先兆子痫患者外周血、脐血及蜕膜NK细胞的相关研究

目的：对先兆子痫孕妇外周血、脐血及蜕膜NK细胞进行研究，以探讨先兆子痫的病因。方法：对42例先兆子痫患者及20例正常孕妇外周血、脐血NK细胞分离后记数。采用免疫组织化学法检测胎盘蜕膜NK表型后记数并检测其平均灰度。结果：①轻度及重度先兆子痫患者母血及脐血NK细胞数均显著高于正常孕妇（P〈0．05）；②重度先兆子痫患者蜕膜NK细胞数高于正常孕妇（P〈0．05）；③轻度及重度先兆子痫患者胎盘蜕膜NK细胞CD56组化染色平均灰度值高于正常孕妇（P〈0．05）。结论：先兆子痫患者外周血、脐血及蜕膜的NK细胞数量均高于正常孕妇，且呈激活状态的胎盘蜕膜NK细胞较多，可能与发病有关。     

CD4+CD25+Foxp3+调节性T细胞在子痫前期患者外周血与蜕膜中水平变化研究

目的本文检测CD4+CD25+Foxp3+调节性T细胞在子痫前期患者外周血及胎盘附着处蜕膜中的表达,探讨其在子痫前期免疫耐受失衡中的作用。方法选择子痫前期患者20例,正常晚期妊娠患者20例。采用流式细胞仪检测外周血CD4+CD25+Foxp3+的表达;免疫组织化学法检测蜕膜CD4+CD25+调节性T细胞的特异性转录因子Foxp3的表达。结果 1.子痫前期组外周血CD4+CD25+Foxp3+T细胞表达率(1.70±0.23%)明显低于正常晚期妊娠对照组(3.55±0.47%)(P<0.05)。2.蜕膜中Foxp3在子痫前期组的表达阳性率为(16.67%)明显低于正常对照组(66.67%)(P<0.05)。结论子痫前期患者外周血和蜕膜组织中的CD4+CD25+Foxp3+调节性T细胞均低于正常孕妇,提示其数量的减少使其免疫抑制功能减弱,母胎免疫耐受失衡,导致子痫前期的发生。     

NK细胞在重度子痫前期发病中的作用

目的：探讨NK细胞在重度子痫前期发病中的作用及其机制。 方法： 采集重度子痫前期晚孕、正常晚孕孕妇外周血及其新生儿脐血，Percoll分离NK细胞，SAP法计数，MTT法检测其增殖活性，［51Cr］释放法检测其杀伤活性，免疫组织化学法检测胎盘蜕膜组织NK细胞数量及HLA-G蛋白表达水平。 结果： ①重度子痫前期患者外周血、蜕膜组织及其新生儿脐血中NK细胞数量均显著高于正常晚孕组（P<0.05）；②重度子痫前期患者外周血及其新生儿脐血NK细胞增殖和杀伤活性均高于正常晚孕组（P<0.05）；③重度子痫前期患者胎盘蜕膜HLA-G蛋白表达水平显著低于正常晚孕组（P<0.05）。 结论： 重度子痫前期患者NK细胞功能异常增强，可能参与疾病发生。     

动态检测孕妇血中NK、Treg细胞水平在早期预测子痫前期中的作用

目的探讨妊娠早、中期孕妇外周血中NK、Treg细胞数量和表型的动态变化及其在子痫前期发病中的预测作用。方法选取280名孕妇随访观察,在其妊娠7~27周分阶段采集外周血,采用流式细胞分析技术检测NK和Treg细胞水平,并对NK细胞CD56~(dim)CD16~+和CD56~(bright)CD16~-表型变化进行比较,应用酶联免疫吸附实验测定相关细胞因子IFN-γ和IL-10的含量。同时监测孕妇血压、尿蛋白量、肝肾功能的异常变化并记录患者临床表现,将最终发展为子痫前期的孕妇归为PE组,从随访对象中随机选择相同例数正常妊娠者作为对照组。回顾性分析2组孕妇在妊娠早、中期外周血中NK、Treg细胞数量、表型及IFN-γ和IL-10的变化情况。结果子痫前期患者外周血中NK细胞及Treg细胞异常变化始于妊娠14~20周,且CD56~(dim)CD16~+NK细胞所占比例与Treg细胞数量在轻、重度PE组间差异有统计学意义(P0.05);PE患者血中细胞因子IFN-γ和IL-10浓度异常出现在妊娠21~27周,且其水平变化与疾病严重程度相关;在妊娠21~27周,重度早发型PE组CD56~(dim)CD16~+NK/Treg的比值明显高于晚发型PE组(P0.05)。结论检测妊娠中期孕妇血中NK/Treg失衡现象对PE发生和发展的预测具有重要价值。     

