression in the endometrium from women affected by endometriosis compared to controls. The expression of TSG-6, a multifunctional protein involved in several inflammatory disease, was also evaluated. Study Design SETTING: Experimental clinical study. PATIENTS 10 patients affected by endometriosis and 11 controls. INTERVENTIONS Patients underwent to an ultrasound transvaginal examination and a diagnostic hysteroscopy in order to exclude any uterine abnormality. All patients underwent endometrial biopsy using a Novak's curette. MAIN OUTCOME MEASURES The endometrial expression of type 1 (IL- 1 β TNF-α, IL-8) and type 2 (IL-10) cytokines, and of TSG-6 was evaluated by immunohistochemistry and by real time PCR. The expression of TSG-6 was confirmed by western blot. RESULTS Results of PCR analysis and of immunohistochemistry revealed an increased expression of IL-1β, TNF-α, IL-8 and of TSG-6 in the endometrium of endometriosic patients. IL-10 expression did not show any difference. CONCLUSIONS An increased expression of pro-inflammatory type 1 cytokines was demonstrated in the endometrium from endometriosic patients, suggesting an endometrial environment harmful for implantation due to the prevalence of Th1 related immunity. An increased expression of TSG-6 was also demonstrated for the first time. Our findings concur to better define the inflammatory imbalance and the abnormal endometrial receptivity, reported in literature, of the eutopic endometrium of women affected by endometriosis.
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Affiliation(s)
- M Matteo
- Institute of Obstetrics and Gynecology, Department of Medical and Surgical Sciences, University of Foggia, Italy.
| | - E Cicinelli
- Institute of Obstetrics and Gynecology, University of Bari, Bari, Italy
| | - M Neri
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, 44100 Ferrara, Italy
| | - R Carrubba
- Institute of Obstetrics and Gynecology, Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - F A Carpagnano
- Institute of Obstetrics and Gynecology, Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - F Romeo
- Institute of Obstetrics and Gynecology, Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - G Scutiero
- Institute of Obstetrics and Gynecology, Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - P Greco
- Institute of Obstetrics and Gynaecology of Ferrara, Italy
| | - C Garlanda
- Humanitas Clinical and Research Center, Laboratory of Experimental Immunopathology, Rozzano, Italy
| | - G Vendemiale
- Institute of Internal Medicine, Department of Medical and Surgical Sciences, University of Foggia, Italy
| | - P E Levi Setti
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Humanitas Research Hospital, Humanitas Fertility Center, 20084 Rozzano, Milano, Italy
| | - G Serviddio
- Institute of Internal Medicine, Department of Medical and Surgical Sciences, University of Foggia, Italy
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Liang X, Qiu T, Qiu L, Wang X, Zhao A, Lin Q. Female third party lymphocytes are effective for immunotherapy of patients with unexplained primary recurrent spontaneous abortion: A retrospective analysis of outcomes. EUR J CONTRACEP REPR 2015; 20:428-37. [DOI: 10.3109/13625187.2015.1046593] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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6
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Wang LQ, Yan CF, Zhao Y, Chu J, Yu XW. Reduced CD200 and CD200R1 expression in human chorionic villi contributes to early spontaneous abortion. Acta Obstet Gynecol Scand 2014; 93:1248-54. [PMID: 25145957 DOI: 10.1111/aogs.12476] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 08/05/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine the expression of CD200 and its receptor (CD200R) in human chorionic villi during the first trimester of normal pregnancy and early spontaneous abortion (ESA). DESIGN Prospective study. METHODS Expression of CD200 and CD200R in the chorionic villi was determined using streptavidin-peroxidase immunohistochemistry, confocal laser scanning microscopy and real-time polymerase chain reaction. POPULATION Thirty-five women diagnosed with ESA and 30 women experiencing a healthy pregnancy in a medical university hospital in China were enrolled in this study between 2011 and 2013. MAIN OUTCOME MEASURES CD200 and CD200R expression. RESULTS The expression of CD200 in syncytiotrophoblast cells was significantly higher during normal pregnancy than in ESA (0.51 ± 0.05 vs. 0.35 ± 0.05). In contrast, expression of CD200 in cytotrophoblast cells and CD200R in stromal cells was significantly lower during normal pregnancy when compared with ESA (CD200: 0.16 ± 0.02 vs. 0.32 ± 0.03; CD200R: 0.19 ± 0.03 vs. 0.22 ± 0.02). In villi, the expression of both CD200 protein and CD200R transcripts were significantly higher in healthy first-trimester pregnancy than in ESA (CD200: 156.89 ± 105.65 vs. 37.51 ± 17.62). CONCLUSIONS There is an increase in inhibitory properties of human chorionic villi during normal pregnancy. The mechanism underlying ESA might be associated with enhanced expression of CD200 and CD200R in the trophoblast, leading to an upregulation of the immune response during the first trimester of pregnancy.
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Affiliation(s)
- Li-Qin Wang
- Department of Prevention and Health, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an
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7
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Kacerovsky M, Drahosova M, Krejsek J, Musilova I, Hornychova H, Matula V, Simetka O, Jacobsson B, Andrys C. Amniotic fluid CD200 levels in pregnancies complicated by preterm prelabor rupture of the membranes. J Matern Fetal Neonatal Med 2013; 26:1416-24. [PMID: 23489112 DOI: 10.3109/14767058.2013.785517] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To determine the amniotic fluid CD200 levels in uncomplicated pregnancies and in preterm prelabor rupture of the membranes (PPROM) according to microbial invasion of the amniotic cavity and histological chorioamnionitis and its association with neonatal outcomes. METHODS One hundred and fifty-nine women with singleton pregnancies were included in this study. Amniotic fluid was collected, and CD200 levels were determined using ELISA. RESULTS No difference was found in CD200 levels between women in the second trimester and women at term without labor. Women at term with labor had higher CD200 levels than women in the second trimester and women at term without labor. The presence of funisitis in PPROM pregnancies was associated with higher CD200 levels independent of gestational age (with funisitis: median 197.5 pg/mL versus without funisitis: median 61.0 pg/mL; p = 0.003). The need for tracheal intubation and the development of bronchopulmonary dysplasia were associated with higher CD200 levels. CONCLUSIONS Amniotic fluid CD200 levels remained stable in advanced pregnancy and they were increased during parturition. Elevated CD200 levels in the presence of funisitis suggest the involvement of negative regulatory mechanisms of innate immunity. CD200 may play a role in the development of pulmonary aspects of neonatal morbidity.
