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Jia Y, Huang Y, Ai ZH, Dong YJ, Guo YH, Yang Y, Zhang D, Ye HX, Yang J. Exploring the effectiveness of endometrial receptivity array and immune profiling in patients with multiple implantation failure:A retrospective cohort study based on propensity score matching. J Reprod Immunol 2024; 163:104218. [PMID: 38422808 DOI: 10.1016/j.jri.2024.104218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
This study aimed to evaluate the effectiveness of the endometrial receptivity array (ERA), endometrial immune profiling, and a combination of both in improving the pregnancy outcomes for multiple implantation failure patients. According to patients' willingness, 1429 women who incurred at least two or more consecutive implantation failures in IVF/ICSI treatment opted for frozen embryo transfer and were divided into four groups: 'No test', 'Immune Profiling', 'ERA' and 'ERA+ Immune Profiling'. Women in three test groups underwent timed endometrial biopsy for ERA, immune profiling, a combination of both. We observed the overall incidence rates of the displaced window of implantation (WOI) and endometrial immune dysregulation were 75.14% and 79.29%, respectively. After 1:1 propensity score matching (PSM), our data revealed that the 'ERA' and 'ERA + Immune Profiling' groups demonstrated significantly higher rates of biochemical, clinical, ongoing pregnancy, and implantation compared to the 'No test' group (p < 0.01). The 'Immune Profiling' group showed a higher implantation rate compared to 'No test' group (p < 0.05). Furthermore, when comparing three test groups, the 'ERA + Immune Profiling' group exhibited notably higher rates of clinical and ongoing pregnancy compared to the 'Immune Profiling' group (p < 0.017). However, there was no association between endometrial immune profiling and ERA phases, and their results did not differ between embryo implantation and non-implantation in these patients. Our findings underline the increased implantation rates by use of ERA and endometrial immune profiling in patients with multiple implantation failure, either individually or corporately. Moreover, a combination of both could improve their pregnancy outcomes significantly.
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Affiliation(s)
- Yan Jia
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, PR China; Department of Reproductive Immunology, Sichuan Jinxin Xi'nan Women's and Children's Hospital, Chengdu, Sichuan, PR China
| | - Yan Huang
- Department of Reproductive Immunology, Sichuan Jinxin Xi'nan Women's and Children's Hospital, Chengdu, Sichuan, PR China
| | - Zhong-Hua Ai
- Institute of Health Studies, School of Public Health, Kunming Medical University, Kunming, Yunnan, PR China
| | - Ya-Jun Dong
- Department of Reproductive Immunology, Sichuan Jinxin Xi'nan Women's and Children's Hospital, Chengdu, Sichuan, PR China
| | - Yan-Hua Guo
- Department of Reproductive Immunology, Sichuan Jinxin Xi'nan Women's and Children's Hospital, Chengdu, Sichuan, PR China
| | - Yue Yang
- Department of Reproductive Immunology, Sichuan Jinxin Xi'nan Women's and Children's Hospital, Chengdu, Sichuan, PR China
| | - Dan Zhang
- Department of Reproductive Immunology, Sichuan Jinxin Xi'nan Women's and Children's Hospital, Chengdu, Sichuan, PR China
| | - Hong-Xia Ye
- Department of Reproductive Immunology, Sichuan Jinxin Xi'nan Women's and Children's Hospital, Chengdu, Sichuan, PR China; Jinxin Research Institute for Reproductive Medicine and Genetics, Chengdu, Sichuan, PR China.
| | - Jie Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, PR China; Department of Reproductive Immunology, Sichuan Jinxin Xi'nan Women's and Children's Hospital, Chengdu, Sichuan, PR China.
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Yu S, Huang C, Lian R, Diao L, Zhang X, Cai S, Wei H, Chen C, Li Y, Zeng Y. Establishment of reference intervals of endometrial immune cells during the mid-luteal phase. J Reprod Immunol 2023; 156:103822. [PMID: 36758471 DOI: 10.1016/j.jri.2023.103822] [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: 08/01/2022] [Revised: 01/12/2023] [Accepted: 01/28/2023] [Indexed: 01/30/2023]
Abstract
This study aimed to develop reference intervals (RIs) of endometrial immune cells in control infertile women during the mid-luteal phase, and compare with the proportion of endometrial immune cells in recurrent reproductive failure (RRF) patients. Endometrial tissue sections were obtained from 113 fertile women and 79 patients with RRF, including 40 patients who had suffered recurrent miscarriage (RM) and 39 patients with repeated implantation failure (RIF) during the mid-luteal phase of the menstrual cycle. Immunohistochemical staining and quantitative analysis of CD56+, Foxp3+, CD163+, CD1a+ and CD8+ cells were performed in endometriums. RIs of endometrial immune cells in control infertile women were as follows: CD56+ uterine natural killer cells (uNK) cells, 1.785-8.712%, forkhead box P3 (Foxp3)+ Tregs, 0.041-0.154%, CD163+ M2 macrophages, 0.298-1.492%, CD1a+ dendritic cells (DCs), 0.006-0.081% and CD8+ T cells, 0.674-2.504%. Compared with control infertile women, the percentage of endometrial CD56+ uNK cells, CD163+ M2 macrophages, CD1a+ DCs and CD8+ T cells were significantly increased in patients with RRF. Moreover, Foxp3+ Tregs levels were decreased in patients with RRF, and were statistically significant only in patients with RM. In conclusion, the RIs of endometrial immune cells were established in control infertile women during the mid-luteal phase, and a disordered endometrial immune microenvironment was observed in patients with RRF. The RIs of endometrial immune cells may be of important clinical significance for the treatment of RRF.