不明原因自然流产与蜕膜NK细胞表面活化性受体表达的相关性研究

探讨不明原因自然流产患者蜕膜NK细胞杀伤活性与其细胞表面活化性受体NKp46、NKp44、NKp30和NKG2D表达的相关性。选取21例早孕不明原因自然流产患者为病例组,25例正常早孕人流妇女为对照组,收集两组的蜕膜组织,Ficoll密度梯度离心分离淋巴细胞,MACS磁珠分选CD3-CD56+NK细胞。以K562细胞为靶细胞,用细胞染色及流式细胞技术检测两组蜕膜NK细胞杀伤活性,用流式细胞技术检测两组蜕膜CD56brightCD16-NK和CD56dimCD16+NK细胞上活化性受体NKp46、NKp44、NKp30和NKG2D的表达,并与NK细胞杀伤活性进行相关性分析。结果:(1)早孕蜕膜NK细胞具有杀伤活性;(2)病例组蜕膜NK细胞的杀伤活性较正常对照组显著增强(P=0.014);(3)病例组蜕膜CD56brightCD16-NK细胞中NKp44的表达比正常对照组显著升高(P=0.021);病例组蜕膜CD56dimCD16+NK细胞中NKp46和NKp44的表达比正常对照组显著升高(分别P=0.026,P=0.041);其余活化性受体的表达两组未见明显差异;(4)蜕膜NK细胞杀伤功能与蜕膜CD56brightCD16-NK细胞中NKp44的表达呈显著正相关(r=0.677,P<0.05),和蜕膜CD56dimCD16+NK细胞中NKp46的表达呈显著正相关(r=0.634,P<0.05)。蜕膜NK细胞活化性受体NKp46和NKp44表达增加,从而使蜕膜NK细胞的杀伤功能增强可能在不明原因自然流产的发病中起重要作用。     

妊娠期高血压患者外周血CD4~+CD25~+Foxp3~+调节性T细胞的变化及意义

目的:研究CD4+CD25+Foxp3+调节性T细胞在妊娠期高血压疾病患者(HDCP)外周血中比例改变,并探讨其在妊娠期高血压疾病进程中的意义。方法:选取2007年11月至2008年6月在镇江市妇幼保健院、镇江市润州区人民医院门诊及住院妊娠期高血压疾病患者56例,其中妊娠期高血压20例,轻度子痫前期16例,重度子痫前期20例。选择同期正常妊娠妇女20例,正常育龄妇女16例。采用细胞内染色的流式细胞术及定量PCR的方法,分别在蛋白质和mRNA水平检测调节性T细胞Foxp3的表达。结果:(1)轻度子痫前期和重度子痫前期妇女外周血中CD4+CD25+T细胞比例分别为6.78%±1.18%、4.79%±1.17%,显著低于正常妊娠妇女11.95%±3.73%(P0.01)和正常育龄妇女8.99%±2.40%(P0.05);重度子痫前期CD4+CD25+T细胞比例明显低于妊娠期高血压的10.17%±1.46%(P0.05);正常妊娠妇女外周血CD4+CD25+细胞比例显著高于正常育龄妇女(P0.05)。(2)妊娠期高血压、轻度子痫前期和重度子痫前期患者CD4+CD25+Foxp3+细胞分别为1.80%±0.45%、1.36%±0.21%和0.72%±0.25%,显著低于正常妊娠妇女的4.23%±1.28%(P0.01)和正常育龄妇女的2.75%±1.09%(P0.05),而轻度子痫前期和重度子痫前期患者CD4+CD25+Foxp3调节性T细胞明显低于妊娠期高血压(P0.05);正常妊娠妇女外周血CD4+CD25+Foxp3+细胞显著高于正常育龄妇女(P0.05)。(3)Foxp3mRNA表达水平与蛋白质水平相一致。结论:妊娠期高血压疾病发病时CD4+CD25+Foxp3+调节性T细胞明显减少,这些调节性T细胞改变可能参与了妊娠高血压疾病的病理进程。     