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Affiliation(s)
- Marian Kacerovsky
- Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
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8
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Fong CY, Chak LL, Biswas A, Tan JH, Gauthaman K, Chan WK, Bongso A. Human Wharton's jelly stem cells have unique transcriptome profiles compared to human embryonic stem cells and other mesenchymal stem cells. Stem Cell Rev Rep 2011; 7:1-16. [PMID: 20602182 DOI: 10.1007/s12015-010-9166-x] [Citation(s) in RCA: 231] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The human umbilical cord that originates from the embryo is an extra-embryonic membrane and the Wharton's jelly within it is a rich source of stem cells (hWJSCs). It is not definitely known whether these cells behave as human embryonic stem cells (hESCs), human mesenchymal stem cells (hMSC) or both. They have the unique properties of high proliferation rates, wide multipotency, hypoimmunogenicity, do not induce teratomas and have anticancer properties. These advantages are important considerations for their use in cell based therapies and treatment of cancers. In a search for properties that confer these advantages we compared a detailed transcriptome profiling of hWJSCs using DNA microarrays with that of a panel of known hESCs, hMSCs and stromal cells. hWJSCs expressed low levels of the pluripotent embryonic stem cell markers including POUF1, NANOG, SOX2 and LIN28, thus explaining why they do not produce teratomas. Several cytokines were significantly upregulated in hWJSCs including IL12A which is associated with the induction of apoptosis, thus explaining their anticancer properties. When GO Biological Process analysis was compared between the various stem cell types, hWJSCs showed an increased expression of genes associated with the immune system, chemotaxis and cell death. The ability to modulate immune responses makes hWJSCs an important compatible stem cell source for transplantation therapy in allogeneic settings without immunorejection. The data in the present study which is the first detailed report on hWJSC transcriptomes provide a foundation for future functional studies where the exact mechanisms of these unique properties of hWJSCs can be confirmed.
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Affiliation(s)
- Chui-Yee Fong
- Department of Obstetrics and Gynaecology, National University of Singapore, Kent Ridge, Singapore
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Jabbour HN, Sales KJ, Catalano RD, Norman JE. Inflammatory pathways in female reproductive health and disease. Reproduction 2009; 138:903-19. [PMID: 19793840 DOI: 10.1530/rep-09-0247] [Citation(s) in RCA: 220] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Inflammation involves alterations to vascular and immune cell function. It is well recognised that many physiological reproductive events such as ovulation, menstruation, implantation and onset of labour display hallmark signs of inflammation. These are orchestrated by specific molecular pathways involving a host of growth factors, cytokines, chemokines and lipid mediators. Resumption of normal reproductive function involves prompt and proper resolution of these inflammatory pathways. Recent literature confirms that resolution of inflammatory pathways involves specific biochemical events that are activated to re-establish homeostasis in the affected tissue. Moreover, initiation and maintenance of inflammatory pathways are the key components of many pathologies of the reproductive tract and elsewhere in the body. The onset of reproductive disorders or disease may be the result of exacerbated activation and maintenance of inflammatory pathways or their dysregulated resolution. This review will address the role of inflammatory events in normal reproductive function and its pathologies.
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Affiliation(s)
- Henry N Jabbour
- MRC Human Reproductive Sciences Unit Reproductive and Developmental Sciences, Queen's Medical Research Institute, The University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK.
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Karsten CM, Kruse A. The Role of Vascular Addressins in Implantations Sites During Successful and Failing Mouse Pregnancies. Immunol Invest 2009; 37:449-66. [DOI: 10.1080/08820130802191250] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Siva A, Xin H, Qin F, Oltean D, Bowdish KS, Kretz-Rommel A. Immune modulation by melanoma and ovarian tumor cells through expression of the immunosuppressive molecule CD200. Cancer Immunol Immunother 2008; 57:987-96. [PMID: 18060403 PMCID: PMC11030565 DOI: 10.1007/s00262-007-0429-6] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2007] [Accepted: 11/13/2007] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND OBJECTIVE Immune escape by tumors can occur by multiple mechanisms, each a significant barrier to immunotherapy. We previously demonstrated that upregulation of the immunosuppressive molecule CD200 on chronic lymphocytic leukemia cells inhibits Th1 cytokine production required for an effective cytotoxic T cell response. CD200 expression on human tumor cells in animal models prevents human lymphocytes from rejecting the tumor; treatment with an antagonistic anti-CD200 antibody restored lymphocyte-mediated tumor growth inhibition. The current study evaluated CD200 expression on solid cancers, and its effect on immune response in vitro. METHODS AND RESULTS CD200 protein was expressed on the surface of 5/8 ovarian cancer, 2/4 melanoma, 2/2 neuroblastoma and 2/3 renal carcinoma cell lines tested, but CD200 was absent on prostate, lung, breast, astrocytoma, or glioblastoma cell lines. Evaluation of patient samples by immunohistochemistry showed strong, membrane-associated CD200 staining on malignant cells of melanoma (4/4), ovarian cancer (3/3) and clear cell renal cell carcinoma (ccRCC) (2/3), but also on normal ovary and kidney. CD200 expression on melanoma metastases was determined by RT-QPCR, and was found to be significantly higher in jejunum metastases (2/2) and lung metastases (2/6) than in normal samples. Addition of CD200-expressing, but not CD200-negative solid tumor cell lines to mixed lymphocyte reactions downregulated the production of Th1 cytokines. Inclusion of antagonistic anti-CD200 antibody restored Th1 cytokine responses. CONCLUSION These data suggest that melanoma, ccRCC and ovarian tumor cells can express CD200, thereby potentially suppressing anti-tumor immune responses. CD200 blockade with an antagonistic antibody may permit an effective anti-tumor immune response in these solid tumor types.