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Affiliation(s)
- Shuyi Yu
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, China; Shenzhen Jinxin Medical Technology Innovation Center, Co., Ltd., Shenzhen, China; Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation
| | - Chunyu Huang
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, China; Shenzhen Jinxin Medical Technology Innovation Center, Co., Ltd., Shenzhen, China; Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation
| | - Ruochun Lian
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, China; Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation
| | - Lianghui Diao
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, China; Shenzhen Jinxin Medical Technology Innovation Center, Co., Ltd., Shenzhen, China; Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation
| | - Xueling Zhang
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, China; Shenzhen Jinxin Medical Technology Innovation Center, Co., Ltd., Shenzhen, China; Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation
| | - Songchen Cai
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, China; Shenzhen Jinxin Medical Technology Innovation Center, Co., Ltd., Shenzhen, China; Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation
| | - Hongxia Wei
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, China; Shenzhen Jinxin Medical Technology Innovation Center, Co., Ltd., Shenzhen, China; Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation
| | - Cong Chen
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, China; Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation
| | - Yuye Li
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, China; Shenzhen Jinxin Medical Technology Innovation Center, Co., Ltd., Shenzhen, China; Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation.
| | - Yong Zeng
- Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Fertility Center, Shenzhen Zhongshan Urology Hospital, Shenzhen 518045, Guangdong, China; Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation.
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Maternal Smoking in the First Trimester and its Consequence on the Early Placenta. J Transl Med 2023; 103:100059. [PMID: 36801640 DOI: 10.1016/j.labinv.2022.100059] [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: 10/25/2022] [Revised: 12/23/2022] [Accepted: 12/30/2022] [Indexed: 01/11/2023] Open
Abstract
Smoking during pregnancy increases the risk of adverse pregnancy outcomes, such as stillbirth and fetal growth restriction. This suggests impaired placental function and restricted nutrient and oxygen supply. Studies investigating placental tissue at the end of pregnancy have revealed increased DNA damage as a potential underlying cause, which is driven by various toxic smoke ingredients and oxidative stress induced by reactive oxygen species (ROS). However, in the first trimester, the placenta develops and differentiates, and many pregnancy pathologies associated with reduced placental function originate here. Therefore, we determined DNA damage in a cohort of first-trimester placental samples of verified smokers and nonsmokers. In fact, we observed an 80% increase in DNA breaks (P < .001) and shortened telomeres by 5.8% (P = .04) in placentas exposed to maternal smoking. Surprisingly, there was a decrease in ROS-mediated DNA damage, ie, 8-oxo-guanidine modifications, in placentas of the smoking group (-41%; P = .021), which paralleled the reduced expression of base excision DNA repair machinery, which restores oxidative DNA damage. Moreover, we observed that the increase in placental oxidant defense machinery expression, which usually occurs at the end of the first trimester in a healthy pregnancy as a result of the full onset of uteroplacental blood flow, was absent in the smoking group. Therefore, in early pregnancy, maternal smoking causes placental DNA damage, contributing to placental malfunction and increased risk of stillbirth and fetal growth restriction in pregnant women. Additionally, reduced ROS-mediated DNA damage along with no increase in antioxidant enzymes suggests a delay in the establishment of physiological uteroplacental blood flow at the end of the first trimester, which may further add to a disturbed placental development and function as a result of smoking in pregnancy.
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Krstic J, Deutsch A, Fuchs J, Gauster M, Gorsek Sparovec T, Hiden U, Krappinger JC, Moser G, Pansy K, Szmyra M, Gold D, Feichtinger J, Huppertz B. (Dis)similarities between the Decidual and Tumor Microenvironment. Biomedicines 2022; 10:biomedicines10051065. [PMID: 35625802 PMCID: PMC9138511 DOI: 10.3390/biomedicines10051065] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 02/05/2023] Open
Abstract
Placenta-specific trophoblast and tumor cells exhibit many common characteristics. Trophoblast cells invade maternal tissues while being tolerated by the maternal immune system. Similarly, tumor cells can invade surrounding tissues and escape the immune system. Importantly, both trophoblast and tumor cells are supported by an abetting microenvironment, which influences invasion, angiogenesis, and immune tolerance/evasion, among others. However, in contrast to tumor cells, the metabolic, proliferative, migrative, and invasive states of trophoblast cells are under tight regulatory control. In this review, we provide an overview of similarities and dissimilarities in regulatory processes that drive trophoblast and tumor cell fate, particularly focusing on the role of the abetting microenvironments.