妊娠早期蜕膜CD56~+NK样细胞杀伤活性的研究

分离早孕妇女蜕膜CD56~+NK样细胞,采用改进的乳酸脱氢酶(LDH)释放试验,比较蜕膜与外周血NK细胞杀伤活性。结果发现:蜕膜NK样细胞杀伤活性低于孕妇外周血及正常育龄妇女外周血NK细胞。提示妊娠早期蜕膜局部NK细胞活性受到抑制,可能有利于滋养细胞侵袭和胎盘形成。     

CD39分子在子痫前期患者外周血CD4+T细胞及脐静脉内皮细胞的表达及临床意义北大核心CSCD

目的：探讨CD39分子在子痫前期患者外周血CD4+T细胞、Treg、Foxp3-CD4+T细胞及脐静脉内皮细胞的表达及临床意义。方法：采集59例正常妊娠者、23例妊娠期高血压患者及65例子痫前患者(包括28例轻度子痫前期患者和37例重度子痫前期患者)外周血，流式细胞技术检测各组妊娠妇女外周血CD4+T细胞、Treg(Foxp3+CD4+T细胞)、Foxp3-CD4+T细胞比例及CD39分子表达率。随机获取胎儿分娩后的脐带(正常妊娠组18例、重度子痫前期组20例)，检测脐静脉血管内壁细胞CD31+CD39+内皮细胞群比例。结果：正常妊娠组、妊娠期高血压组、子痫前期组3组母体外周血CD4+T细胞比例[(33.71±9.80)%vs (29.59±14.22)%vs (29.63±11.11)%]及CD39表达率[2.84(0.89～5.51) vs 2.50(0.89～4.19) vs 1.39(0.79～3.51)]差异无统计学意义(P>0.05)。正常妊娠组Treg比例及CD39表达率明显高于子痫前期组[3.25(1.39～4.53) vs 1.63(1.01～2.58);33.90(22.80～59.40) vs 21.20(16.70～32.55),P<0.001]；正常妊娠组Foxp3-CD4+T细胞比例明显低于子痫前期组[94.40(93.00～96.10) vs 95.60(94.10～97.40),P=0.016]，但3组CD39表达率差异无统计学意义[1.80(0.55～4.49) vs 1.92(0.54～3.60) vs 0.92(0.49～3.24),P=0.340]。轻度子痫前期组与重度子痫前期组外周血CD4+T细胞[(32.35±10.51)%vs (27.56±11.24)%]、Treg[1.80(0.93～2.58) vs 1.44(1.03～2.58)]、Foxp3-CD4+T细胞[95.6(94.5～97.1) vs 95.6(94.0～97.6]比例差异无统计学意义(P>0.05)；轻度子痫前期组CD4+T细胞、Treg、Foxp3-CD4+T细胞CD39表达率均明显高于重度子痫前期组[2.08(1.20～5.05) vs 0.95(0.68～1.78);26.20(19.55～58.55) vs 17.60(13.90～23.15);2.14(0.78～3.69) vs 0.62(0.40～1.73),P<0.05]。重度子痫前期患者脐静脉血管内壁细胞CD31+CD39+内皮细胞群比例明显低于正常妊娠组[6.32(3.27～10.55) vs 18.95(9.90～27.48),P=0.020]。结论：母体外周血发挥免疫抑制功能的Treg数量及CD39分子表达减少可能参与子痫前期发生发展；重度子痫前期患者脐静脉血管内壁细胞CD31+CD39+内皮细胞群较正常妊娠者明显减少，可能与血管内皮损伤机制有关。     

