Immunomorphological Features of the Placenta in Allogeneic Pregnancy as the Background for the Development of Obstetric Complications

Rudenko, Е.Е.; Kogan, Evgeniya; Demura, Tatiana; Zharkov, N.V.; Trifonova, N.S.; Жукова, Э.В.; Александров, Л.С.; Bayanova, S.N.

doi:10.1159/000506776

Cited by 8 publications

(3 citation statements)

References 17 publications

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“…Thus, it is probably worth talking about the immunological nature of the development of perivascular in ltrates and impaired remodeling of the spiral arteries in the group of allogeneic pregnancies. Earlier, we found signs of immune alteration of placental tissues in allogeneic pregnancy, apparently similar mechanisms underlie structural changes in the placental bed [29].…”

Section: Discussionsupporting

confidence: 65%

The Placental Bed in Allogenic Pregnancy: Structural and Immunohistochemical Features

Rudenko

Kogan

Demura

et al. 2023

Preprint

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Today, ART cycles using a donor egg cell are used more often, but this group of pregnancies has not been sufficiently studied in terms of detecting structural predictors of pregnancy complications caused by a special immunological relationship between the recipient mother and allogeneic blastocytes. A comprehensive clinical and morphological study of 89 allogeneic pregnancies was carried out. The morphological study was performed on placental sites biopsies taken at caesarean section (H & E, Orcein), for immunohistochemical analysis PanCK (AE1 / AE3), SMA (1A4), CD56 (123C3.D5), CD138 (B-A38), CD4 (SP35), CD25 (SP176), CD8 (SP16) were used as primary antibodies. A defect of the remodeling of the spiral arteries, including in subgroups without preeclampsia, the formation of perivascular foci of chronic inflammation were found (the accumulation of CD8 + T lymphocytes, CD56 + NK cells, CD138 + plasma cells, HLA-DR + dendritic cells). In subgroups with PE, significant changes were found for T lymphocytes (51.04 ± 2.3, 55.36 ± 11, 7 versus 37.12 ± 2.3), plasma cells (19.5 ± 3.2, 21.43 ± 8.4 versus 8.94 ± 1.2), Kruskal-Wallace test. Structural and immunohistochemical features of the allogenic placental bed may reflect the complexity of cytotrophoblast invasion and induction of maternal immunity with the formation of immune inflammation.

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Section: Discussionsupporting

confidence: 65%

The Placental Bed in Allogenic Pregnancy: Structural and Immunohistochemical Features

Rudenko

Kogan

Demura

et al. 2023

Preprint

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“…Linear C4d deposition has been detected on the syncytiotrophoblast of VUE placentas, but was absent in healthy placentas and those infected with cytomegalovirus (71,161). The fact that VUE is significantly more common in donoroocyte pregnancies (where the fetus is completely allogeneic) compared with own-oocyte IVF pregnancies lends support to the humoral rejection hypothesis (162). However, the placental alloantigen to which the mother raises an antibody, triggering complement activation, is unknown.…”

Section: Vue: Evidence For An Immune Aetiologymentioning

confidence: 99%

Chronic Inflammatory Placental Disorders Associated With Recurrent Adverse Pregnancy Outcome

2022

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Chronic inflammatory placental disorders are a group of rare but devastating gestational syndromes associated with adverse pregnancy outcome. This review focuses on three related conditions: villitis of unknown etiology (VUE), chronic histiocytic intervillositis (CHI) and massive perivillous fibrin deposition (MPFD). The hallmark of these disorders is infiltration of the placental architecture by maternal immune cells and disruption of the intervillous space, where gas exchange between the mother and fetus occurs. Currently, they can only be detected through histopathological examination of the placenta after a pregnancy has ended. All three are associated with a significant risk of recurrence in subsequent pregnancies. Villitis of unknown etiology is characterised by a destructive infiltrate of maternal CD8+ T lymphocytes invading into the chorionic villi, combined with activation of fetal villous macrophages. The diagnosis can only be made when an infectious aetiology has been excluded. VUE becomes more common as pregnancy progresses and is frequently seen with normal pregnancy outcome. However, severe early-onset villitis is usually associated with fetal growth restriction and recurrent pregnancy loss. Chronic histiocytic intervillositis is characterised by excessive accumulation of maternal CD68+ histiocytes in the intervillous space. It is associated with a wide spectrum of adverse pregnancy outcomes including high rates of first-trimester miscarriage, severe fetal growth restriction and late intrauterine fetal death. Intervillous histiocytes can also accumulate due to infection, including SARS-CoV-2, although this infection-induced intervillositis does not appear to recur. As with VUE, the diagnosis of CHI requires exclusion of an infectious cause. Women with recurrent CHI and their families are predisposed to autoimmune diseases, suggesting CHI may have an alloimmune pathology. This observation has driven attempts to prevent CHI with a wide range of maternal immunosuppression. Massive perivillous fibrin deposition is diagnosed when >25% of the intervillous space is occupied by fibrin, and is associated with fetal growth restriction and late intrauterine fetal death. Although not an inflammatory disorder per se, MPFD is frequently seen in association with both VUE and CHI. This review summarises current understanding of the prevalence, diagnostic features, clinical consequences, immune pathology and potential prophylaxis against recurrence in these three chronic inflammatory placental syndromes.

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“…The independent award committee decided to attribute the Pathobiology Award to the work by Dr. E. Rudenko [1], entitled “Immunomorphological features of the placenta in allogeneic pregnancy as the background for the development of obstetric complications.” Assisted reproductive technologies with allogeneic egg (oocyte donation and surrogate motherhood) are rarely investigated on the histopathological level. This study is also using tissue samples that are rarely available.…”

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confidence: 99%

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Borisch¹,

Bourquin²

2020

Pathobiology

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Immunomorphological Features of the Placenta in Allogeneic Pregnancy as the Background for the Development of Obstetric Complications

Cited by 8 publications

References 17 publications

The Placental Bed in Allogenic Pregnancy: Structural and Immunohistochemical Features

The Placental Bed in Allogenic Pregnancy: Structural and Immunohistochemical Features

Chronic Inflammatory Placental Disorders Associated With Recurrent Adverse Pregnancy Outcome

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