Backé E, Jiménez E, Unger M, Schäfer A, Jauniaux E, Vogel M
Department of Paediatric Pathology, Free University of Berlin, Germany.
J Clin Pathol. 1992 Oct;45(10):871-4. doi: 10.1136/jcp.45.10.871.
To show the presence of HIV infected cells in the placentas and membranes exposed to HIV during pregnancy, and to trace the possible transmission routes from mother to fetus.
Twenty three therapeutic abortions and 11 term placentas were investigated for the presence of HIV antigen by immunostaining with HIV core protein specific antibodies and HIV nucleic acids by in situ hydridisation (ISH) with a 35S-labelled HIV specific RNA probe.
HIV antigen as well as HIV RNA positive cells were rarely found in placental tissue and membranes. In therapeutic abortions HIV antigen was shown in 10 out of 23 placentas, HIV RNA in two. HIV antigen was detected in five out of 11 term placentas and HIV RNA in two. Infected cell types comprised syncytiotrophoblasts, Hofbauer cells, amnionic epithelium, chorionic macrophages as well as maternal lymphocytes in the intervillous space and decidua.
These data suggest that the transmission routes are: (1) a haematogenous route from the maternal intervillous space to villous stromal cells; (2) from chorion laeve to amnionic fluid and vice versa. Two additional transmission routes are partly suggested by the data: (1) in early gestation by direct extension from basal decidua to budding trophoblastic cells; (2) from the capsular decidua to chorion laeve and chorionic plate, entering the fetal circulation via the small veins.
显示孕期暴露于HIV的胎盘和胎膜中HIV感染细胞的存在情况，并追踪从母亲到胎儿的可能传播途径。
通过用HIV核心蛋白特异性抗体进行免疫染色来检测23例治疗性流产胎盘和11例足月胎盘是否存在HIV抗原，并用35S标记的HIV特异性RNA探针通过原位杂交（ISH）检测HIV核酸。
在胎盘组织和胎膜中很少发现HIV抗原以及HIV RNA阳性细胞。在治疗性流产中，23例胎盘中有10例显示HIV抗原，2例显示HIV RNA。11例足月胎盘中有5例检测到HIV抗原，2例检测到HIV RNA。感染的细胞类型包括合体滋养层细胞、霍夫鲍尔细胞、羊膜上皮细胞、绒毛膜巨噬细胞以及绒毛间隙和蜕膜中的母体淋巴细胞。
这些数据表明传播途径为：（1）从母体绒毛间隙到绒毛基质细胞的血源性途径；（2）从平滑绒毛膜到羊水，反之亦然。数据还部分提示了另外两条传播途径：（1）在妊娠早期从基蜕膜直接扩展到出芽的滋养层细胞；（2）从包蜕膜到平滑绒毛膜和绒毛板，通过小静脉进入胎儿循环。
