When Less Is More – Pipelle Endometrial Sampling for Quantification of Uterine Natural Killer Cells in Patients With Recurrent Implantation Failure or Habitual Abortion

Lapides, Lenka; Varga, Ivan; Klein, Martin; Rybánska, L; Belušáková, V; Babál, P

doi:10.33549/physiolres.934961

Cited by 2 publications

(3 citation statements)

References 32 publications

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“…The recent principal histopathological approach in the study of uNK cells in uterine bioptic samples is immunohistochemistry. Most published immunohistochemical studies evaluated the CD56-positive cells in the endometrium and decidua of patients with unexplained recurrent implantation failure and habitual abortion as absolute numbers of CD56-positive cells per square millimeter [ 55 , 56 , 57 , 58 , 59 , 60 ]. The advantage of such a histological approach is the possibility of studying the cyto-architectonics in the endometrial tissue.…”

Section: Current Histological Knowledge and Immunohistochemistry Of U...mentioning

confidence: 99%

The Neglected Uterine NK Cells/Hamperl Cells/Endometrial Stromal Granular Cell, or K Cells: A Narrative Review from History through Histology and to Medical Education

Lapides

Varga

Csöbönyeiová

et al. 2023

IJMS

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Reproductive immunology is at the forefront of research interests, aiming to better understand the mechanisms of immune regulation during gestation. The relationship between the immune system and the implanting embryo is profound because the embryo is semi-allogenic but not targeted by the maternal immune system, as expected in graft-versus-host reactions. The most prominent cell population at the maternal–fetal interface is the population of uterine natural killer (uNK) cells. Uterine NK cells are two-faced immunologically active cells, bearing comparison with Janus, the ancient Roman god of beginnings and endings. Their first face can be seen as natural killer cells, namely lymphocytes, which are critical for host defense against viruses and tumors. Even though uNK cells contain cytolytic molecules, their cytotoxic effect is not applied to classical target cells in vivo, playing a permissive rather than a defensive role. Their second face is crucial in maintaining physiological gestation—uNK cells show critical immunomodulatory functions with the potential to control embryo implantation and trophoblast invasion, regulate placental vascular remodeling, and promote embryonic/fetal growth. Therefore, we believe that their current designation “natural killer cells” (the first “cytotoxic” Janus’s face) is misleading and inappropriate, considering their principal function is supporting and maintaining pregnancy. In this narrative review, we will focus on three lesser-known areas of knowledge about uNK cells. First, from the point of view of histology, we will comprehensively map the history of the discovery of these cells, as well as the current histological possibilities of their identification within the endometrium. To be brief, the discovery of uNK cells is generally attributed to Herwig Hamperl, one of the most influential and prominent representatives of German pathology in the 20th century, and his co-worker, Gisela Hellweg. Secondly, we will discuss the interesting aspect of terminology, since uNK cells are probably one of the human cells with the highest number of synonymous names, leading to significant discrepancies in their descriptions in scientific literature. From the first description of this cell type, they were referred to as endometrial granulocytes, granular endometrial stromal cells, or large granular lymphocytes until the end of the 1980s and the beginning of the 1990s of the last century, when the first publications appeared where the name “uterine NK cells” was used. The third area of present review is medical teaching of histology and clinical embryology. We can confirm that uNK cells are, in most textbooks, overlooked and almost forgotten cells despite their enormous importance. In the present narrative review, we summarize the lesser-known historical and terminological facts about uNK cells. We can state that within the textbooks of histology and embryology, this important cell population is still “overlooked and neglected” and is not given the same importance as in fields of clinical research and clinical practice.

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Section: Current Histological Knowledge and Immunohistochemistry Of U...mentioning

confidence: 99%

The Neglected Uterine NK Cells/Hamperl Cells/Endometrial Stromal Granular Cell, or K Cells: A Narrative Review from History through Histology and to Medical Education

Lapides

Varga

Csöbönyeiová

et al. 2023

IJMS

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“…Several commercial tests are already available which directly or indirectly capture immune-related changes. Endometrial biopsies or pipelle samples can be tested for NK cell, Treg, and plasma cell counts [ 194 , 195 ]. Altered numbers in these immune cells can be an indication of an immune-related cause of infertility.…”

Section: Clinical Significance In Reproductive Medicinementioning

confidence: 99%

“…Treg cell count Th1:Th2 ratios [194,195,[202][203][204][205] Glucocorticoids [219], intrauterine application of phospholipid-stabilized soybean oil [225,232], anti-TNFα [235][236][237],…”

Section: Nk Cell Count Plasma Cell Countmentioning

confidence: 99%

Immune Cell Functionality during Decidualization and Potential Clinical Application

Stope

Mustea

Sänger

et al. 2023

Life

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Due to a vast influx in the secretory phase of the menstrual cycle, leukocytes represent 40–50% of the decidua at the time of implantation. Their importance for the implantation, maintenance of pregnancy, and parturition are known yet not fully understood. Thus, in idiopathic infertility, decidual immune-related factors are speculated to be the cause. In this review, the immune cell functions in the decidua were summarized, and clinical diagnostics, as well as interventions, were discussed. There is a rising number of commercially available diagnostic tools. However, the intervention options are still limited and/or poorly studied. In order for us to make big steps towards the proper use of reproductive immunology findings, we need to understand the mechanisms and especially support translational research.

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When Less Is More – Pipelle Endometrial Sampling for Quantification of Uterine Natural Killer Cells in Patients With Recurrent Implantation Failure or Habitual Abortion

Cited by 2 publications

References 32 publications

The Neglected Uterine NK Cells/Hamperl Cells/Endometrial Stromal Granular Cell, or K Cells: A Narrative Review from History through Histology and to Medical Education

The Neglected Uterine NK Cells/Hamperl Cells/Endometrial Stromal Granular Cell, or K Cells: A Narrative Review from History through Histology and to Medical Education

Immune Cell Functionality during Decidualization and Potential Clinical Application

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