Expression of dNK cells and their cytokines in twin pregnancies with preeclampsia

Abstract

OBJECTIVES:To assess the expression of decidual natural killer (dNK) cells and their cytokines in twin pregnancies with preeclampsia.METHODS:This was a prospective case-control study. The inclusion criteria were diamniotic (monochorionic or dichorionic) twin pregnancies in the third trimester with negative serological results for infectious diseases; absence of major fetal abnormalities or twin-twin transfusion syndrome; and no history of administration of corticosteroids in this pregnancy. The control group (CG) included uncomplicated twin pregnancies, and the preeclampsia group (PEG) included twin gestations with clinical and laboratory confirmation of the disease according to well-established criteria. Samples of the decidua were obtained and analyzed by immunohistochemistry for the expression of dNK cells and interleukins (ILs) 10, 12 and 15. In addition, maternal serum samples were collected to determine the levels of these interleukins.RESULTS:Thirty twin pregnancies were selected: 20 in the control group (CG) and 10 in the preeclampsia group (PEG). The PEG showed strong placental immunostaining for IL-15 (p=0.001) and high maternal serum levels of IL-10 (22.7 vs. 11.9 pg/mL, p=0.024) and IL-15 (15.9 vs. 7.4 pg/mL, p=0.024).CONCLUSION:A higher maternal serum concentration of both pro- and anti-inflammatory factors was observed in the twin pregnancies in the PEG. However, no difference in placental expression of IL-10 was found between the groups. These findings may suggest that maternal attempts to balance these interleukins were not sufficient to cause a placental response, and this failure may contribute to the development of preeclampsia.

Síndromes hipertensivas gestacionais: impacto da pré-eclâmpsia na saúde das gestantes

“…É necessário uma avaliação individual e monitoramento hemodinâmico para indicar terapia de reposição hídrica dentro da estratégia de controle da pré-eclâmpsia. Agra, K. R. I., et al (2019) Expression of dNK cells and their cytokines in twin pregnancies with preeclampsia. Clinics.…”

“…É uma importante complicação gestacional e caracteriza-se como a principal causa de morbimortalidade materna no Brasil e a terceira em todo o mundo. Segundo a Organização Mundial de Saúde, a pré-eclâmpsia é caracterizada como uma patologia multissistêmica e multifatorial, a qual ocorre geralmente após a vigésima semana de gestação, sem uma etiologia completamente esclarecida e atinge cerca de 7% das gestantes brasileiras, apresentando alto índice de mortalidade em toda a América Latina (Agra et al, 2019). Por ser classificada como uma das principais síndromes hipertensivas da gestação, é necessário fornecer maior atenção a pré-eclâmpsia, visto que ocorre de forma isolada ou associada a hipertensão arterial crônica, e sugere resultados complicações na saúde materna e fetal (Peraçoli et al, 2018).…”

“…A presença de edema generalizado que não diminui ao repouso é considerado um sinal clínico relevante. O quadro também pode permanecer silencioso, sem alterações clínicas perceptíveis pela gestante (Agra et al, 2019). Com desenvolvimento principalmente em primigestas, a progressão da pré-eclâmpsia, na carência de um tratamento adequado, poderá gerar intercorrências em diversos sistemas e lesões de orgãos-alvo, comprometendo a qualidade de vida materno-fetal.…”

The function of decidua natural killer cells in physiology and pathology of pregnancy

“…In addition, dNK cells can secrete some inflammatory factors, for example, IL‐10, IL‐12, IL‐15, and others 83,86 . A prospective case‐control study suggested that the level of placental interface IL‐15, and serum IL‐10 and IL‐15 in PE patients was higher than those in the control group 87 . IL‐15 is a pro‐inflammatory factor, and it can also promote expression of IFN‐γ, which is detrimental to trophoblast invasion 88 .…”

Effect of IL-15-Mediating IFN-γ on HTR-8/SVneo Cells and a Preeclampsia Mouse Model Induced by Lipopolysaccharides

“…Accumulating studies have demonstrated abnormally expressed IL-15 in PE. For example, strong placental immunostaining of IL-15 and a higher maternal serum level of IL-15 were detected by Agra et al [10] in twin pregnancies with PE. Kalantar et al [11] also observed markedly elevated serum IL-15 levels in PE patients compared with normal pregnant women.…”