Human Decidual Cells Activity in Women with Spontaneous Abortions of Probable CMV Aetiology During the First Trimester of Gestation. An Immunohistochemical Study with CMV-Associated Antigen

Abstract

Aim: To determine the expression of CMV-associated antigen in the human decidual endometrial stromal cells in spontaneous abortions with no evidence of maternal relapse during the first trimester of gestation. Experimental design: We examined 15 placentas resulting from intrauterine fetal death after spontaneous abortion during the 8th, 10th, and 12th week of gestation respectively, and in which CMV reactivation was ruled out from serological evaluation of the pregnant women at admission, versus equal controls after voluntary abortion following well-documented maternal viral recurrence. In addition, a panel of monoclonal antibodies for the identification of leukocytes (CD45/LCA), B-lymphocytes (CD20/L-26), and T-lymphocytes (CD45RO/UCHL1), was performed. All women received hormonal medication to support gestation, in the cases of spontaneous abortions. Results: Immunohistochemical examination using a specific antibody against cytomegalovirus showed large multinucleated infected cells with intranuclear inclusions, located primarily in the decidual stroma within a lymphoplasmacytic infiltrate in the cases of spontaneous abortions. No evidence of infection was observed in the chorionic villi. In the cases of voluntary abortions same findings were observed in the relevant areas, and a strong evidence of infection was observed in the chorionic villi. Conclusion: This study demonstrates 1) that the decidual endometrial stromal cells can express the CMV-associated antigen prior to serological manifestation of the viral replication, 2) the expression of the antigen is higher in cases of hormonal administration to support gestation. In these cases a mild mononuclear infiltrate of UCHL1 (T marker) positive cells, accompanies the CMV-associated antigen positive cells.

Unique Severe COVID-19 Placental Signature Independent of Severity of Clinical Maternal Symptoms

“…In our cohort, placental SARS-CoV-2 positivity was characterised by an unprecedented combination of chronic intervillositis, massive perivillous fibrin depositions, necrotic syncytiotrophoblast, chronic villitis and the presence of a unique, distinctive CD20+ B-cell infiltrate ( Figure 1 ). Although some articles have mentioned sporadic B-cells, primarily in foetal vessels or in the stroma of villous stromal cells [ 40 , 41 , 42 , 43 ], a chronic intervillositis or chronic villitis with a CD20+ B-cell infiltrate has not been described in association with any other placental infection and the presence of B-cells is highly unusual in the placenta.…”

Isolation of Leukocytes from the Human Maternal-fetal Interface

“…, T cells, macrophages, neutrophils, B cells, dendritic cells, and NK cells, have been identified in the decidual tissues, and their proportions and activation status have been shown to vary spatially and temporally throughout gestation 6–10,12,14,24,27–30 . Perturbations in the leukocyte population and/or function are associated with several perinatal disorders such as spontaneous abortion 31 , preeclampsia 32 , intrauterine growth restriction 32,33 , and preterm labor 7,24 . Therefore, the study of the phenotypic characteristics and functionality of leukocytes at the human maternal-fetal interface will facilitate the elucidation of the immunological pathways dysregulated in pregnancy-related complications.…”