Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway; Faculty of Medicine, University of Oslo, Norway; Institute for Experimental Medical Research, Oslo University Hospital, Norway.
Division of Obstetrics and Gynaecology, Oslo University Hospital, Norway; Faculty of Medicine, University of Oslo, Norway.
J Reprod Immunol. 2019 Apr;132:42-48. doi: 10.1016/j.jri.2019.03.003. Epub 2019 Mar 22.
Uteroplacental acute atherosis (AA) is a common spiral arterial lesion in preeclampsia, characterized by intramural foam cells, fibrinoid necrosis, and a perivascular immune cell infiltrate. A clear definition of this infiltrate is lacking. Therefore, our aim was to characterize lymphocytes in pre-defined zones regarding spiral arteries with or without AA, from preeclamptic and normotensive pregnancies. Lymphocytes were characterized in decidua basalis samples (n = 91), previously evaluated for AA, around spiral arteries in three pre-defined zones; 1) intramural, 2) perivascular and 3) interstitial. Adjacent serial sections were immunostained to identify different T-cell populations (CD3+, CD8+, FOXP3+), and NK-cells (CD56+). CD3+CD8- T-cells were also identified. These were presumed to be largely CD4+ T-cells. AA was associated with significantly higher intramural CD3+ cell concentrations in Zone 1, in both normotensives and preeclamptics. In preeclamptics only, this difference extended into Zone 2. Similar results were observed for CD3+CD8- cells. AA was also associated with increased intramural CD8+ concentration; however, the number of cells was low. Regulatory T-cells (FOXP3+) were generally scarce or absent in all pre-defined zones. Although intramural NK-cells (CD56+) were scarce, the intramural concentration was significantly lower in spiral arteries with AA compared to without AA in preeclamptics. Our main finding was that CD3+CD8-FoxP3- T-cells were associated with AA. We therefore suggest that T-cells, of a non-regulatory CD4+ subtype, could be involved in the formation of spiral artery AA in the decidua basalis. Whether AA gives rise to, or is partly mediated by increased T-cell concentration around the lesions, remains to be determined.
胎盘急性动脉粥样硬化（AA）是子痫前期中常见的螺旋动脉病变，其特征为血管壁泡沫细胞、纤维蛋白样坏死和血管周围免疫细胞浸润。目前对这种浸润缺乏明确的定义。因此，我们的目的是描述胎盘蜕膜中存在或不存在 AA 的螺旋动脉周围不同区域的淋巴细胞特征。在这项研究中，我们分析了来自子痫前期和正常妊娠的蜕膜basalis 样本（n=91），这些样本之前已经评估过 AA，在三个预定义区域（1）血管壁内、2）血管周围和 3）间质中围绕螺旋动脉进行了淋巴细胞特征分析。相邻的连续切片被免疫染色以识别不同的 T 细胞群体（CD3+、CD8+、FOXP3+）和 NK 细胞（CD56+）。还鉴定了 CD3+CD8- T 细胞。这些细胞被认为主要是 CD4+T 细胞。在正常妊娠和子痫前期患者中，AA 与 Zone 1 中血管壁内 CD3+细胞浓度显著升高相关。仅在子痫前期患者中，这种差异扩展到 Zone 2。对于 CD3+CD8-细胞也观察到类似的结果。AA 还与血管壁内 CD8+浓度增加相关；然而，细胞数量较少。在所有预定义区域中，调节性 T 细胞（FOXP3+）通常很少或不存在。尽管血管壁内 NK 细胞（CD56+）很少，但与没有 AA 的螺旋动脉相比，AA 患者的血管壁内浓度显著降低。我们的主要发现是 CD3+CD8-FoxP3- T 细胞与 AA 相关。因此，我们认为非调节性 CD4+亚型的 T 细胞可能参与胎盘 basalis 中螺旋动脉 AA 的形成。AA 是否导致病变周围 T 细胞浓度增加，或者部分由其介导，仍有待确定。