自然流产患者外周血与蜕膜NK细胞亚群数量变化的研究

目的：研究自然流产患者外周血与蜕膜组织自然杀伤细胞亚群数量的变化。方法：对36例自然流产患者及30例正常健康早孕者（对照）外周血及蜕膜组织中淋巴细胞进行单克隆抗体标记,应用流式细胞仪定性、定量分析技术对NK细胞（natural killer)亚群进行分析。结果：（1）流产组外周血及蜕膜组织NK细胞CD56＋CD16＋百分比较对照组明显升高。（P＜0．01）,而蜕膜组织中NK细胞CD56＋CD16－百分比明显低于对照组（P＜0．001）。（2）外周血与蜕膜组织NK细胞CD56＋CD16＋亚群存在相关性（γ＝0．516,P＜0．05）。结论：NK细胞亚群的数量变化可以引起蜕膜免疫微环境的失调,导致自然流产。外周血与蜕膜NK细胞CD56＋CD16＋亚群存在正相关关系。     

补肾中药对溴隐亭致流产鼠模型中蜕膜CD56~+NK细胞表面CD69和CD94表达的影响

为了观察补肾中药是否能影响蜕膜CD5 6 + NK细胞比例及其表面CD6 9、CD94的表达 ,从而进一步阐明补肾中药对母胎界面免疫的影响机制。SD大鼠于孕 6～ 8d皮下注射溴隐亭 0 3mg/kg·d ,建立改良的溴隐亭致SD大鼠流产模型 ,随机分为三组。A组为模型组 ;B、C组在孕 1～ 1 1d分别给予大剂量中药 (4 5g/kg·d)、P(8mg/kg·d) ,另设正常孕鼠对照 (D组 )。孕 1 2d处死 ,取蜕膜组织 ,分离成单个细胞悬液 ,用流式细胞分析技术观察 4组蜕膜CD5 6 + NK细胞的量及蜕膜NK细胞表面CD6 9、CD94的表达差异。结果发现 :B组 (P <0 0 5 )、C、D组 (P <0 0 1 )妊娠率与A组相比增加 ,并且有差异 ;B、C组蜕膜CD5 6 + NK细胞比例与A组相比明显增加 ,与D组无差异 ;各组蜕膜CD5 6 + NK细胞表面CD6 9表达无差异 ;B、C、D组CD94的表达与A组相比显著增加 ;A组蜕膜CD5 6 + NK细胞表达CD6 9与CD94相比明显增加 ,B、C组相反。因此 ,补肾中药能影响蜕膜CD5 6 + NK细胞表面CD6 9、CD94的表达 ,可能通过增加CD94的表达 ,抑制CD6 9从而进一步抑制NK细胞的活性 ,起到保胎作用     

RCAS1 decidual immunoreactivity in severe pre-eclampsia: immune cell presence and activity

PROBLEM: Pre-eclampsia seems to be related to the disturbance of immune tolerance regulation during pregnancy. Receptor-binding cancer antigen expressed on SiSo cells (RCAS1) decidual level alterations were concomitant with changes in immune cell number and activity in decidua. As decidual immunomodulating activity participates in the development of immune tolerance during pregnancy, we aimed to evaluate the immunoreactivity level of decidual RCAS1 with respect to the presence and activity of immune cells. METHOD OF STUDY: RCAS1, CD3, CD56, CD69, and CD25 immunoreactivity was assessed by immunohistochemistry in 30 decidual samples derived from patients with severe pre-eclampsia (sPE) and from a healthy control group. RESULTS: RCAS1 immunoreactivity was statistically significantly higher in decidual tissue samples derived from patients with sPE tissue than in those derived from healthy patients in whom elective cesarean section at term was performed. A statistically significantly lower number of CD56(+) and CD3(+) cells and lower immunoreactivity level of CD69 were found in patients with sPE compared with those from the control group. CONCLUSION: The limited immune cells infiltration in decidua during sPE is associated with increase in RCAS1 decidual level.     