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Affiliation(s)
- Jelena Krstic
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria; (J.K.); (J.F.); (M.G.); (J.C.K.); (G.M.); (B.H.)
| | - Alexander Deutsch
- Division of Hematology, Medical University of Graz, Stiftingtalstrasse 24, 8010 Graz, Austria; (A.D.); (K.P.); (M.S.)
| | - Julia Fuchs
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria; (J.K.); (J.F.); (M.G.); (J.C.K.); (G.M.); (B.H.)
- Division of Biophysics, Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria
| | - Martin Gauster
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria; (J.K.); (J.F.); (M.G.); (J.C.K.); (G.M.); (B.H.)
| | - Tina Gorsek Sparovec
- Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria; (T.G.S.); (U.H.); (D.G.)
| | - Ursula Hiden
- Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria; (T.G.S.); (U.H.); (D.G.)
| | - Julian Christopher Krappinger
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria; (J.K.); (J.F.); (M.G.); (J.C.K.); (G.M.); (B.H.)
| | - Gerit Moser
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria; (J.K.); (J.F.); (M.G.); (J.C.K.); (G.M.); (B.H.)
| | - Katrin Pansy
- Division of Hematology, Medical University of Graz, Stiftingtalstrasse 24, 8010 Graz, Austria; (A.D.); (K.P.); (M.S.)
| | - Marta Szmyra
- Division of Hematology, Medical University of Graz, Stiftingtalstrasse 24, 8010 Graz, Austria; (A.D.); (K.P.); (M.S.)
| | - Daniela Gold
- Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria; (T.G.S.); (U.H.); (D.G.)
| | - Julia Feichtinger
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria; (J.K.); (J.F.); (M.G.); (J.C.K.); (G.M.); (B.H.)
- Correspondence:
| | - Berthold Huppertz
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria; (J.K.); (J.F.); (M.G.); (J.C.K.); (G.M.); (B.H.)
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5
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Guettler J, Forstner D, Cvirn G, Maninger S, Brugger BA, Nonn O, Kupper N, Pritz E, Wernitznig S, Dohr G, Hutter H, Juch H, Isermann B, Kohli S, Gauster M. Maternal platelets pass interstices of trophoblast columns and are not activated by HLA-G in early human pregnancy. J Reprod Immunol 2021; 144:103280. [PMID: 33530024 DOI: 10.1016/j.jri.2021.103280] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/11/2020] [Accepted: 01/22/2021] [Indexed: 11/28/2022]
Abstract
In early human gestation, maternal arterial blood flow into the intervillous space of the developing placenta is obstructed by invaded trophoblasts, which form cellular plugs in uterine spiral arteries. These trophoblast plugs have recently been described to be loosely cohesive with clear capillary-sized channels into the intervillous space by 7 weeks of gestation. Here, we analysed localisation of maternal platelets at the maternal-foetal interface of human first trimester pregnancy, and tested the hypothesis whether HLA-G, which is primarily expressed by extravillous trophoblasts, affects aggregation and adhesion of isolated platelets. Immunohistochemistry of first trimester placental sections localised maternal platelets in vessel-like channels and adjacent intercellular gaps of extravillous trophoblasts in distal parts of columns. Furthermore, this localisation was confirmed by transmission electron microscopy. Neither co-incubation of HLA-G overexpressing JAR cells with isolated platelets, nor incubation with cell-derived soluble HLA-G or recombinant HLA-G affected platelet adhesion and aggregation. Our study suggests that maternal platelets flow through vessel-like channels of distal trophoblast columns and spread into adjacent lateral intercellular gaps, where platelet-derived factors could contribute to trophoblast differentiation into the invasive phenotype.
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Affiliation(s)
- Jacqueline Guettler
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Austria
| | - Désirée Forstner
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Austria
| | - Gerhard Cvirn
- Division of Physiological Chemistry, Otto Loewi Research Center, Medical University of Graz, Austria
| | - Sabine Maninger
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Austria
| | - Beatrice A Brugger
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Austria
| | - Olivia Nonn
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Austria
| | - Nadja Kupper
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Austria
| | - Elisabeth Pritz
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Austria
| | - Stefan Wernitznig
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Austria
| | - Gottfried Dohr
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Austria
| | - Heinz Hutter
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Austria
| | - Herbert Juch
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Austria
| | - Berend Isermann
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Germany
| | - Shrey Kohli
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Germany
| | - Martin Gauster
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Austria.