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Affiliation(s)
- A. Siva
- Alexion Antibody Technologies, Inc., 3985 Sorrento Valley Blvd, Ste A, San Diego, CA 92121 USA
| | - H. Xin
- Alexion Antibody Technologies, Inc., 3985 Sorrento Valley Blvd, Ste A, San Diego, CA 92121 USA
| | - F. Qin
- Alexion Antibody Technologies, Inc., 3985 Sorrento Valley Blvd, Ste A, San Diego, CA 92121 USA
| | - D. Oltean
- Alexion Antibody Technologies, Inc., 3985 Sorrento Valley Blvd, Ste A, San Diego, CA 92121 USA
| | - K. S. Bowdish
- Alexion Antibody Technologies, Inc., 3985 Sorrento Valley Blvd, Ste A, San Diego, CA 92121 USA
| | - A. Kretz-Rommel
- Alexion Antibody Technologies, Inc., 3985 Sorrento Valley Blvd, Ste A, San Diego, CA 92121 USA
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Clark DA. REVIEW ARTICLE: Immunological Factors in Pregnancy Wastage: Fact or Fiction. Am J Reprod Immunol 2008; 59:277-300. [DOI: 10.1111/j.1600-0897.2008.00580.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Foerster K, He W, Manuel J, Bartczak A, Liu M, Markert UR, Levy GA, Clark DA. LPS-induced occult loss in mice requires FGL2. Am J Reprod Immunol 2008; 58:524-9. [PMID: 17997751 DOI: 10.1111/j.1600-0897.2007.00543.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
PROBLEM FGL2 prothrombinase is required for spontaneous abortion (resorptions) in the CBA x DBA/2 model, and for abortions in C57Bl/6 (B6) mice triggered by Salmonella enteritidis lipopolysaccharide (LPS). Unlike abortions, occult losses in B6 mice, which begin before gestation day 9.5 in mice, do not require the tumor necrosis factor-alpha receptor type 1, and may be triggered by either Salmonella enteritidis or Escherichia coli LPS. Heterozygous matings of fgl2+/-xfgl2+/- B6 mice also have a high spontaneous occult loss of fgl2-/- and to a lesser extent, fgl2+/- embryos caused by hemorrhage between trophoblast and Reichert's membrane. However, the frequency of such losses appears to vary among breeding periods and between laboratories. METHOD OF STUDY We tested the hypothesis that FGL2-deficient embryos were uniquely susceptible to LPS by treating B6 fgl2+/-xfgl2+/- heterozygous matings with 2 microg E. coli LPS intraperitoneally on day 6.5 of pregnancy. Progesterone 2 mg in 100 microL sesame oil was administered subcutaneously at the same time to ensure that the effects of the LPS were not because of suppression of ovarian hormone production. PCR DNA genotyping was performed on embryos at day 13.5 of pregnancy, or after parturition. RESULTS Surprisingly, we found that LPS caused occult loss of fgl2+/+, and to a lesser extent fgl2+/- embryos, both at term and by PCR typing of embryos at gestation day 13.5, and these losses obscured the effect of fgl2 knockout. CONCLUSION Spontaneous loss of fgl2-/- embryos may relate to adhesion effects, whereas fgl2+/+ embryos are susceptible to LPS-induced loss; fgl2+/- embryos may be affected by both mechanisms. Antagonizing FGL2 could prevent occult pregnancy loss in some human and animal situations.
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Affiliation(s)
- Katharina Foerster
- Toronto General Research Institute and CIHR Group on Cellular and Molecular Mechanisms of Organ Injury, Toronto Hospital, Toronto, ON, Canada
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Kretz-Rommel A, Bowdish KS. Rationale for anti-CD200 immunotherapy in B-CLL and other hematologic malignancies: new concepts in blocking immune suppression. Expert Opin Biol Ther 2008; 8:5-15. [PMID: 18081533 DOI: 10.1517/14712598.8.1.5] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Immune evasion in cancer is increasingly recognized as a contributing factor in the failure of a natural host antitumor immune response as well as in the failure of cancer vaccine trials. Immune evasion may be the result of a number of factors, including expansion of regulatory T cells, production of immunosuppressive cytokines, downregulation of HLA class I and tumor-associated antigens and upregulation of immunosuppressive molecules on the surface of tumor cells. CD200, a cell surface ligand that plays a role in regulating the immune system, has been shown to be upregulated on the surface of some hematologic and solid tumor malignancies. This review characterizes the role of CD200 in immune suppression, and describes strategies to target this molecule in the oncology setting, thus directly modulating immune regulation and potentially altering tolerance to tumor antigens.
