Immunology Research Group, Department of Medical Biology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
Department of Pathology, Center for Perinatal and Pregnancy-Related Pathology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Placenta. 2021 Sep 1;112:89-96. doi: 10.1016/j.placenta.2021.07.291. Epub 2021 Jul 23.
Maternal alloimmunization against human platelet antigen (HPA)-1a has been implied to mediate both reduced birth weight and chronic placental inflammation. Fetal growth restriction is associated with different types of chronic inflammation in the placenta, mainly chronic histiocytic intervillositis and chronic villitis. The aim of this prospective study was to do a systematic examination of placentas from HPA-1a alloimmunized pregnancies, with focus on the histopathological and immunohistochemical diagnosis of variants of chronic inflammation.
In a Polish-Norwegian study, 48 placentas were examined. The histopathology of placentas from 27 HPA-1a immunized women was compared with 21 placentas from non-immunized HPA-1a negative women (controls). In the group of alloimmunized women, ten received antenatal intravenous immunoglobulin G (IVIg). Tissue sections from formalin fixed paraffin embedded placental tissue were stained with hematoxylin and eosin and microscopically examined with focus on various types of chronic placental inflammations.
Chronic histiocytic intervillositis was observed in 40.7% of placentas from HPA-1a alloimmunized pregnancies, compared to none in the control group (p = 0.001). Chronic villitis of unknown etiology was more frequently found in the alloimmunized group, however this difference was not statistically significant. Maternal administration of IVIg did not seem to protect against chronic inflammatory lesions.
Placentas with detectable maternal anti-HPA-1a antibodies are associated with highly increased risk of low-grade chronic histiocytic intervillositis.
母体对人类血小板抗原（HPA）-1a 的同种免疫已被暗示介导了出生体重降低和慢性胎盘炎症。胎儿生长受限与胎盘内不同类型的慢性炎症有关，主要是慢性组织细胞性绒毛膜炎和慢性绒毛膜炎。本前瞻性研究的目的是对 HPA-1a 同种免疫孕妇的胎盘进行系统检查，重点是慢性炎症变体的组织病理学和免疫组织化学诊断。
在波兰-挪威的一项研究中，检查了 48 个胎盘。将 27 例 HPA-1a 免疫孕妇的胎盘组织病理学与 21 例非 HPA-1a 阴性孕妇（对照组）的胎盘组织病理学进行比较。在同种免疫组的 10 名孕妇接受了产前静脉注射免疫球蛋白 G（IVIg）。用苏木精和伊红染色固定在石蜡中的胎盘组织切片，并进行显微镜检查，重点关注各种类型的慢性胎盘炎症。
HPA-1a 同种免疫孕妇的胎盘中有 40.7%观察到慢性组织细胞性绒毛膜炎，而对照组中无一例（p=0.001）。同种免疫组中更常发现病因不明的慢性绒毛膜炎，但这一差异无统计学意义。母体 IVIg 治疗似乎不能预防慢性炎症病变。
可检测到母体抗 HPA-1a 抗体的胎盘与低度慢性组织细胞性绒毛膜炎的高风险密切相关。