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Forstner D, Maninger S, Nonn O, Guettler J, Moser G, Leitinger G, Pritz E, Strunk D, Schallmoser K, Marsche G, Heinemann A, Huppertz B, Gauster M. Platelet-derived factors impair placental chorionic gonadotropin beta-subunit synthesis. J Mol Med (Berl) 2019; 98:193-207. [PMID: 31863152 PMCID: PMC7007904 DOI: 10.1007/s00109-019-01866-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 11/08/2019] [Accepted: 12/06/2019] [Indexed: 02/03/2023]
Abstract
Abstract During histiotrophic nutrition of the embryo, maternal platelets may be the first circulating maternal cells that find their way into the placental intervillous space through narrow intertrophoblastic gaps within the plugs of spiral arteries. Activation of platelets at the maternal-fetal interface can influence trophoblast behavior and has been implicated in serious pregnancy pathologies. Here, we show that platelet-derived factors impaired expression and secretion of the human chorionic gonadotropin beta-subunit (βhCG) in human first trimester placental explants and the trophoblast cell line BeWo. Impaired βhCG synthesis was not the consequence of hampered morphological differentiation, as assessed by analysis of differentiation-associated genes and electron microscopy. Platelet-derived factors did not affect intracellular cAMP levels and phosphorylation of CREB, but activated Smad3 and its downstream-target plasminogen activator inhibitor (PAI)-1 in forskolin-induced BeWo cell differentiation. While TGF-β type I receptor inhibitor SB431542 did not restore impaired βhCG production in response to platelet-derived factors, Smad3 inhibitor SIS3 interfered with CREB activation, suggesting an interaction of cAMP/CREB and Smad3 signaling. Sequestration of transcription co-activators CBP/p300, known to bind both CREB and Smad3, may limit βhCG production, since CBP/p300 inhibitor C646 significantly restricted its forskolin-induced upregulation. In conclusion, our study suggests that degranulation of maternal platelets at the early maternal-fetal interface can impair placental βhCG production, without substantially affecting morphological and biochemical differentiation of villous trophoblasts. Key messages Maternal platelets can be detected on the surface of the placental villi and in intercellular gaps of trophoblast cell columns from gestational week 5 onwards. Platelet-derived factors impair hCG synthesis in human first trimester placenta. Platelet-derived factors activate Smad3 in trophoblasts. Smad3 inhibitor SIS3 interferes with forskolin-induced CREB signaling. Sequestration of CBP/p300 by activated Smad3 may limit placental hCG production.
Electronic supplementary material The online version of this article (10.1007/s00109-019-01866-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Désirée Forstner
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, II, 8010, Graz, Austria
| | - Sabine Maninger
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, II, 8010, Graz, Austria
| | - Olivia Nonn
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, II, 8010, Graz, Austria
| | - Jacqueline Guettler
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, II, 8010, Graz, Austria
| | - Gerit Moser
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, II, 8010, Graz, Austria
| | - Gerd Leitinger
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, II, 8010, Graz, Austria
| | - Elisabeth Pritz
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, II, 8010, Graz, Austria
| | - Dirk Strunk
- Cell Therapy Institute, Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS), Paracelsus Medical University, Salzburg, Austria
| | - Katharina Schallmoser
- Department of Transfusion Medicine and Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS), Paracelsus Medical University, Salzburg, Austria
| | - Gunther Marsche
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Akos Heinemann
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Berthold Huppertz
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, II, 8010, Graz, Austria
| | - Martin Gauster
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, II, 8010, Graz, Austria.
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Cantonwine DE, Zhang Z, Rosenblatt K, Goudy KS, Doss RC, Ezrin AM, Page G, Brohman B, McElrath TF. Evaluation of proteomic biomarkers associated with circulating microparticles as an effective means to stratify the risk of spontaneous preterm birth. Am J Obstet Gynecol 2016; 214:631.e1-631.e11. [PMID: 26874302 DOI: 10.1016/j.ajog.2016.02.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 01/22/2016] [Accepted: 02/04/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND The analysis of circulating microparticles in pregnancy is of revolutionary potential because it represents an in vivo biopsy of active gestational tissues. OBJECTIVE We hypothesized that circulating microparticle signaling will differ in pregnancies that experience spontaneous preterm birth from those delivering at term and that these differences will be evident many weeks in advance of clinical presentation. STUDY DESIGN Utilizing plasma specimens obtained between 10 and 12 weeks' gestation as part of a prospectively collected birth cohort in which pregnancy outcomes are independently validated by 2 board-certified maternal-fetal medicine physicians, 25 singleton cases of spontaneous preterm birth ≤ 34 weeks were matched by maternal age, race, and gestational age of sampling (±2 weeks) with 50 uncomplicated term deliveries. Circulating microparticles from these first-trimester specimens were isolated and analyzed by multiple reaction monitoring mass spectrometry for potential protein biomarkers following previous studies. Markers with robust univariate performance in correlating spontaneous preterm birth were further evaluated for their biological relevance via a combined functional profiling/pathway analysis and for multivariate performance. RESULTS Among the 132 proteins evaluated, 62 demonstrated robust power of detecting spontaneous preterm birth in a bootstrap receiver-operating characteristic curve analysis at a false discovery rate of < 20% estimated via label permutation. Differential dependency network analysis identified spontaneous preterm birth-associated coexpression patterns linked to biological processes of inflammation, wound healing, and the coagulation cascade. Linear modeling of spontaneous preterm birth using a multiplex of the candidate biomarkers with a fixed sensitivity of 80% exhibited a specificity of 83% with median area under the curve of 0.89. These results indicate a strong potential of multivariate model development for informative risk stratification. CONCLUSION This project has identified functional proteomic factors with associated biological processes that are already unique in their expression profiles at 10-12 weeks among women who go on to deliver spontaneously ≤ 34 weeks. These changes, with further validation, will allow the stratification of patients at risk of spontaneous preterm birth before clinical presentation.
