Dynamic Function and Composition Changes of Immune Cells During Normal and Pathological Pregnancy at the Maternal-Fetal Interface

Yang, Fenglian; Zheng, Qi-Teng; Jin, Liping

doi:10.3389/fimmu.2019.02317

Cited by 289 publications

(270 citation statements)

References 148 publications

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“…Teng et al [3] hypothesized that the pathogenesis of pregnancy-induced HLH was similar to preeclampsia, where the immature placenta releases genetically foreign material into the maternal circulation. Additionally, these functional alterations can affect placental apoptosis and syncytial integrity, as well as induce preeclampsia, intrauterine growth retardation, or fetal death [40,41].…”

Section: Discussionmentioning

confidence: 99%

Management of pregnancy-related hemophagocytic lymphohistiocytosis

Liu¹,

Gao²,

Liu³

2020

Preprint

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Background: Pregnancy-related hemophagocytic lymphohistiocytosis (HLH) is rare, diagnosing HLH in pregnancy is difficult. There is currently no consensus on the treatment of pregnancy-related HLH. We aim to analyze and summarize the clinical characteristics of pregnancy-related HLH, and to discuss effective diagnostic and treatment options.Methods: Thirteen patients with pregnancy-related HLH who were diagnosed and treated at the Peking Union Medical College Hospital of the Chinese Academy of Medical Sciences from January 2000 to December 2019 were studied retrospectively. We collected data on treatment regimens and on maternal and pregnancy outcomes.Results: All patients had a singleton pregnancy, with a median age of 28 years (range, 22–33 years) and a median gestational age of 23 weeks (8–36 weeks). There were underlying associated diagnoses in 6 patients; of the patients, 12 (92.3%, 12/13) were treated with corticosteroids, and a good efficiency was achieved in 5 (41.7%, 5/12) of them, including 3 complicated by autoimmune diseases. Two patients completed their pregnancies, and the conditions of 2 patients were alleviated with dexamethasone and etoposide treatment. Four pregnant women died (all multiparas), and the mortality rate was 30.77% (4/13). Fetal or neonatal death up to 1 week after delivery occurred in 8 (61.54%) pregnancies, and there were 4 cases of miscarriage, 2 of stillbirth, and 2 of neonatal death. Complications also included premature birth (57.14% of neonates), small for gestational age (SGA, 7.70%), premature rupture of membranes (15.38%), and fetal stress (15.38%). The maternal mortality rates of patients in the first, second, and third trimesters of pregnancy were 100% (1/1), 14.29% (1/7), and 40% (2/5) (P = 0.129), respectively, and the fetal or neonatal death rates in the trimesters were 100% (1/1), 85.71% (6/7), and 20% (1/5) (P = 1.00), respectively.Conclusion: Early diagnosis and treatment are important for maternal survival, and corticosteroids are the first choice for most patients with pregnancy-related HLH. For patients who do not respond to corticosteroids, etoposide, and termination of pregnancy may be more effective.

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Section: Discussionmentioning

confidence: 99%

Management of pregnancy-related hemophagocytic lymphohistiocytosis

Liu¹,

Gao²,

Liu³

2020

Preprint

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“…To date, several studies have shown that changes in the DICs are partly due to the resident population of endometrium, and partly due to the recruitment of peripheral immune cells. 27,60,61 The mechanism of recruitment of these DICs has yet to be fully elucidated, although a series of research articles have reported that chemokines are critical in the trafficking and maintenance of DICs. 27,62,63 During pregnancy, an increase in the number of NK cells in the decidua recruited from the periphery occurs, and it is generally recognized that NK cells that express CXCR4 may be recruited from the periphery to the uterus by trophoblast-derived CXCL12.…”

Section: Effect Of Cxcl16 On Immune Cell Recruitmentmentioning

confidence: 99%

The role of CXC chemokine ligand 16 in physiological and pathological pregnancies

Shi

Yang

Fan

et al. 2020

American J Rep Immunol

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The survival and development of a semi‐allogeneic fetus during pregnancy require the involvement of a series of cytokines and immune cells. Chemokines are a type of special cytokine those were originally described as having a role in leukocyte trafficking. CXC chemokine ligand (CXCL) 16 is a member of the chemokine family, and CXC chemokine receptor (CXCR) 6 is its sole receptor. Emerging evidence has shown that CXCL16/CXCR6 is expressed at the maternal‐fetal interface, by cell types that include trophoblast cells, decidual stroma cells, and decidual immune cells (eg, monocytes, γδT cells, and natural killer T (NKT) cells). The regulation of expression of CXCL16 is quite complex, and this process involves a multitude of factors. CXCL16 exerts a critical role in the establishment of a successful pregnancy through a series of molecular interactions at the maternal‐fetal interface. However, an abnormal expression of CXCL16 is associated with certain pathological states associated with pregnancy, including recurrent miscarriage, pre‐eclampsia, and gestational diabetes mellitus (GDM). In the present review, the expression and pleiotropic roles of CXCL16 under conditions of physiological and pathological pregnancy are systematically discussed.

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“…However, in RSA decidua their portion raises to more than one fold of the normal counterpart. Besides, they exert enhanced production of pro-inflammatory cytokines, which is likely causing the decidual environment harmful to the fetal cells and other maternal immune cells such as T cells and macrophages (Fridman et al, 2012;Fu et al, 2013;Ma et al, 2017;Sotnikova et al, 2014;Yang et al, 2019).…”

Section: Comparison Of the Differential Gene Expression In Dnk Subsetmentioning

confidence: 99%

Single-cell immune landscape of human recurrent spontaneous abortion

Wang

Jia

Fan

et al. 2020

Preprint

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SUMMARYSuccessful pregnancy in placental mammals substantially depends on the establishment of maternal immune tolerance to the semi-allogenic fetus. Disorders in this process are tightly associated with adverse pregnancy outcomes including recurrent spontaneous abortion (RSA). However, an in-depth understanding of the disorders from the aspect of systematic and decidual immune environment in RSA remains largely lacking. In this study, we utilized single-cell RNA-sequencing to comparably analyze the cellular and molecular signatures of decidual and peripheral leukocytes in normal and RSA pregnancies at the early stage of gestation. Integrative analysis identified 22 distinct cell clusters in total, and a dramatic difference in leukocyte subsets and molecular properties in RSA cases was revealed. Specifically, the cytotoxic properties of CD8T effector, NK, and MAIT cells in peripheral blood indicated apparently enhanced immune inflammatory status, and the subpopulation proportions and ligand-receptor interactions of the decidual leukocyte subsets demonstrated preferential immune activation in RSA patients. The molecular features, spatial distribution and the developmental trajectories of five decidual NK (dNK) subsets were illustrated. The proportion of a dNK subset responsible for fetal protection was reduced, while the ratio of another dNK subset with cytotoxic and immune-active signature was significantly increased. Notably, a unique pro-inflammatory CD56+CD16+ dNK subpopulation was substantially accumulated in RSA decidua. These findings reveal a comprehensive cellular and molecular atlas of decidual and peripheral leukocytes in human early pregnancy, which provides an in-depth insight into the immune pathogenesis for early pregnancy loss.

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Dynamic Function and Composition Changes of Immune Cells During Normal and Pathological Pregnancy at the Maternal-Fetal Interface

Cited by 289 publications

References 148 publications

Management of pregnancy-related hemophagocytic lymphohistiocytosis

Management of pregnancy-related hemophagocytic lymphohistiocytosis

The role of CXC chemokine ligand 16 in physiological and pathological pregnancies

Single-cell immune landscape of human recurrent spontaneous abortion

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