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van den Heuvel MJ, Peralta CG, Hatta K, Han VK, Clark DA. Decline in number of elevated blood CD3(+) CD56(+) NKT cells in response to intravenous immunoglobulin treatment correlates with successful pregnancy. Am J Reprod Immunol 2007; 58:447-59. [PMID: 17922698 DOI: 10.1111/j.1600-0897.2007.00529.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
PROBLEM Patients with elevated blood natural killer (NK) cells may be offered intravenous immunoglobulin (IVIG) treatment, but there is controversy about the utility of blood NK cell testing. Human CD56(+) NK cells include several subpopulations that include the putatively cytotoxic CD56(+) CD16(+) subset. In mouse models of pregnant failure, NKT cells appear to be important. However, a mouse model may only be pertinent to a subset of patients, as recurrent pregnancy failure is a heterogenous group. METHOD OF STUDY An ethics-approved observational study was done to observe the effect of treatment on total blood lymphoid cells, and subsets of CD56(+) blood lymphocytes including CD56(+) CD3(+) NKT cells determined by flow cytometry, and to correlate with pregnancy outcome. Fifteen fertile women with a history of successful pregnancy and thirty-one women suffering from repeated implantation failure or recurrent spontaneous abortion provided serial blood samples during one menstrual cycle or prior to and during treatment. IVIG was administered to the latter group with or without heparin/aspirin. RESULTS Eight of thirty infertile women presented with high numbers of CD56(+) CD3(+) NKT cells, which declined after treatment with IVIG. The elevated NKT cell group with or without concomitant autoimmunity achieved a significantly higher successful pregnancy rate over the course of the study, as compared to women with average numbers of NKT cells and no evidence of autoimmunity (P = 0.018). Elevated NKT levels alone was an independent predictor of success on treatment (P = 0.003). CONCLUSION Elevated NKT cells in recurrent pregnancy loss or implantation failure can be ameliorated with IVIG treatment, and result in successful pregnancy. Assay of NKT cell numbers may identify patients who are more likely to benefit from IVIG therapy and merits further examination in randomized phase II studies.
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Nonaka T, Takakuwa K, Ooki I, Akashi M, Yokoo T, Kikuchi A, Tanaka K. Results of Immunotherapy for Patients with Unexplained Primary Recurrent Abortions – Prospective Non-Randomized Cohort Study. Am J Reprod Immunol 2007; 58:530-6. [DOI: 10.1111/j.1600-0897.2007.00536.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Fernekorn U, Butcher EC, Behrends J, Karsten CM, Röbke A, Schulze TJ, Kirchner H, Kruse A. Selectin, Platelet Plays a Critical Role in Granulocyte Access to the Pregnant Mouse Uterus Under Physiological and Pathological Conditions1. Biol Reprod 2007; 76:645-53. [PMID: 17151351 DOI: 10.1095/biolreprod.106.056192] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Leukocyte recruitment to the pregnant mouse uterus is associated with highly regulated patterns of expression of vascular adhesion receptors. One striking observation is the localized expression of mucosal vascular addressin cell adhesion molecule (MADCAM1) and selectin, platelet (SELP, formerly P-selectin) by maternal vessels in the vascular zone (VZ) during the first half of pregnancy. From midgestation onwards, endothelial cells lining the maternal vessels of the VZ in addition express vascular cell adhesion molecule-1 (VCAM1). The predominant cell population within these vessels is monocyte-like cells. Granulocytes and low numbers of lymphocytes are also present. Murine fetal trophoblast cells are almost devoid of adhesion molecules, including SELP. In contrast, spontaneous abortions of allogeneic pregnancies are characterized by dramatic upregulation of SELP on maternal VZ vessels and on fetal trophoblast cells. Upregulation of SELP is associated with a dramatic influx of highly activated granulocytes, which infiltrate the vessels and tissue of the VZ and the trophoblast. The majority of the activated granulocytes within the trophoblast undergo nuclear fragmentation, which can be detected by TUNEL staining. To demonstrate that SELP is involved in the recruitment of granulocytes to the pregnant uterus, we undertook long-term in vivo inhibition studies using a monoclonal antibody to inhibit the contribution of SELP to leukocyte trafficking to the decidua. In addition, the pregnant uteri of syngeneic Selp(-/-) x Selp(-/-) mice were investigated and compared to the controls. Our results clearly demonstrate the importance of SELP for granulocyte access to the pregnant mouse uterus under physiological and pathological conditions.
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Affiliation(s)
- Uta Fernekorn
- Institute of Immunology and Transfusion Medicine, University of Lübeck, 23538 Lübeck, Germany
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Zhang J, Sun R, Wei H, Wu D, Tian Z. Toll-like receptor 3 agonist enhances IFN-gamma and TNF-alpha production by murine uterine NK cells. Int Immunopharmacol 2007; 7:588-96. [PMID: 17386406 DOI: 10.1016/j.intimp.2006.12.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2006] [Revised: 12/02/2006] [Accepted: 12/20/2006] [Indexed: 10/23/2022]
Abstract
To understand the response of murine uterine natural killer (uNK) cells to Toll-like receptor (TLR) 3 agonist at the early gestation stage, CBA x DBA/2 mice were intraperitoneally (i.p.) injected with polyinosinic-polycytidylic acid (poly I:C), the specific TLR3 agonist, at a dose of 10 microg/g BW or PBS at gestation day (gd) 6.5. The CD69 expression of uNK (DX5(+)CD3(-)) cells was highly up-regulated and reached 92.3+/-0.9%, the percentage of intracellular TNF-alpha(+) or IFN-gamma(+) uNK (DX5(+)CD3(-)) cells in the implantation sites of CBAxDBA/2 matings was also significantly increased 24 h after poly I:C injection. Surprisingly, poly I:C treatment significantly decreased the total number of uNK cells (either DX5(+)CD3(-) or DBA(+)) at fetal-maternal surface, but had no influence on local NKT cells, T cells and DCs. This investigation will help to explain the central role for hyperactivated uNK cells in the progress of mice pregnancy.