人早孕期蜕膜基质细胞下调蜕膜NK细胞杀伤活性

通过分析人早孕期蜕膜基质细胞(decidual stromal cell,DSC)对蜕膜NK细胞(dNK)表面趋化因子受体CXCR4与细胞内颗粒酶B表达水平的影响,研究早孕蜕膜基质细胞对局部NK细胞的训导作用。收集早孕蜕膜组织,分离DSC及蜕膜免疫活性细胞,进一步通过磁珠分选蜕膜CD3-CD56bright NK细胞,将分离的蜕膜NK细胞与DSC按1∶1比例共培养24h,收集蜕膜NK细胞,流式细胞仪检测其表面趋化因子受体CXCR4和细胞内颗粒酶B(granzyme B)的表达水平。结果显示,与对照组相比,在与DSC细胞共培养之后,趋化因子受体CXCR4+NK细胞的百分率明显上升,而蜕膜NK细胞内颗粒酶B阳性率显著下降(P<0.05)。结果表明,人早孕母-胎界面DSC细胞上调蜕膜NK细胞表面趋化因子受体CXCR4的表达,下调NK细胞内颗粒酶B的表达水平,可能抑制其杀伤活性。     

Foxp3在子痫前期患者胎盘的表达变化

目的本文检测Foxp3在子痫前期患者胎盘中的表达,探讨其在子痫前期免疫耐受失衡中的作用。方法选择子痫前期患者30例,正常晚期妊娠患者30例。采用免疫组织化学法检测胎盘调节性T细胞的特异性转录因子Foxp3的表达。结果胎盘中Foxp3在子痫前期组的表达阳性率为(26.67%)明显低于正常对照组(63.33%)(P<0.05)。结论子痫前期患者胎盘组织中的Foxp3低于正常孕妇,提示其数量的减少使其免疫抑制功能减弱,母胎免疫耐受失衡,导致子痫前期的发生。     

Tim-3分子表达异常与原因不明复发性流产的关系

目的探究T细胞免疫球蛋白粘蛋白分子3（Tim-3）表达异常与不明原因复发性流产（URSA）的关系。方法选择31例URSA患者作为研究组,并以同期30例正常孕妇作为对照组。采用流式细胞术检测两组外周血单个核细胞（PBMC）中CD4＋Tim-3＋细胞/CD4＋细胞的比例,Western Blot技术检测蜕膜中Tim-3蛋白的相对含量,并以免疫磁珠法分选CD4＋Tim-3＋细胞,荧光定量RT-PCR检测两组外周血PBMC、CD4＋Tim-3＋细胞及蜕膜组织中Tim-3 mRNA的表达。结果 URSA组中,PBMC中CD4＋Tim-3＋细胞/CD4＋细胞为5.23±0.96%,蜕膜中Tim-3蛋白的相对表达量为0.64±0.09,PBMC及蜕膜中Tim-3 mRNA的相对表达量为0.65±0.09及0.50±0.07,均显著高于正常对照组（P〈0.01）。但是,URSA组CD4＋Tim-3＋细胞（Th1细胞）Tim-3 mRNA的表达量低于正常对照组,差异具有显著性（P〈0.01）。结论 Th1细胞Tim-3表达降低,Th1细胞过度活化可能参与了URSA的发生发展过程。     

ORIGINAL ARTICLE: Peripheral Blood NK Cells Reflect Changes in Decidual NK Cells in Women With Recurrent Miscarriages

