Department of Gynecological Endocrinology and Fertility Disorders, Ruprecht-Karls University Heidelberg, Heidelberg, Germany.
Placenta-Lab, Department of Obstetrics, University Hospital Jena, Jena, Germany.
Am J Reprod Immunol. 2017 Oct;78(4). doi: 10.1111/aji.12721. Epub 2017 Jun 21.
Uterine natural killer (uNK) cells are major players during implantation and early pregnancy. The aim of our study was to analyze uNK cell concentration in the endometrium of idiopathic recurrent miscarriage (iRM) patients and fertile controls.
Out of n=130 couples with ≥3 consecutive, clinical RM screened according to a standardized diagnostic protocol, n=58 patients with iRM were identified. Endometrial biopsies were investigated in patients and n=17 fertile women (controls) via immunohistochemistry.
Compared to controls, the concentration of uNK cells was significantly higher in iRM patients (257±212 vs. 148±73 uNK cells/mm², P=.04). IRM patients showed a higher prevalence of >300 uNK cells/mm² than controls (34.5% vs. 5.9%, P=.02). In 88% of controls and 62% of iRM patients, uNK cells were detected within the range of 40-300/mm².
Idiopathic recurrent miscarriage patients showed higher uNK cell levels than controls supporting the possible impact of uNK cells in the pathophysiology of miscarriage. Our cutoff levels might help to select RM patients which may benefit from immunomodulatory treatment.
子宫自然杀伤 (uNK) 细胞是着床和早期妊娠的主要参与者。我们研究的目的是分析特发性复发性流产 (iRM) 患者和生育力正常对照者的子宫内膜中 uNK 细胞的浓度。
在根据标准化诊断方案筛选出的 n=130 对连续发生 3 次以上临床 RM 的夫妇中，我们确定了 n=58 例 iRM 患者。通过免疫组织化学法检测患者和 n=17 例生育力正常的女性（对照组）的子宫内膜活检。
与对照组相比，iRM 患者的 uNK 细胞浓度明显更高（257±212 比 148±73 uNK 细胞/mm²，P=.04）。iRM 患者中 uNK 细胞＞300/mm²的比例高于对照组（34.5%比 5.9%，P=.02）。在 88%的对照组和 62%的 iRM 患者中，uNK 细胞的检测范围为 40-300/mm²。
特发性复发性流产患者的 uNK 细胞水平高于对照组，支持 uNK 细胞在流产的病理生理学中可能发挥作用。我们的临界值可能有助于选择可能受益于免疫调节治疗的 RM 患者。