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Affiliation(s)
- Jianhong Zhang
- Institute of Immunology, Hefei National Laboratory for Physical Sciences at Microscale, China; School of Life Sciences, University of Science and Technology of China, 443 Huangshan Road, Hefei, Anhui 230027, China
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Clark DA, Blois S, Kandil J, Handjiski B, Manuel J, Arck PC. Reduced uterine indoleamine 2,3-dioxygenase versus increased Th1/Th2 cytokine ratios as a basis for occult and clinical pregnancy failure in mice and humans. Am J Reprod Immunol 2006; 54:203-16. [PMID: 16135011 DOI: 10.1111/j.1600-0897.2005.00299.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
PROBLEM Indoleamine 2,3-dioxygenase (IDO) expression in fetal trophoblast and decidual antigen-presenting cells has been proposed to inactivate maternal T cells and thereby prevent rejection of the "fetal allograft" in early pregnancy. Psychic stress has been proposed to cause miscarriages as well as infertility, at the same time in pregnancy when blockade of IDO causes loss, but the suggested mechanism of stress-triggered loss has been an increased ratio of pro-rejection Th1-type cytokines to anti-rejection Th2/3 cytokines. Could stress act by reducing IDO expression? METHODS Using DBA/2-mated A/J mice where stress causes early pregnancy failure, we examined the role of stress in reducing IDO versus increasing Th1/Th2 ratio in deciduas. IDO loss was also examined in human decidua associated with pregnancy failure. RESULTS A post-implantation sonic stress increased the pregnancy failure rate, increased the Th1/Th2 ratio, but did not reduce IDO. IDO was reduced, and Th1/Th2 ratios increased in A/J mice pre-immunized against paternal DBA/2 antigens, and concomitant stress increased these effects. The rate of pregnancy failure was not further increased consistent with recent discoveries of factors that limit the impact of Th1 cytokines at the feto-maternal interface. In deciduas from spontaneous miscarriage patients, IDO(+) cell frequencies were low in only 30% of patients. CD3(+) T-cell numbers and percentage terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-digoxigenin nick end-labelling (TUNEL)(+) apoptotic T cells were increased, but the level of IDO did not correlate with likelihood of apoptosis. CONCLUSIONS Loss of an allogeneic embryo in early pregnancy is more likely to be due to a high Th1/Th2 ratio than loss of putative protection by IDO.
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MESH Headings
- Abortion, Induced
- Abortion, Spontaneous/enzymology
- Abortion, Spontaneous/immunology
- Abortion, Spontaneous/metabolism
- Animals
- Cytokines/biosynthesis
- Female
- Humans
- Immunohistochemistry
- Indoleamine-Pyrrole 2,3,-Dioxygenase/antagonists & inhibitors
- Indoleamine-Pyrrole 2,3,-Dioxygenase/metabolism
- Keratins/metabolism
- Lymphocyte Count
- Male
- Mice
- Mice, Inbred A
- Mice, Inbred DBA
- Pregnancy
- Th1 Cells/immunology
- Th1 Cells/metabolism
- Th2 Cells/immunology
- Th2 Cells/metabolism
- Uterus/enzymology
- Uterus/immunology
- Uterus/pathology
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Affiliation(s)
- David A Clark
- Biomedical Research Center, Charité, University Medicine of Berlin, Berlin, Germany.
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Clark DA, Coulam CB, Stricker RB. Is intravenous immunoglobulins (IVIG) efficacious in early pregnancy failure? A critical review and meta-analysis for patients who fail in vitro fertilization and embryo transfer (IVF). J Assist Reprod Genet 2006; 23:1-13. [PMID: 16421767 PMCID: PMC3455429 DOI: 10.1007/s10815-005-9013-1] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2005] [Accepted: 10/24/2005] [Indexed: 10/25/2022] Open
Abstract
PROBLEM Intravenous Immunoglobulins (IVIG) are widely used off label in the treatment of early reproductive failure. As IVIG is expensive, and may have side-effects, evidence of efficacy is needed. Previous results have suggested that the pre-conception treatment of primary recurrent abortion patients might be effective, but the data set has been too small for adequate statistical power. More recently it has been suggested that IVIG may improve the success rate of in vitro fertilization and embryo transfer (IVF) in patients with prior IVF failures, but clinical trials have given conflicting results that need explanation. Systematic reviews generating inconclusive results have focused on methodological rigor to the exclusion of biological plausibility. METHODS Review of current basic science of design, measurement, and evaluation of clinical trials and basic science mechanisms providing a rationale for treatment. Meta-analysis of published randomized controlled and cohort-controlled trials (updated with two unpublished data sets) evaluating IVIG treatment in IVF failure patients. Live birth rate was used as the most relevant endpoint. The ability of different sources of IVIG to suppress natural killer (NK) cell activity was determined using a standard (51)Cr-release assay in vitro. RESULTS AND CONCLUSIONS Meta-analysis of three published randomized controlled trials (RCTs) of IVIG in IVF failure patients shows a significant increase in the live birth rate per woman (p = 0.012; Number Needed to Treat for 1 additional live birth, NNT = 6.0 women). Using live birth rate per embryo transferred, and adding data from two cohort-controlled trials to the meta-analysis further supports this conclusion (overall p = 0.000015, NNT = 3.7 women). Relevant variables appear to include properties and scheduling of the IVIG, and selection of patients with abnormal immune test results. Different IVIG preparations vary significantly in their ability to suppress NK activity in vitro. A rationale for use of IVIG is provided by a review of mechanisms of IVIG action and mechanisms underlying failure of chromosomally normal embryos.
