Ordi Jaume, Casals Gemma, Ferrer Berta, Creus Montserrat, Guix Cristina, Palacín Antonio, Campo Elias, Balasch Juan
Department of Anatomical Pathology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona, Barcelona, Spain.
Am J Reprod Immunol. 2006 May;55(5):369-77. doi: 10.1111/j.1600-0897.2006.00377.x.
Whether decidual leukocyte recruitment and/or increase is primarily hormonally regulated or induced mainly by blastocyst implantation is a matter of debate. Thus, this study investigated the number and distribution of leukocyte populations, with emphasis on natural killer (NK) cells of uterine and peripheral type, within decidual tissue from women with decidualized endometrium both related and unrelated to pregnancy and those with ectopic decidua associated with intrauterine pregnancy, as well as in tubal implantation sites.
Immunohistochemical characterization of immune cells using antibodies to CD3, CD4, CD8, CD20, CD68, CD16, CD56, CD57, in formalin-fixed, paraffin-embedded tissue, and a quantitative analysis of these subpopulations was conducted in tissue blocks from four groups of patients: (i) 20 women with decidualized endometrium due to progestin therapy (i.e. not associated with gestation) (group Prog-D); (ii) 20 women with intrauterine pregnancy-associated ectopic decidua (seven in the Fallopian tube, five in the ovary, five in the uterine cervix, and three in the omentum) (group Ect-D); (iii) 20 women with spontaneous abortion who had an histologic sample of the decidua at the uterine implantation site (group Uter-D); and (iv) 20 consecutive patients who had had an ectopic tubal pregnancy (group Tub-Preg). Twenty gynecologic specimens with marked inflammatory reaction were used as controls (group Con).
CD3+, CD4+, CD8+, CD68+ cells were detected in all tissue samples investigated. In contrast, CD20+ cells were detected in all samples in group Con, but only in 75%, 25%, 55% and 70% of groups Prog-D, Ect-D, Uter-D and Tub-Preg, respectively. In all tissue samples investigated, CD57+ and CD16+ cells were detected. Conversely, CD56+ cells were completely absent in 15 of 40 cases (37.5%) lacking decidual reaction (group Tub-Preg, 7/20; group Con, 8/20) but were present in all cases showing decidual reaction. In contrast with CD56+ cells, CD57+ NK cells were more abundant in group Con than in the four study groups.
CD56+ NK cells are closely related to decidua irrespective of its eutopic or ectopic location rather than to the implantation site. This suggests that the recruitment and/or increase of uterine NK cells into the uterus is not dependent on the physical presence of an implanting embryo but instead is controlled hormonally.
蜕膜白细胞的募集和/或增加主要是受激素调节还是主要由胚泡着床诱导，这是一个存在争议的问题。因此，本研究调查了蜕膜组织中白细胞群体的数量和分布，重点关注子宫型和外周型自然杀伤（NK）细胞，这些组织来自与妊娠相关和不相关的蜕膜化子宫内膜的女性，以及与宫内妊娠相关的异位蜕膜女性，还有输卵管着床部位。
在福尔马林固定、石蜡包埋的组织中，使用针对CD3、CD4、CD8、CD20、CD68、CD16、CD56、CD57的抗体对免疫细胞进行免疫组织化学表征，并对四组患者组织块中的这些亚群进行定量分析：（i）20名因孕激素治疗导致蜕膜化子宫内膜的女性（即与妊娠无关）（Prog-D组）；（ii）20名与宫内妊娠相关的异位蜕膜女性（7例在输卵管，5例在卵巢，5例在子宫颈，3例在大网膜）（Ect-D组）；（iii）20名自然流产且在子宫着床部位有蜕膜组织学样本的女性（Uter-D组）；以及（iv）20名连续的输卵管异位妊娠患者（Tub-Preg组）。20份有明显炎症反应的妇科标本用作对照（Con组）。
在所有研究的组织样本中均检测到CD3 +、CD4 +、CD8 +、CD68 +细胞。相比之下，Con组所有样本中均检测到CD20 +细胞，但Prog-D组、Ect-D组、Uter-D组和Tub-Preg组分别只有75%、25%、55%和70%的样本检测到。在所有研究的组织样本中均检测到CD57 +和CD16 +细胞。相反，在40例缺乏蜕膜反应的病例中有15例（37.5%）完全没有CD56 +细胞（Tub-Preg组，7/20；Con组，8/20），但在所有有蜕膜反应的病例中均有CD56 +细胞。与CD56 +细胞相反，Con组中的CD57 + NK细胞比四个研究组中的更丰富。
CD56 + NK细胞与蜕膜密切相关，无论其为正常位置还是异位位置，而不是与着床部位相关。这表明子宫NK细胞募集到子宫和/或在子宫内增加不依赖于着床胚胎的实际存在，而是受激素控制。
