An Immunological Basis for Chronic Histiocytic Intervillositis in Recurrent Fetal Loss
An Immunological Basis for Chronic Histiocytic Intervillositis in Recurrent Fetal Loss
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DOI：
10.1111/aji.12125
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发表时间：
2013-09-01
影响因子：
3.6
通讯作者：
Exalto, Niek
中科院分区：
文献类型：
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作者：
Reus, Averil D.;van Besouw, Nicole M.;Exalto, Niek
慢性组织细胞绒毛间炎（CHIV）是一种罕见的胎盘病理类型，与所有孕龄的生殖能力丧失有关。本研究的目的是调查CHIV的严重程度和妊娠结局之间的关系，并比较CHIV患者和对照组之间的免疫反应，以探索CHIV的免疫起源。研究方法根据先前发表的分级系统，对22例CHIV患者的30次妊娠进行了回顾性分析和评分。伴侣特异性混合淋巴细胞反应，细胞毒性T淋巴细胞前体细胞频率（CTLpf），和抗HLA抗体测定在4例患者和7个controls.ResultsHigher CHIV评分与不良妊娠结局。CHIV患者表现出更高的CTLpf对他们的合作伙伴相比，非复杂的妊娠（P = 0.03）。75%的患者CTLpf极高。抗父亲HLA抗体只存在于75%的CHIV患者相比，没有控制（P = 0.02）。对伴侣特异性CTLpf的高抗父细胞（T细胞）和体液（B细胞）应答以及针对伴侣的抗HLA抗体的存在表明CHIV的免疫起源。
ProblemChronic histiocytic intervillositis (CHIV) is a rare type of placental pathology that is associated with reproductive loss at all gestational ages. The aim of the study was to investigate the relationship between the severity of CHIV and the outcome of pregnancy and to compare the immune response between CHIV patients and controls to explore an immunological origin of CHIV.Method of studyMicroscopic slides were reviewed and scored according to a previously published grading system in 30 pregnancies of 22 CHIV patients. Partner- specific mixed lymphocyte reactions, cytotoxic T-lymphocyte precursor frequencies (CTLpf), and anti-HLA antibodies were determined in four patients and seven controls.ResultsHigher CHIV scores are associated with worse pregnancy outcome. CHIV patients demonstrated a higher CTLpf against their partner compared to non-complicated pregnancies (P = 0.03). The CTLpf was extremely high in 75% of the patients. Antipaternal HLA antibodies were only present in 75% of the CHIV patients compared to none of the controls (P = 0.02).ConclusionCHIV scores seem to be associated with the severity of adverse pregnancy outcome. High antipaternal cellular (T-cell) and humoral (B-cell) response to partner-specific CTLpf and the presence of anti-HLA antibodies directed to the partner suggest an immunologic origin of CHIV.