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Affiliation(s)
- David A Clark
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
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Gutiérrez G, Sarto A, Berod L, Canellada A, Gentile T, Pasqualini S, Margni RA. Regulation of Interleukin-6 Fetoplacental Levels could be Involved in the Protective Effect of Low-molecular Weight Heparin Treatment on Murine Spontaneous Abortion. Am J Reprod Immunol 2004; 51:160-5. [PMID: 14748844 DOI: 10.1046/j.8755-8920.2003.00131.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PROBLEM CBA/J x DBA/2 abortion rate could be the consequence of a deficient local production of T helper (Th2) cytokines, which cause fetal wastage via fgl2 prothrombinase. Heparin reduces significantly the abortion rate in mice and recurrent spontaneous abortion (RSA) patients. We proposed to determine the effect of enoxaparin on the levels of local interleukin (IL)-6 during murine pregnancy. METHOD OF STUDY Recombinant human IL-6 (rhIL-6) or enoxaparin were inoculated in CBA/J x DBA/2 pregnant mice on days 6.5-12.5. IL-6 levels in sera as well as in culture supernatants of day 9.5 fetoplacental units of CBA/J x BALB/c control mice or CBA/J x DBA/2 abortion combination were determined by enzyme-linked immunosorbent assay (ELISA) test. RESULTS CBA/J x DBA/2 fetoplacental units secreted significantly lower levels of IL-6 with regard to CBA/J x BALB/c normal units. rhIL-6h and enoxaparin treatments decreased the resorption rate and regulated IL-6 fetoplacental levels. CONCLUSION This study suggests that regulation of IL-6 fetoplacental levels could be involved in heparin-mediated anticoagulation protection against abortion.
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Affiliation(s)
- G Gutiérrez
- Institute of Immunology, IDEHU, Univerity of Buenos Aires, Buenos Aires, Argentina.
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Karhukorpi J, Laitinen T, Karttunen R. Searching for links between endotoxin exposure and pregnancy loss: CD14 polymorphism in idiopathic recurrent miscarriage. Am J Reprod Immunol 2004; 50:346-50. [PMID: 14672339 DOI: 10.1034/j.1600-0897.2003.00092.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PROBLEM Lipopolysaccharide (LPS) (endotoxin) is a well-known inducer of abortions in mice. In addition it has been proposed that gut-derived LPS of gram-negative bacteria may play a role in triggering idiopathic recurrent miscarriage (IRM) in humans. CD14 is one of the key molecules that mediates the effects of LPS. Promoter region polymorphism (-159C/T) in the CD14 gene is functionally important by regulating CD14 levels. High-producing CD14 genotype (TT) associates with deleterious effects of gut-derived LPS in hepatic cirrhosis in humans. It is not known whether women with IRM are genetically more prone to suffer from toxic effects of LPS. METHOD OF STUDY By using polymerase chain reaction we analyzed the CD14 promoter region polymorphism in 38 women with IRM and in 127 normal controls of Finnish origin. RESULTS There were no significant differences in the CD14 (-159C/T) allele or the genotype frequencies between the IRM women and the controls. However, there was a trend associating the presence of the T allele with increased odds of miscarriage. CONCLUSIONS Although we were not able to find a statistically significant association between CD14 genotypes and IRM in our relatively small study population, a further study with a larger sample size is warranted to explore the role of high-producing CD14 genotypes in IRM. Also studies highlighting environmental LPS triggers and other intrinsic mediators of LPS signalling are needed to solve the enigmatic role of LPS in IRM in humans.
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Affiliation(s)
- Jari Karhukorpi
- Department of Medical Microbiology, University of Oulu, Finland.
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Coulam CB, Roussev RG. Increasing circulating T-cell activation markers are linked to subsequent implantation failure after transfer of in vitro fertilized embryos. Am J Reprod Immunol 2004; 50:340-5. [PMID: 14672338 DOI: 10.1034/j.1600-0897.2003.00090.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PROBLEM Implantation determines success of in vitro fertilization (IVF) and embryo transfer (ET) cycles. Data are accumulating to support a role of the immune system in implantation. Most of the literature addresses the importance of natural killer (NK) cells in this process. The purpose of the current study is to examine the role of circulating T cells in implantation failure. METHOD OF STUDY Blood from 22 women undergoing IVF/ET during November, 2001, was drawn on cycle day 9 and analyzed for the percentage of circulating T cells expressing the activation markers CD69+ and human leukocyte antigen (HLA)-DR and the suppressor marker CD11b using immunofluorescence and flow cytometry. These results were compared with total percentage circulating CD3, CD4 and CD8 cells as well as NK cells and pregnancy outcome that cycle. RESULTS Infertile women had significantly greater expression of the activation marker of CD69+ among CD8+ and CD4+ T cells and HLA-DR among CD4 cells than fertile women. No difference in expression of T cell suppressor marker of CD11b was noted when infertile and fertile women were compared. No correlations were observed when activated T cells were compared with circulating CD3+, CD4+, CD8+, activated NK cells and NK cytotoxicity. CD3+ 4+ HLA-DR+ was expressed significantly less among successfully pregnant compared with unsuccessfully pregnant women. CONCLUSION T-cell activation markers CD 69+ and HLA-DR+ are associated with increased implantation failure after IVF/ET.
