羊膜腔炎症或感染孕妇羊水中单核/巨噬细胞的来源。
The origin of amniotic fluid monocytes/macrophages in women with intra-amniotic inflammation or infection.
机构信息
Department of Obstetrics and Gynecology, Wayne State University School of Medicine, 275 E. Hancock, Detroit, MI 48201, USA.
Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD and Detroit, MI, USA.
出版信息
J Perinat Med. 2019 Oct 25;47(8):822-840. doi: 10.1515/jpm-2019-0262.
Background Monocytes, after neutrophils, are the most abundant white blood cells found in the amniotic cavity of women with intra-amniotic inflammation/infection. However, the origin of such cells has not been fully investigated. Herein, we determined (1) the origin of amniotic fluid monocytes/macrophages from women with intra-amniotic inflammation/infection, (2) the relationship between the origin of amniotic fluid monocytes/macrophages and preterm or term delivery and (3) the localization of monocytes/macrophages in the placental tissues. Methods Amniotic fluid samples (n = 16) were collected from women with suspected intra-amniotic inflammation or infection. Amniotic fluid monocytes/macrophages were purified by fluorescence-activated cell sorting, and DNA fingerprinting was performed. Blinded placental histopathological evaluations were conducted. Immunohistochemistry was performed to detect CD14+ monocytes/macrophages in the placental tissues. Results DNA fingerprinting revealed that (1) 56.25% (9/16) of amniotic fluid samples had mostly fetal monocytes/macrophages, (2) 37.5% (6/16) had predominantly maternal monocytes/macrophages and (3) one sample (6.25% [1/16]) had a mixture of fetal and maternal monocytes/macrophages. (4) Most samples with predominantly fetal monocytes/macrophages were from women who delivered early preterm neonates (77.8% [7/9]), whereas all samples with mostly maternal monocytes/macrophages or a mixture of both were from women who delivered term or late preterm neonates (100% [7/7]). (5) Most of the women included in this study presented acute maternal and fetal inflammatory responses in the placenta (85.7% [12/14]). (6) Women who had mostly fetal monocytes/macrophages in amniotic fluid had abundant CD14+ cells in the umbilical cord and chorionic plate, whereas women with mostly maternal amniotic fluid monocytes/macrophages had abundant CD14+ cells in the chorioamniotic membranes. Conclusion Amniotic fluid monocytes/macrophages can be of either fetal or maternal origin, or a mixture of both, in women with intra-amniotic inflammation or infection. These immune cells could be derived from the fetal and maternal vasculature of the placenta.
背景
在有宫内炎症/感染的女性的羊水中，单核细胞是继中性粒细胞之后最丰富的白细胞。然而，这些细胞的来源尚未被充分研究。在此，我们确定了（1）来自宫内炎症/感染孕妇羊水中的羊水单核细胞/巨噬细胞的来源；（2）羊水单核细胞/巨噬细胞的来源与早产或足月分娩的关系；（3）单核细胞/巨噬细胞在胎盘组织中的定位。
方法
收集了 16 例疑似宫内炎症或感染孕妇的羊水样本。通过荧光激活细胞分选纯化羊水单核细胞/巨噬细胞，并进行 DNA 指纹分析。对胎盘进行盲法组织病理学评估。通过免疫组织化学检测胎盘组织中的 CD14+单核细胞/巨噬细胞。
结果
DNA 指纹分析显示：（1）16 例羊水样本中，有 56.25%（9/16）主要为胎儿单核细胞/巨噬细胞；（2）37.5%（6/16）主要为母亲单核细胞/巨噬细胞；（3）1 例样本（6.25%[1/16]）为胎儿和母亲单核细胞/巨噬细胞的混合；（4）大多数主要为胎儿单核细胞/巨噬细胞的样本来自早产的新生儿（77.8%[7/9]），而所有主要为母亲单核细胞/巨噬细胞或两者混合的样本均来自足月或晚期早产的新生儿（100%[7/7]）；（5）本研究中的大多数女性在胎盘上表现出急性母婴炎症反应（85.7%[12/14]）；（6）在羊水中有主要胎儿单核细胞/巨噬细胞的女性，在脐带和绒毛板中有丰富的 CD14+细胞，而在羊膜绒毛膜中有丰富的 CD14+细胞的女性，其羊水中有主要的母亲单核细胞/巨噬细胞。
结论
在有宫内炎症/感染的女性中，羊水单核细胞/巨噬细胞可以来源于胎儿或母亲，或者两者混合。这些免疫细胞可能来自胎盘的胎儿和母亲血管。
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