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Taatjes DJ, Roth J. The Histochemistry and Cell Biology omnium-gatherum: the year 2015 in review. Histochem Cell Biol 2016; 145:239-74. [DOI: 10.1007/s00418-016-1417-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2016] [Indexed: 02/07/2023]
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Kervancioglu Demirci E, Salamonsen LA, Gauster M. The role of CX3CL1 in fetal-maternal interaction during human gestation. Cell Adh Migr 2016; 10:189-96. [PMID: 26745855 DOI: 10.1080/19336918.2015.1089378] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Embryo implantation and subsequent placentation require a fine balanced fetal-maternal cross-talk of hormones, cytokines and chemokines. Amongst the group of chemokines, CX3CL1 (also known as fractalkine) has recently attracted attention in the field of reproductive research. It exists both as membrane-bound and soluble isoforms. On the basis of current experimental evidence, fractalkine is suggested to regulate adhesion and migration processes in fetal-maternal interaction at different stages of human pregnancy. Expressed by uterine glandular epithelial cells, predominantly during the mid-secretory phase of the menstrual cycle, fractalkine appears to prime the blastocyst for forthcoming implantation. After implantation, fractalkine is suggested to regulate invasion of extravillous trophoblasts by altering their expression profile of adhesion molecules. With onset of perfusion of the intervillous space at the end of first trimester, fractalkine present at the apical microvillous plasma membrane of the syncytiotrophoblast may mediate close interaction of placental villi with circulating maternal blood cells.
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Affiliation(s)
- Elif Kervancioglu Demirci
- a Department of Histology and Embryology , Marmara University School of Medicine , Istanbul , Turkey
| | - Lois A Salamonsen
- b Hudson Institute of Medical Research , Clayton , Victoria , Australia.,c Monash University , Clayton , Victoria , Australia
| | - Martin Gauster
- d Institute of Cell Biology, Histology and Embryology, Medical University Graz , Austria
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Mannelli C, Ietta F, Avanzati AM, Skarzynski D, Paulesu L. Biological Tools to Study the Effects of Environmental Contaminants at the Feto-Maternal Interface. Dose Response 2015; 13:1559325815611902. [PMID: 26740808 PMCID: PMC4679191 DOI: 10.1177/1559325815611902] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The identification of reproductive toxicants is a major scientific challenge for human health. Prenatal life is the most vulnerable and important time span of human development. For obvious ethical reasons, in vivo models cannot be used in human pregnancy, and animal models do not perfectly reflect human physiology. This review describes the in vitro test models representative of the human feto-maternal interface and the effects of environmental chemicals with estrogen-like activity, mainly bisphenol A and para-nonylphenol, with a particular emphasis on the effects at low, nontoxic doses similar to concentrations commonly detected in the population.
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Affiliation(s)
- Chiara Mannelli
- Department of Life Sciences, University of Siena, Siena, Italy
- Department of Reproductive Immunology and Pathology, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Francesca Ietta
- Department of Life Sciences, University of Siena, Siena, Italy
| | | | - Dariusz Skarzynski
- Department of Reproductive Immunology and Pathology, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Olsztyn, Poland
| | - Luana Paulesu
- Department of Life Sciences, University of Siena, Siena, Italy
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Siwetz M, Sundl M, Kolb D, Hiden U, Herse F, Huppertz B, Gauster M. Placental fractalkine mediates adhesion of THP-1 monocytes to villous trophoblast. Histochem Cell Biol 2015; 143:565-74. [PMID: 25566740 DOI: 10.1007/s00418-014-1304-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2014] [Indexed: 11/26/2022]
Abstract
The chemokine fractalkine (CX3CL1) recently attracted increasing attention in the field of placenta research due to its dual nature, acting both as membrane-bound and soluble forms. While the membrane-bound form mediates flow-resistant adhesion of leukocytes to endothelial and epithelial cells via its corresponding receptor CX3CR1, the soluble form arises from metalloprotease-dependent shedding and bears chemoattractive activity for monocytes, natural killer cells and T cells. In human placenta, fractalkine is expressed at the apical microvillous plasma membrane of the syncytiotrophoblast, which may enable close physical contact with circulating maternal leukocytes. Based on these observations, we tested the hypothesis that fractalkine mediates adhesion of monocytes to the villous trophoblast. Forskolin-induced differentiation and syncytialization of the trophoblast cell line BeWo was accompanied with a substantial upregulation in fractalkine expression and led to increased adhesion of the monocyte cell line THP-1, which preferentially bound to syncytia. Blocking as well as silencing of the fractalkine receptor CX3CR1 proved involvement of the fractalkine/CX3CR1 system in adherence of THP-1 monocytes to villous trophoblast. Pre-incubation of THP-1 monocytes with human recombinant fractalkine as well as silencing of CX3CR1 expression in THP-1 monocytes significantly impaired their adherence to BeWo cells and primary term trophoblasts. The present study suggests fractalkine as another candidate among the panel of adhesion molecules enabling stable interaction between leukocytes and the syncytiotrophoblast.
