Schwartz D A, Khan R, Stoll B
Department of Pathology, Emory University School of Medicine, Atlanta, Ga 30335.
Arch Pathol Lab Med. 1992 Jan;116(1):21-7.
The histopathologic features of cytomegalovirus placentitis, an established cause of chronic villitis, are well documented. However, the immunologic features of the fetal inflammatory response to placental cytomegalovirus infection are largely unknown. The characterization of the fetal-derived inflammatory cell reaction may be important in our understanding of both the intrauterine as well as the antenatal immunological response of the neonate to this important viral infection. We examined formalin-fixed placentas from four cases of confirmed congenital cytomegalovirus infection using an in situ DNA probe to cytomegalovirus, and a variety of antibodies to leukocyte antigens, including anti-CD68, CD45RO, CDw75, CD74, IgG, IgM, and IgA. All four placentas showed marked hyperplasia of fetal-derived placental macrophages, termed Hofbauer cells. A lymphocytic villitis was present in all placentas, which was characterized by positive staining in all cases with T-cell antibodies. There was no evidence of positive staining of lymphocytes using B-cell antibodies in any of the cases. Two placentas showed plasmacellular villitis, which stained positively for both IgG- and IgM-secreting cells, that was present as early as the second trimester of gestation. No IgA positivity of plasma cells was observed. These data are presented in light of current theories of fetal viral immunity.
巨细胞病毒胎盘炎是慢性绒毛炎的既定病因，其组织病理学特征已有充分记载。然而，胎儿对胎盘巨细胞病毒感染的炎症反应的免疫特征在很大程度上尚不清楚。胎儿来源的炎症细胞反应的特征对于我们理解新生儿对这种重要病毒感染的宫内免疫反应以及出生前免疫反应可能都很重要。我们使用针对巨细胞病毒的原位DNA探针以及多种针对白细胞抗原的抗体，包括抗CD68、CD45RO、CDw75、CD74、IgG、IgM和IgA，检查了4例确诊为先天性巨细胞病毒感染的福尔马林固定胎盘。所有4个胎盘均显示胎儿来源的胎盘巨噬细胞（即霍夫鲍尔细胞）明显增生。所有胎盘均存在淋巴细胞性绒毛炎，其特征是在所有病例中T细胞抗体染色均呈阳性。在任何病例中均未发现使用B细胞抗体时淋巴细胞染色呈阳性的证据。两个胎盘显示浆细胞性绒毛炎，分泌IgG和IgM的细胞染色均呈阳性，最早在妊娠中期就已出现。未观察到浆细胞IgA阳性。现根据当前胎儿病毒免疫理论呈现这些数据。
