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Immune tolerance toward the semiallogeneic fetus plays a crucial role in the maintenance of pregnancy. Myeloid-derived suppressor cells (MDSCs) are innate immune cells characterized by their ability to modulate T-cell responses. Recently, we showed that MDSCs accumulate in cord blood of healthy newborns, yet their role in materno-fetal tolerance remained elusive. In the present study, we demonstrate that MDSCs with a granulocytic phenotype (GR-MDSCs) are highly increased in the peripheral blood of healthy pregnant women during all stages of pregnancy compared with nonpregnant controls, whereas numbers of monocytic MDSCs were unchanged. GR-MDSCs expressed the effector enzymes arginase-I and iNOS, produced high amounts of ROS and efficiently suppressed T-cell proliferation. After parturition, GR-MDSCs decreased within a few days. In combination, our results show that GR-MDSCs expand in normal human pregnancy and may indicate a role for MDSCs in materno-fetal tolerance.Keywords: Myeloid-derived suppressor cells (MDSCs) r Reproductive immunology r T cells r Tolerance Additional supporting information may be found in the online version of this article at the publisher's web-site

f Testing for E6/E7 mRNA in cells infected with high-risk (HR) human papillomavirus (HPV) might improve the specificity of HPV testing for the identification of cervical precancerous lesions. Here we compared the RNA-based Aptima HPV (AHPV) assay (Hologic) and the DNA-based Hybrid Capture 2 (HC2) HPV test (Qiagen) to liquid-based cytology (LBC) for women undergoing routine cervical screening. A total of 10,040 women, 30 to 60 years of age, were invited to participate in the study, 9,451 of whom were included in the analysis. Specimens were tested centrally by LBC, the AHPV test, and the HC2 test, and women who tested positive on any test were referred for colposcopy. Genotyping was performed on all HR-HPV-positive samples. Test characteristics were calculated based on histological review. As a result, we identified 90 women with cervical intraepithelial neoplasia grade 2؉ (CIN2؉), including 43 women with CIN3؉. Sensitivity differences between the AHPV test and the HC2 test in detecting CIN2؉ (P ‫؍‬ 0.180) or CIN3؉ (P ‫؍‬ 0.0625) lesions were statistically nonsignificant. Of three CIN3 cases that were missed with the AHPV test, two cases presented lesion-free cones and one had a non-HR HPV67 infection. The specificity (30 years of age.T he cervical cancer mortality rate in Germany has decreased dramatically since the introduction of gynecological screening for cervical cancer in 1971 (1). Annual opportunistic screening is performed by conventional cytology (Pap smear) and is covered by health insurance for women Ն20 years of age. Despite this extensive effort, 4,600 new cases of cervical cancer (and approximately 1,500 deaths attributable to cervical cancer) (2) and 150,000 cases of cervical cancer precursors (cervical intraepithelial neoplasia grade 3 [CIN3]) are diagnosed each year (3). Persistent infections with high-risk (HR) human papillomaviruses (HPVs) have been shown to be causal for the development of cervical precancerous lesions and cancer. This has led to the development and investigation of various HPV detection methods, and HR HPV testing in addition to cytology is now widely applied in cervical cancer screening programs (4-7). Three DNA-based and one RNAbased assay for HR HPV group detection and two HPV16/18 genotyping assays have been approved by the U.S. Food and Drug Administration (FDA) for cervical cancer screening (http://www.fda.gov /MedicalDevices/ProductsandMedicalProcedures/InVitroDiagnostics /ucm330711.htm). These assays include the Digene Hybrid Capture 2 (HC2) high-risk ...

ClinicalTrials.gov Identifier: NCT03048396.

Uterus transplantation (UTx) can provide a route to motherhood for women with Mayer–Rokitansky–Küster–Hauser syndrome (MRKHS), a congenital disorder characterized by uterovaginal aplasia, but with functional ovaries. Based on our four successful living-donor transplantations and two resulting births, this analysis presents parameters relevant to standardizing recipient/donor selection, UTx surgery, and postoperative treatment, and their implementation in routine settings. We descriptively analyzed prospectively collected observational data from our four uterus recipients, all with MRKHS, their living donors, and the two newborns born to two recipients, including 1-year postnatal follow-ups. Analysis included only living-donor/recipient pairs with completed donor/recipient surgery. Two recipients, both requiring ovarian restimulation under immunosuppression after missed pregnancy loss in one case and no pregnancy in the other, each delivered a healthy boy by cesarean section. We conclude that parameters crucial to successful transplantation, pregnancy, and childbirth include careful selection of donor/recipient pairs, donor organ quality, meticulous surgical technique, a multidisciplinary team approach, and comprehensive follow-up. Surgery duration and blood vessel selection await further optimization, as do the choice and duration of immunosuppression, which are crucial to timing the first embryo transfer. Data need to be collected in an international registry due to the low prevalence of MRKHS.