Labarrere C A, McIntyre J A, Faulk W P
Center for Reproduction and Transplantation Immunology, Methodist Hospital of Indiana, Indianapolis 46202.
Am J Obstet Gynecol. 1990 Feb;162(2):515-22. doi: 10.1016/0002-9378(90)90421-3.
Villitis of unestablished origin is a lesion in placentas from normal and high-risk pregnancies. We have studied villitis areas in 25 normal term placentas for immune cells, coagulation components, and endothelial markers. Villitis areas were filled with activated (HLA-DR, HLA-DP, and HLA-DQ reactive) macrophages. B lymphocytes were not identified, and T lymphocytes were of the helper (CD4) phenotype. Antibodies to coagulation components revealed perivascular and trophoblastic basement membrane deposits of factor IX, increased numbers of platelets, and fetal stem vessels that did not react with endothelial markers. These findings suggest helper T lymphocytes activate macrophages that mediate coagulation activation and alter endothelium. This combination of immunologic events results in tissue changes that are histologically diagnosed as villitis. It is not known what triggers these immunologic events, but the finding of villitis in normal placentas suggests the causative factor(s) is present in all pregnancies.
病因不明的绒毛炎是正常及高危妊娠胎盘的一种病变。我们研究了25例足月正常胎盘绒毛炎区域的免疫细胞、凝血成分及内皮标志物。绒毛炎区域充满了活化的（对HLA - DR、HLA - DP和HLA - DQ有反应的）巨噬细胞。未发现B淋巴细胞，T淋巴细胞为辅助性（CD4）表型。针对凝血成分的抗体显示，因子IX在血管周围和滋养层基底膜沉积，血小板数量增加，且胎儿干血管不与内皮标志物反应。这些发现提示辅助性T淋巴细胞激活巨噬细胞，后者介导凝血激活并改变内皮。这种免疫事件的组合导致了组织学上被诊断为绒毛炎的组织变化。尚不清楚是什么引发了这些免疫事件，但在正常胎盘中发现绒毛炎提示致病因素存在于所有妊娠中。