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Clark DA. Shall We properly Re-examine the Status of Allogeneic Lymphocyte Therapy for Recurrent early Pregnancy Failure? Am J Reprod Immunol 2004; 51:7-15. [PMID: 14725561 DOI: 10.1046/j.8755-8920.2003.00133.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PROBLEM How to evaluate immunological therapy advocated for recurrent spontaneous abortion and implantation failure. I was invited to comment on the opinion article of Chaouat (AJRI December 2003). METHODS A critical examination of key beliefs and application of the principles of evidence and logic utilizing current data. RESULTS AND CONCLUSIONS Although rationale has no bearing on efficacy of proposed treatments and is not sufficient justification for routine practice, insufficient attention to data concerning patient selection, insufficient attention to treatment methodology, and lack of full disclosure in some clinical trials needs to be corrected. A more systematic collection of follow-up data is needed.
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Affiliation(s)
- David A Clark
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
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Clark DA, Keil A, Chen Z, Markert U, Manuel J, Gorczynski RM. Placental Trophoblast from Successful Human Pregnancies Expresses the Tolerance Signaling Molecule, CD200 (OX-2)*. Am J Reprod Immunol 2003; 50:187-95. [PMID: 14629022 DOI: 10.1034/j.1600-0897.2003.00086.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PROBLEM Th1 cytokine-dependent abortions in the CBA x DBA/2 mouse model have been linked to down-regulation of expression of the CD200 (OX-2) 'tolerance' signal on trophoblast and in decidua prior to onset of the abortion process. Abortions could be prevented by administration of a soluble CD200. Is CD200 expressed on trophoblast in successful human pregnancy? METHOD OF STUDY As one cannot easily obtain trophoblasts in large quantities from successful human pregnancies in the first trimester prior to the onset of the abortion process at 6 weeks gestation, we examined as a first step, trophoblast isolated from term placentae (i.e. successful pregnancies). CD9- trophoblasts were isolated by affinity column and stained for intracellular cytokeratin, and surface CD200 using PE-anti-human CD200 monoclonal antibody. mRNA was extracted from CD9+ and CD9- cells and tested by reverse transcription-polymerase chain reaction for CD200 mRNA. CD9- placental cells were separated by velocity sedimentation and test for CD200-dependent suppression of an allogeneic human mixed lymphocyte culture where cytotoxic T cell (CTL) generation, and Thl --> Th2 cytokine production shift were measured. RESULTS CD9- but not CD9+ placental cell populations contained cells with mRNA for CD200, both a normal length transcript and a truncated transcript. Flow cytometry showed a CD200+ cytokeratin+ moderate-to-large-sized cell population compatible with trophoblasts and a smaller subset of cytokeratin- cells that expressed CD200 at normal and at high levels. The moderate-sized population proved most potent at inhibiting CTL generation and caused a Th1 --> Th2 cytokine shift. These effects were blocked by monoclonal anti-CD200. CONCLUSIONS A subpopulation of cytokeratin+ placental trophoblasts express bioactive CD200 able to alter maternal immune responses in a favorable (Th2 > Th1) direction. Two populations of CD200+ small- and medium-small-sized cytokeratin- placental cells remain to be identified. Studies of karyotyped first trimester elective termination and spontaneous miscarriage tissues are needed.
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Affiliation(s)
- David A Clark
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
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Clark DA, Yu G, Arck PC, Levy GA, Gorczynski RM. MD-1 is a critical part of the mechanism causing Th1-cytokine-triggered murine fetal loss syndrome. Am J Reprod Immunol 2003; 49:297-307. [PMID: 12854734 DOI: 10.1034/j.1600-0897.2003.00045.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PROBLEM Fetal loss syndrome (abortion/resorption) occurring on or after gestation day (gd) 9.5 in CBA/JxDBA/2 matings is dependent upon presence of TNF-alpha + IFN-gamma, which act by increasing expression of fg12 prothrombinase at the feto-maternal interface. The magnitude by which the abortion rate can be boosted by an injection of these cytokines on gd 7.5 depends on endogenous rate of loss, and appears to depend on microbial flora. Is cytokine-triggered abortion dependent upon a third signaling pathway that senses 'danger'? METHODS Female CBA/J were mated to DBA/2 males and, C57B1/6 and C57B1/6 TNFalphaR1-/-Mak were mated to C57B1/6 control or TNFalphaR1-/-Mak males. LPS from Escherichia coli and Salmonella enteritidis, or the combination of TNF-alpha + IFN-gamma, was injected to stimulate abortions. The effect of anti-MD-1, which interferes with expression of CD14 and, hence, with signaling by LPS via the CD14-tlr4 complex, on TNF-alpha + IFN-gamma was tested. The presence of MD-1 in the uterus was evaluated by in situ hybridization, and effect of lipopolysaccharide (LPS) on mice lacking TNF-alphaR1 was tested. RESULTS Anti-MD-1 completely abrogated TNF-alpha + IFN-gamma-induced abortions. MD-1 was expressed on trophoblast and in deciduas on gd 8.5 but LPS could not abort mice that lacked the type 1 receptor for TNF-alpha. Pregnant CBA/J females had classical resorptions (abortions) countable on gd 13.5-14.5 in response to LPS from E. coli or S. enteritidis, but C57B1/6 strain mice resorbed only in response to the latter, and E. coli LPS appeared to induce 'occult' losses. 'Occult' loss did not require TNF-alphaR1. CONCLUSIONS TNF-alpha + IFN-gamma could not induce murine abortions without co-presence of a 'danger' signal such as LPS acting via CD14 on toll receptors, and LPS could not act without co-signaling by TNF-alpha. Classical resorptions/abortions and 'occult' losses have a different mechanism in these models as reflected in type of endotoxin and requirement for TNF-alphaR1 signaling.