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Affiliation(s)
- Monika Siwetz
- Institute of Cell Biology, Histology and Embryology, Medical University Graz, Harrachgasse 21/VII, 8010, Graz, Austria
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Avagliano L, Terraneo L, Virgili E, Martinelli C, Doi P, Samaja M, Bulfamante GP, Marconi AM. Autophagy in Normal and Abnormal Early Human Pregnancies. Reprod Sci 2014; 22:838-44. [DOI: 10.1177/1933719114565036] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Laura Avagliano
- Department of Health Sciences, San Paolo Hospital Medical School, Università degli Studi di Milano, Milan, Italy
| | - Laura Terraneo
- Department of Health Sciences, San Paolo Hospital Medical School, Università degli Studi di Milano, Milan, Italy
| | - Eleonora Virgili
- Department of Health Sciences, San Paolo Hospital Medical School, Università degli Studi di Milano, Milan, Italy
| | - Carla Martinelli
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Patrizia Doi
- Department of Health Sciences, San Paolo Hospital Medical School, Università degli Studi di Milano, Milan, Italy
| | - Michele Samaja
- Department of Health Sciences, San Paolo Hospital Medical School, Università degli Studi di Milano, Milan, Italy
| | - Gaetano Pietro Bulfamante
- Department of Health Sciences, San Paolo Hospital Medical School, Università degli Studi di Milano, Milan, Italy
| | - Anna Maria Marconi
- Department of Health Sciences, San Paolo Hospital Medical School, Università degli Studi di Milano, Milan, Italy
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Baig S, Kothandaraman N, Manikandan J, Rong L, Ee KH, Hill J, Lai CW, Tan WY, Yeoh F, Kale A, Su LL, Biswas A, Vasoo S, Choolani M. Proteomic analysis of human placental syncytiotrophoblast microvesicles in preeclampsia. Clin Proteomics 2014; 11:40. [PMID: 25469110 PMCID: PMC4247627 DOI: 10.1186/1559-0275-11-40] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 10/29/2014] [Indexed: 12/20/2022] Open
Abstract
Background Placental syncytiotrophoblast microvesicles (STBM) are shed into the maternal circulation during normal pregnancy. STBM circulate in significantly increased amounts in preeclampsia (PE) and are considered to be among contributors to the exaggerated proinflammatory, procoagulant state of PE. However, protein composition of STBM in normal pregnancy and PE remains unknown. We therefore sought to determine the protein components of STBM and whether STBM protein expressions differ in preeclamptic and normal pregnancies. Patients with PE (n = 3) and normal pregnant controls (n = 6) were recruited. STBM were prepared from placental explant culture supernatant. STBM proteins were analyzed by a combination of 1D Gel-LC-MS/MS. Protein expressions levels were quantified using spectral counts and validated by immunohistochemistry. Results Over 400 proteins were identified in the STBM samples. Among these, 25 proteins were found to be differentially expressed in preeclampsia compared to healthy pregnant controls, including integrins, annexins and histones. Conclusion STBM proteins include those that are implicated in immune response, coagulation, oxidative stress, apoptosis as well as lipid metabolism pathways. Differential protein expressions of STBM suggest their pathophysiological relevance in PE. Electronic supplementary material The online version of this article (doi:10.1186/1559-0275-11-40) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sonia Baig
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore & National University Health System, 10 Medical Drive, Singapore, 119260 Singapore
| | - Narasimhan Kothandaraman
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore & National University Health System, 10 Medical Drive, Singapore, 119260 Singapore
| | - Jayapal Manikandan
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore & National University Health System, 10 Medical Drive, Singapore, 119260 Singapore
| | - Li Rong
- Experimental Therapeutic Center, Agency for Science, Technology and Research, 31 Biopolis Way, Singapore, 138669 Singapore
| | - Kim Huey Ee
- Experimental Therapeutic Center, Agency for Science, Technology and Research, 31 Biopolis Way, Singapore, 138669 Singapore
| | - Jeffrey Hill
- Experimental Therapeutic Center, Agency for Science, Technology and Research, 31 Biopolis Way, Singapore, 138669 Singapore
| | - Chin Wee Lai
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore & National University Health System, 10 Medical Drive, Singapore, 119260 Singapore
| | - Wan Yu Tan
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore & National University Health System, 10 Medical Drive, Singapore, 119260 Singapore
| | - Felicia Yeoh
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore & National University Health System, 10 Medical Drive, Singapore, 119260 Singapore
| | - Anita Kale
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore & National University Health System, 10 Medical Drive, Singapore, 119260 Singapore
| | - Lin Lin Su
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore & National University Health System, 10 Medical Drive, Singapore, 119260 Singapore
| | - Arijit Biswas
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore & National University Health System, 10 Medical Drive, Singapore, 119260 Singapore
| | - Sheila Vasoo
- Division of Rheumatology, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore & National University Health System, 10 Medical Drive, Singapore, 119260 Singapore
| | - Mahesh Choolani
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore & National University Health System, 10 Medical Drive, Singapore, 119260 Singapore
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Sotnikova N, Voronin D, Antsiferova Y, Bukina E. Interaction of Decidual CD56+ NK with Trophoblast Cells during Normal Pregnancy and Recurrent Spontaneous Abortion at Early Term of Gestation. Scand J Immunol 2014; 80:198-208. [DOI: 10.1111/sji.12196] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 05/24/2014] [Indexed: 12/30/2022]