Citation Park DW, Lee HJ, Park CW, Hong SR, Kwak‐Kim J, Yang KM. Peripheral blood NK cells reflect changes in decidual NK cells in women with recurrent miscarriages. Am J Reprod Immunol 2010; 63: 173–180 Problem We aimed to investigate if peripheral blood natural killer (pNK) cell levels are correlated with decidual NK (dNK) cell levels, and if chemokine expression has any role in dNK cell regulation. Method of study Decidual tissues of women having two or more miscarriages with normal karyotype were collected after miscarriage and an immuno‐histochemisty study was made. pNK cells were evaluated using flow cytometric analysis. Results The %CD3^?/56⁺ and %CD3^?/56⁺/16⁺ pNK cells showed a significant correlation with mean number of CD56⁺ dNK cells. The number of decidual CD16⁺ cells was significantly higher in women with elevated pNK (≥15%) than that of normal pNK (<15%). The %CD3^?/56⁺ and %CD3^?/56⁺/16⁺ pNK cells showed an inverse correlation with duration of gestation. The CCL3⁺ and CXCL12⁺ cells were present in the decidua; however, staining intensity was not correlated with number of dNK cells. Conclusion The pNK cell levels reflect changes in dNK cell levels. This implicates that pNK cell level is a clinically useful marker to predict pregnancy outcome. Further study is needed to examine if elevated pNK cells enhance recruitment of dNK cells in the decidua.     

Role of decidual natural killer (NK) cells in patients with missed abortion: differences between cases with normal and abnormal chromosome.

In order to study the mechanism of abortion, the proportions of NK cells in the peripheral blood and decidual lymphocytes were evaluated in both chromosomally normal and abnormal missed abortions. In normal pregnancy, CD56+16-3- NK cells are a major element of decidual lymphocytes. The percentages of CD56+16-3-NK cells of peripheral lymphocytes in normal pregnancies were not statistically significantly different from those of chromosomally normal and abnormal abortions. In the decidua, the percentages of CD56+16-3- NK cells of decidual lymphocytes showed no statistically significant differences between normal pregnancies and chromosomally abnormal abortions. However, the percentages of CD56+16-3-NK cells of chromosomally normal abortions were lower than those of chromosomally abnormal (P = 0.0025). Moreover, the percentages of CD56+16- NK cells in abortions with normal chromosomes were lower than those in normal pregnancies or abortions with abnormal chromosomes (P = 0.0037, P = 0.0025). However, when the proportion of CD56+ NK cells expressing CD16 was evaluated, there were no statistically significant differences in the percentages of CD56+16+ NK cells in normal pregnancies and missed abortions with normal chromosomes and abnormal chromosomes. We conclude that the expression of decidual CD56+16-3- NK cells in missed abortions with normal chromosomes is different from abortions with abnormal chromosomes and that this phenomenon may depend on an abnormal immune response of the maternal side.     

Decidual natural killer cells in recurrent spontaneous abortion with normal chromosomal content.

PROBLEM: The maternal local immune responses in unexplained recurrent spontaneous abortion (RSA) are not yet well known. Maternal peripheral and decidual natural killer (NK) cells were evaluated in RSA with normal chromosomal content. METHOD OF STUDY: Maternal peripheral blood, villous trophoblast, and decidua were taken from 15 normal pregnancies and 9 RSA patients with normal chromosomes. The NK cells in decidual lymphocytes were evaluated by flow cytometry using monoclonal antibodies for CD56, CD16, and CD3. RESULTS: The percentages of CD56+ CD16- CD3- cells in decidual lymphocytes in RSA were lower than in normal pregnancies (P < 0.002). The CD56+CD16+/CD56+CD16- cells ratio in RSA was higher than in normal pregnancies (P < 0.02). CONCLUSION: The lower percentages of CD56+CD16-CD3- cells in RSA cases may show an inappropriate accumulation of NK cells in the decidua, and this finding may be a factor involved in RSA.     