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Affiliation(s)
- David A Clark
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
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Knackstedt MK, Zenclussen AC, Hertwig K, Hagen E, Dudenhausen JW, Clark DA, Arck PC. Th1 cytokines and the prothrombinase fgl2 in stress-triggered and inflammatory abortion. Am J Reprod Immunol 2003; 49:210-20. [PMID: 12852495 DOI: 10.1034/j.1600-0897.2003.01192.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PROBLEM The immune system contributes to the outcome of pregnancy by complex immunological interactions. Cytokines especially influence the immune milieu pro or contra pregnancy. T helper 1 (Th1) cytokines [tumor necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma)] cause inflammation and together are thought to threaten the maintenance of pregnancy. It has been proposed that increased levels of these Th1 cytokines activate coagulation via up-regulating the novel prothrombinase, fgl2. This study further investigates the Th1 cytokine up-regulation of fgl2 expression in a pathophysiological, stress induced abortion model, and an inflammatory, interleukin-12 (IL-12) triggered abortion model. METHOD The DBA/2J-mated CBA/J female mice were exposed to sonic sound stress or were injected with IL-12 during early gestation. On day 13.5 of pregnancy the uteri were removed and the resorption rate was calculated. We evaluated TNF-alpha, IFN-gamma, fgl2 as well as IL-12 messenger RNA (mRNA) expression in decidual samples of all mice by quantitative, real-time polymerase chain reaction (PCR). RESULTS A similar resorption rate of 24% was detected in stressed mice, as well as in IL-12 injected mice compared with approximately 11% in non-stressed, non-injected control mice. In stressed mice compared with controls, we observed on day 13.5 up-regulated TNF-alpha, unchanged IFN-gamma down-regulated fgl2, and a slightly increased levels of IL-12. In the IL-12 triggered abortion model, we observed up-regulated levels of TNF-alpha, IFN-gamma and fgl2. CONCLUSION These novel data suggest two distinct cytokine patterns leading to similar abortion rates. A physiological cascade associated with up-regulation of TNF-alpha, and an IL-12-triggered cascade characterized by persistent up-regulation of TNF-alpha and IFN-gamma as well as a persistent increase in fgl2.
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Affiliation(s)
- M K Knackstedt
- Department of Internal Medicine, Charité, Charité, Humboldt University, Berlin, Germany
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Clark DA. Is there any evidence for immunologically mediated or immunologically modifiable early pregnancy failure? J Assist Reprod Genet 2003; 20:63-72. [PMID: 12688590 PMCID: PMC3455793 DOI: 10.1023/a:1021788024214] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Human reproduction is an inefficient process. There is a high rate of loss of early pregnancies, often before the mother (or physician) knows she is pregnant. Genetic abnormalities can explain much of the wastage, but can it explain all of the failures? As embryos bear paternal and embryonic antigens foreign to the maternal immune system, could some otherwise normal embryos be "rejected"? METHODS Critical review of existing data. RESULTS AND CONCLUSIONS Otherwise normal embryos can fail prior to implantation, at implantation, in the periimplantation period as occult/chemical pregnancies, and as clinically evident miscarriages. The maternal immune system and its products (e.g., cytokines) can have innocent bystander effects, and a good case for direct recognition and "rejection" can also be made. The tools needed for accurate clinical diagnosis of such situations require further development and validation. Deliberate modification of the maternal host defence system can improve the chance of success, but the best evidence for efficacy of immunotherapeutic interventions is the situation of recurrent spontaneous abortions, which constitutes only a small percentage of losses. There is also evidence of clinical efficacy for several types of treatment to improve implantation and early pregnancy success.
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Affiliation(s)
- David A Clark
- Department of Medicine, 3V39 McMaster Universitty Medical Center, 1200 Main Street West, Hamilton, Ontario, Canada L8N 3Z5.
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Clark DA, Chaouat G, Gorczynski RM. Thinking outside the box: mechanisms of environmental selective pressures on the outcome of the materno-fetal relationship. Am J Reprod Immunol 2002; 47:275-82. [PMID: 12148542 DOI: 10.1034/j.1600-0897.2002.01093.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PROBLEM Study of mechanisms causing spontaneous abortion of the vascularized placenta have focused primarily on the feto-maternal immunological relationship within the pregnant mother. The Th1 cytokines such as tumor necrosis factor (TNF)-alpha + interferon (IFN)-gamma derived in part from natural killer (NK) and NKgammadeltaT cells have been implicated in causing abortion via up-regulation of the novel prothrombinase fgl2 at the feto-maternal interface; Th2/3 cytokines such as interleukin (IL)-10, progesterone-induced blocking factor (PIBF), and TGF-beta2 derived from gammadeltaT cells stimulated by embryo antigens in the context of the OX-2 (CD200) tolerance signal have been viewed as counteracting the Th1 effect. These mechanisms are distinct from those causing and preventing occult pregnancy loss during the periimplantation phase of pregnancy prior to development of a vascularized placenta. Spontaneous abortions in the CBA/J x DBA/2 can be boosted by injecting TNF-alpha + IFN-gamma, but the boosted abortion rates can range from < or = 30 to > 80%, depending on the loss rate in uninjected mice, and this is not explainable by the endogenous level of these cytokines. Furthermore, there is a poor correlation between Th1/Th2.3 cytokine ratios and abortion rates. Could there be a third factor involved, and if so, what might this mean? METHODS Known precipitants of recurrent abortion in mice were reviewed with particular attention to stress and endotoxin absorption. The effect of antagonizing the response to bacterial lipopolysaccharide (LPS) (endotoxin) was tested. Data on environmental selective pressures were considered (i.e. thinking outside the 'box', which typifies the conventional approach to thinking about materno-fetal interactions). RESULTS Th1 cytokine-triggered abortions appear to depend on availability/presence of LPS. CONCLUSIONS Environmental selective pressures are implicated in eliminating 'genetically weaker' embryos in early pregnancy.
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Affiliation(s)
- David A Clark
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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