Affiliation(s)
- N. Sotnikova
- Federal State Research Institute of Maternity and Childhood named V.N. Gorodkov; Ivanovo Russia
| | - D. Voronin
- Federal State Research Institute of Maternity and Childhood named V.N. Gorodkov; Ivanovo Russia
| | - Y. Antsiferova
- Federal State Research Institute of Maternity and Childhood named V.N. Gorodkov; Ivanovo Russia
| | - E. Bukina
- Federal State Research Institute of Maternity and Childhood named V.N. Gorodkov; Ivanovo Russia
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Bisphenol A alters β-hCG and MIF release by human placenta: an in vitro study to understand the role of endometrial cells. Mediators Inflamm 2014; 2014:635364. [PMID: 24737926 PMCID: PMC3967812 DOI: 10.1155/2014/635364] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 01/06/2014] [Accepted: 01/30/2014] [Indexed: 12/20/2022] Open
Abstract
A proper fetomaternal immune-endocrine cross-talk in pregnancy is fundamental for reproductive success. This might be unbalanced by exposure to environmental chemicals, such as bisphenol A (BPA). As fetoplacental contamination with BPA originates from the maternal compartment, this study investigated the role of the endometrium in BPA effects on the placenta. To this end, in vitro decidualized stromal cells were exposed to BPA 1 nM, and their conditioned medium (diluted 1 : 2) was used on chorionic villous explants from human placenta. Parallel cultures of placental explants were directly exposed to 0.5 nM BPA while, control cultures were exposed to the vehicle (EtOH 0.1%). After 24–48 h, culture medium from BPA-treated and control cultures was assayed for concentration of hormone human Chorionic Gonadotropin (β-hCG) and cytokine Macrophage Migration Inhibitory Factor (MIF). The results showed that direct exposure to BPA stimulated the release of both MIF and β-hCG. These effects were abolished/diminished in placental cultures exposed to endometrial cell-conditioned medium. GM-MS analysis revealed that endometrial cells retain BPA, thus reducing the availability of this chemical for the placenta. The data obtained highlight the importance of in vitro models including the maternal component in reproducing the effects of environmental chemicals on human fetus/placenta.
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Buse E, Häeger JD, Svensson-Arvelund J, Markert UR, Faas MM, Ernerudh J, Dixon D, Cline JM, Pfarrer C. The placenta in toxicology. Part I: Animal models in toxicology: placental morphology and tolerance molecules in the cynomolgus monkey (Macaca fascicularis). Toxicol Pathol 2013; 42:314-26. [PMID: 23548606 DOI: 10.1177/0192623313482208] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The immune system represents a key defense mechanism against potential pathogens and adverse non-self materials. During pregnancy, the placenta is the point of contact between the maternal organism and non-self proteins of the fetal allograft and hence undoubtedly fulfils immune functions. In the placenta bacteria, foreign (non-self) proteins and proteins that might be introduced in toxicological studies or by medication are barred from reaching the progeny, and the maternal immune system is primed for acceptance of non-maternal fetal protein. Both immunologic protection of the fetus and acceptance of the fetus by the mother require effective mechanisms to prevent an immunologic fetomaternal conflict and to keep both organisms in balance. This is why the placenta requires toxicological consideration in view of its immune organ function. The following articles deal with placenta immune-, control-, and tolerance mechanisms in view of both fetal and maternal aspects. Furthermore, models for experimental access to placental immune function are addressed and the pathological evaluation is elucidated. "The Placenta as an Immune Organ and Its Relevance in Toxicological Studies" was subject of a continuing education course at the 2012 Society of Toxicologic Pathology meeting held in Boston, MA.
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The haplotype M2 of the ANXA5 gene is not associated with antitrophoblast antibodies. J Assist Reprod Genet 2013; 30:711-6. [PMID: 23529182 DOI: 10.1007/s10815-013-9978-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 03/12/2013] [Indexed: 02/08/2023] Open
Abstract
PURPOSE The M2 haplotype in ANXA5 as well as antitrophoblast antibodies predispose to recurrent pregnancy loss (RPL). Since M2/ANXA5 can be a factor for development of antiphospholipid antibodies (aPL), this study aimed to trace a possible association of M2 with antitrophoblast antibodies. METHODS One hundred patients with two or more consecutive, idiopathic RPLs were divided in two subgroups, JEG-3(+) (n = 42) and JEG-3(-) (n = 58), according to the anti-JEG-3 reactivity measured in subjects' sera. Both subgroups were genotyped for ANXA5 promoter haplotypes and genetic frequencies were compared to available fertile and control populations, as well as within the subgroups. RESULTS M2/ANXA5 was generally enriched in the JEG-3 screened cohort of RPL patients in comparison to fertile and population controls. Despite the relatively higher abundance of the haplotype in the JEG-3(-) sample as compared to JEG-3(+) patients and in the JEG-3(-) primary RPL subset in particular, compared to the rest of patients, there was no statistically significant difference between both, JEG-3(-) and JEG-3(+) subgroups. CONCLUSION It appears that the haplotype M2/ANXA5 is not associated with the presence of anti-trophoblast antibodies. Our finding indicates that anti-trophoblast antibodies are a class of molecules that differ from aPL and from anti-b2-GPI antibodies, apparently not directed to same or similar epitopes that aPL and anti-b2-GPI would recognize.