The immune potential of decidua-resident CD16+CD56+ NK cells in human pregnancy

Human CD56⁺CD3^? NK cells can be subdivided into two different subsets according to the expression pattern of CD56 and CD16. CD56^+/brightCD16^? (CD16^?) NK cells are prominently cytokine producers with little cytotoxicity whereas CD56^+/dimCD16⁺ (CD16⁺) NK cells are efficient killers with poorer cytokine production potential. In human pregnancy, CD56⁺ decidual (d)NK cells accumulate in the maternal fetal interface to regulate placental immunity and development. Unlike peripheral blood (pb)NK cells, the majority of dNK cells are CD56 positive with limited CD16 reactivity. Our results demonstrated that in normal and pathological pregnancies, CD16⁺ dNK cells are a unique population in comparison to CD16^? dNK subset. The expression of NK activation receptors CD335, CD336, CD244 and CD314 on CD16⁺ dNK subpopulation was lower than that on CD16^? dNK cells. Upon cytokine stimulation with rhIL-12/15/18 or TGFβ blockade, the CD16⁺ dNK subset exhibited more robust response on the expression of IFNG, IL-8 and CD107a, compared to that of the CD16^? dNK subpopulation. Functions of the CD16⁺ dNK subset were shown to be independent of cellular interaction with trophoblast cells. Studies of preeclamptic patients revealed lower proportions of CD16⁺ dNK cells, suggesting potential protective roles of these cells during normal gestations.. Therefore, we suggest that the CD16⁺ dNK subset, through compensating CD16^? dNK cell function, is an indispensable component to regulate decidual immune response and to support placentation.     

Flow-cytometric analysis of immune cell populations in human decidua from various types of first-trimester pregnancy.

We undertook an investigation in which flow cytometry was used to characterize immune cell populations in the decidua of first-trimester normal pregnancies, spontaneous abortions, and ectopic pregnancies in comparison to the nonpregnant endometrium to demonstrate how the proportions of immunocompetent cell populations at the fetomaternal interface are influenced by the presence and state of a fetoplacental allograft. No significant differences were found in the decidua of the different types of first-trimester pregnancy in the proportions of the CD45+, CD14+, CD3+, CD4+, CD8+, CD19+, CD3-/CD16+ and/or CD56+, CD3+/CD16+ and/or CD56+, CD4+/Leu-8+, CD4+/Leu-8-, CD8+/CD11b+, CD8+/CD11b-, and CD3+/HLA-DR- decidual leukocyte subsets. However, the percentage of decidual CD3+/HLA-DR+ cells, which are characteristic of activated T cells, was significantly higher in spontaneous abortions than in normal pregnancies (p less than 0.05). This suggests that the accumulation of decidual leukocytes may be regulated mainly by hormones and/or cytokines rather than by the presence and state of an intrauterine conceptus and that on/off-switching of activation of decidual T cells may be associated with successful maintenance of the implanted embryo.     

The expression of killer cell inhibitory receptors on natural killer cells and activation status of CD4+ and CD8+ T cells in the decidua of normal and abnormal early pregnancies.

The establishment of the human placenta in early pregnancy is characterized by the presence of large numbers of natural killer cells within the maternal decidua. These NK cells have an unusual phenotype, CD3- CD16- CD56(bright), distinguishing them from peripheral blood NK cells. They may control trophoblast migration and placentation. Using a panel of monoclonal antibodies to several members of the KIR family and flow cytometry, we found that KIRs are expressed on decidual NK cells. There is variation in both the percentage of cells expressing a particular receptor and the density of receptor expression between decidual NK cells from different individuals. In anembryonic pregnancy, the proportions of decidual NK cells with a particular KIRs (GL183 and EB6) decreased significantly when compared with normal pregnancy (p = 0.01 and 0.01, respectively), raising the possibility that these NK receptors may be involved in recognition of the allogeneic fetus by the mother at the implantation site. In the decidua, more CD4+ and CD8+ T cells expressed CD69 and HLA-DR than in blood, indicating that T cells are regionally activated during early pregnancy. When compared with normal pregnancy, decidual HLA-DR+CD4+CD3+, CD69+CD8+CD3+ and HLA-DR+CD8+CD3+ T lymphocytes are significantly increased in anembryonic pregnancy. The over-activation of decidual T cells during anembryonic pregnancy may thus contribute to the increased NK cytotoxicity activity.