Preeclampsia in autologous and oocyte donation pregnancy: is there a different pathophysiology?

Lashley, Lisa E.E.L.O.; Buurma, Aletta; Swings, Godelieve M.J.S.; Eikmans, Michael; Anholts, J.; Bakker, J.; Claas, Frans H.J.

doi:10.1016/j.jri.2015.03.004

Cited by 11 publications

(14 citation statements)

References 35 publications

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“…Placental C4d deposition is significantly increased in women with preeclampsia irrespective of whether they have spontaneous or OD pregnancy (Fig. 3) [32]. Importantly, diffuse CD4 deposition is not observed in the chorionic villi in uncomplicated OD pregnancy, suggesting that placental C4d deposition might be a sign of antibody-mediated fetal rejection in preeclampsia (Fig.…”

Section: Placental Pathology In Od Pregnancymentioning

confidence: 90%

“…C4d deposition in the placenta is observed in VUE, spontaneous preterm birth, maternal floor infarction, and preeclampsia [4,32,34,53,55]. Placental C4d deposition is significantly increased in women with preeclampsia irrespective of whether they have spontaneous or OD pregnancy (Fig.…”

Section: Placental Pathology In Od Pregnancymentioning

confidence: 91%

“…3). Placental expression of mRNAs for complement regulatory proteins, such as CD46, CD55, and CD59, is significantly reduced in both uncomplicated and preeclamptic OD pregnancies [32], while upregulation of placental CD55 and CD59 mRNA expressions is observed in autologous preeclamptic pregnancies [4]. Therefore, downregulation of complement regulatory proteins in the placenta is unique to OD pregnancy, and this may trigger C4d deposition in the syncytiotrophoblasts.…”

Section: Placental Pathology In Od Pregnancymentioning

confidence: 98%

“…This effect of seminal plasma is absent in OD pregnancy. Lashley et al [32] reported a significantly higher level of HLA-A, HLA-B, HLA-C, HLA-DR, and HLA-DQ matching between mother and child in uncomplicated OD pregnancy, suggesting that HLA-mismatched OD pregnancy might be associated with an increased risk of fetal loss. It has not been reported whether functional Treg cells are decreased or activated CD8 + T cells are increased when miscarriage of OD pregnancy occurs, and there are also no reports about feto-maternal HLA mismatch in relation to miscarriage.…”

Section: Fetal Loss In Od Pregnancymentioning

confidence: 99%

“…The placenta is the feto-maternal interface, and various immune-mediated pathological changes are observed in villitis of unknown etiology (VUE), chronic deciduitis with or without plasma cells, massive chorionic intervillositis, and maternal floor infarction [4,11,26,32,34,53,55]. These findings may suggest that maternal immune cells are attacking the fetus in such conditions.…”

Section: Placental Pathology In Od Pregnancymentioning

confidence: 99%

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A new era in reproductive medicine: consequences of third-party oocyte donation for maternal and fetal health

et al. 2016

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The fetus is a semi-allograft for the maternal host in natural pregnancy, but the fetus is a complete allograft after oocyte donation (OD), and there is greater antigenic dissimilarity with the mother. Thus, OD pregnancy is a good model for understanding how the fetus is protected by the maternal immune system. Recent clinical data have revealed a higher risk of miscarriage, gestational hypertension, preterm birth, and low birth weight with OD pregnancy. There is also a higher incidence of chorionic deciduitis, dense fibrinoid deposits in the chorionic basal plate, inflammatory lesions in the chorionic plate, and C4d deposition on syncytiotrophoblasts in OD pregnancy. Impaired accumulation of T cells, regulatory T (Treg) cells, natural killer (NK) cells, and monocytes in the decidua basalis and poor remodeling of spiral arteries are observed in OD pregnancy irrespective of whether preeclampsia occurs. These findings may partly explain why OD pregnancy is associated with a high risk of gestational hypertension and preeclampsia. We need to clarify the immunological and pathological differences between uncomplicated and complicated OD pregnancy. In uncomplicated OD pregnancy, the level of HLA match between mother and baby is significantly higher than would be expected by chance, suggesting that miscarriage may be frequent with marked HLA mismatch. This review discusses the relationship between various aspects of the immune system and complications of OD pregnancy.

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Section: Placental Pathology In Od Pregnancymentioning

confidence: 90%