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Ramos-Medina R, García-Segovia Á, León JA, Alonso B, Tejera-Alhambra M, Gil J, Caputo JD, Seyfferth A, Aguarón Á, Vicente Á, Ordoñez D, Alonso J, de Albornoz EC, Carbone J, Caballero P, Fernandez-Cruz E, Ortiz-Quintana L, Sánchez-Ramón S. New decision-tree model for defining the risk of reproductive failure. Am J Reprod Immunol 2013; 70:59-68. [PMID: 23480226 DOI: 10.1111/aji.12098] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 01/24/2013] [Indexed: 12/27/2022] Open
Abstract
PROBLEM Natural killer (NK) cells play a key role in embryo implantation and pregnancy success, whereas blood and uterine NK expansions have been involved in the pathophysiology of reproductive failure (RF). Our main goal was to design in a large observational study a tree-model decision for interpretation of risk factors for RF. METHODS OF STUDY A hierarchical multivariate decision model based on a classification and regression tree was developed. NK and NKT-like cell subsets were analyzed by flow cytometry. RESULTS By multivariate analysis, blood NK cells expansion was an independent risk factor for RF (both recurrent miscarriages and implantation failures). We propose a new decision-tree model for the risk interpretation of women with RF based on a combination of main risk factors. CONCLUSIONS Women with age above 35 years and >13% CD56⁺CD16⁺ NK cells showed the highest risk of further pregnancy loss (100%).
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Affiliation(s)
- Rocío Ramos-Medina
- Unit of Clinical Immunology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Ahmed MAE. Feto-maternal interactions and immunological tolerance of the mother to her semiallogeneic fetus. THE EGYPTIAN JOURNAL OF HISTOLOGY 2013; 36:1-12. [DOI: 10.1097/01.ehx.0000426050.42572.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Bonney EA. Demystifying animal models of adverse pregnancy outcomes: touching bench and bedside. Am J Reprod Immunol 2013; 69:567-84. [PMID: 23448345 DOI: 10.1111/aji.12102] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 01/28/2013] [Indexed: 01/21/2023] Open
Abstract
This represents an overview of the use of animal models to study the adverse pregnancy outcomes seen in humans. The purpose is to entice clinicians to utilize some of this information to seek out the literature and have more meaningful and profitable discussions with their academic colleagues and enhance transdisciplinary research in reproductive health.
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Affiliation(s)
- Elizabeth A Bonney
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Vermont College of Medicine, Burlington, VT, USA.
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Does malaria affect placental development? Evidence from in vitro models. PLoS One 2013; 8:e55269. [PMID: 23383132 PMCID: PMC3561386 DOI: 10.1371/journal.pone.0055269] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 12/29/2012] [Indexed: 11/19/2022] Open
Abstract
Background Malaria in early pregnancy is difficult to study but has recently been associated with fetal growth restriction (FGR). The pathogenic mechanisms underlying malarial FGR are poorly characterized, but may include impaired placental development. We used in vitro methods that model migration and invasion of placental trophoblast into the uterine wall to investigate whether soluble factors released into maternal blood in malaria infection might impair placental development. Because trophoblast invasion is enhanced by a number of hormones and chemokines, and is inhibited by pro-inflammatory cytokines, many of which are dysregulated in malaria in pregnancy, we further compared concentrations of these factors in blood between malaria-infected and uninfected pregnancies. Methodology/Principal Findings We measured trophoblast invasion, migration and viability in response to treatment with serum or plasma from two independent cohorts of Papua New Guinean women infected with Plasmodium falciparum or Plasmodium vivax in early pregnancy. Compared to uninfected women, serum and plasma from women with P. falciparum reduced trophoblast invasion (P = .06) and migration (P = .004). P. vivax infection did not alter trophoblast migration (P = .64). The P. falciparum-specific negative effect on placental development was independent of trophoblast viability, but associated with high-density infections. Serum from P. falciparum infected women tended to have lower levels of trophoblast invasion promoting hormones and factors and higher levels of invasion-inhibitory inflammatory factors. Conclusion/Significance We demonstrate that in vitro models of placental development can be adapted to indirectly study the impact of malaria in early pregnancy. These infections could result in impaired trophoblast invasion with reduced transformation of maternal spiral arteries due to maternal hormonal and inflammatory disturbances, which may contribute to FGR by limiting the delivery of maternal blood to the placenta. Future prevention strategies for malaria in pregnancy should include protection in the first half of pregnancy.
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