Labarrere C A, Carson S D, Faulk W P
Center for Reproduction and Transplantation Immunology, Methodist Hospital of Indiana, Indianapolis 46202.
J Reprod Immunol. 1991 Apr;19(3):225-35. doi: 10.1016/0165-0378(91)90037-q.
We have previously reported the presence in normal human placentae of coagulation, macrophages and helper T lymphocytes in inflammatory foci known as villitis of unestablished etiology. In order to investigate the link between coagulation and immunity, we have studied fetal stem vessel endothelium for tissue factor, which is made available by cytokines and activates coagulation via the extrinsic pathway. We found that fetal stem vessel endothelial cells of normal chorionic villi did not react with antibody to tissue factor. Normal placentae contain small numbers of villitis areas and endothelium in these areas was reactive with antibody to tissue factor. Endothelial tissue factor reactivity was more prominent in placentae from secondary recurrent spontaneous aborters and these placentae have greatly increased numbers of villitis areas. The tissue factor availability on fetal stem vessel endothelium may result from immunologically mediated cytokine release. The net effect of these reactions is the presence of lymphocytes, macrophages, coagulation, necrosis and vasculitis in villitis.
我们之前曾报道，在病因不明的绒毛膜羊膜炎性病灶中，正常人类胎盘存在凝血、巨噬细胞和辅助性T淋巴细胞。为了研究凝血与免疫之间的联系，我们研究了胎儿主干血管内皮细胞的组织因子，该因子由细胞因子释放，并通过外源性途径激活凝血。我们发现，正常绒毛膜绒毛的胎儿主干血管内皮细胞不与组织因子抗体发生反应。正常胎盘含有少量绒毛膜羊膜炎区域，这些区域的内皮细胞与组织因子抗体发生反应。在继发性复发性自然流产患者的胎盘中，内皮组织因子反应性更为显著，且这些胎盘的绒毛膜羊膜炎区域数量大幅增加。胎儿主干血管内皮细胞上的组织因子可用性可能源于免疫介导的细胞因子释放。这些反应的最终结果是绒毛膜羊膜炎中出现淋巴细胞、巨噬细胞、凝血、坏死和血管炎。
